HomeMy WebLinkAbout3022 DONNYBROOK LN - Building PermitsX
�._.:. .�I ,_ . ... . G. � APPIic
CIT� OF COST� MESd ,.
� CANSrRUCiION PERMIT
Addrea �
ArchlEn9.
Address
�Contractor
tiil in a11
License No.
Phone
s wititln heavy bortler lines antl sign all aOPropriate Eec�arations.
S� TRACT�NO. LOT NO. BIDG. NO.
Z � �l g '�
� TVPE OF COf�fRUCTION
;[fsfj' 6� ❑ NEW �ADD O AITERATION
� ❑REPAIR ❑CONVERSION ❑�EMOLISH
❑ OTHER
DF�SCRIPTION OF WORK _
LICENSED CONTRACTON UeGLARHTIOrv
I hereby affirT that 1 am Iicensetl untl¢r p�ovl5ion5 of Chdrt¢r 9(com-
mencin9 �"/�th setLon ]000) o( Divlsion 3 of the Businezs antl
RofeSsions Cotle, antl my Iicense is in (ull force antl ef(ect.
LJcense Class Licenze No. _
Oate Si9nature
WORKERS'COMPENSATION DECLARATION
I hereby affirm that 1 have a tertifi<ate of consent to self-insure or a
certitiwte of Worker5' CompenSdtlOn InsUrance, or a cerNtietl copy
thereof (Sectlon 380Q tab. G.).
�licy No. Company
� Certifietl copy Is hereby furnlshetl.
❑ Certifletl copy is file0 wi[h tha city Builtling Division.
E%EMPTION FROM WORKERS• GOMPENSATION DECLARATION
(This 5ection neetl not be compla[etl if the permit is tor one huntlretl
(5300) or Iess). �
I rertlfy that In the periormance ot the.work for which this permit is
issuetl, I snall not employ any per in any manner so as [o become
subject to the Workers' Compen5a on 's of Californ✓'a. �.
Date �- �J - � 3 SlgnatureJ � �
NOTICE: If afte� making this tleGlara[ion, you shoultl become subjecl
to the Workerl' COmpensation provl5ion5 0( the LabOr Coae, you mu5t
torthwith comply wilh suth proWsions or this permit Shall b¢ tle¢metl
revoketl. - . .
CONSTRVCTION LENDING HGENCV
I hereby attirm thal thcrel5 a ConStrUction lentling a9enGy fOr the per-
torrtwnte of•the.work fonwhich tnis permit is-issuetl"(Section 3097
Civ.C.). �.a. ._ .
Lentler's-Name-
Lentler's Atltlr'ss A�"Q -
OWNER BUILDER DECLA0.ATION " � � � "
I her¢by affirm thal I am exempt trom the ConVacfor'S Licens¢-Law:for
the following reason (Section 7031.5 Busfness antl.Professionz Cotle:
Any city, o� courlty whiCh reqWres_a peiMit to �tOnst�uct, alte�,
Improve, tlemolish or repair any s[ruc[ure, prlor4o Its i55uance, also re-
quires the applicznt for such permit to file a'signetl statemen[ that he
B licensetl pursuanl [o the provislons ot the Contrac[or's LiLense Law'
(Chapter 9(commenting with Sectlon �000) of Division 3 of [he
Busine55 antl Professions Cotle) or [hdt hC Is exempt there(rom antl thC
Dazis for the alle9etl ezemplion. �Any violatlon of 5ection 7031.S,by
�ny appli2ant for a permil Subletts [he appliCant to'a civil penalty.
o�f/��ot more than five huntlretl tlollars ($500). ,.
� I. as owne� of the ProPerty. -- -.. _,,,_�_..___ .... .._�. __..�_:.
- - will tlo.tne work, antl [he structure is not intentletl
or oifered Por sale. (Sectlon �044, eusiness antl Professions Cotle: The
Conlrac[or's' License Law tloes no[ apply to .an owner of a property
wh0 builtls o�. improves thereon, antl who tloes such wOrk himself or
�n.A���n'�nrt��w� a�..o�nvnec. nvitlerf tnrt sucn.imorovemen[s are not
�,ntletl o� ottered mr saie. iq noweveq vne ouuain9 or im{
>Itl�within one year ot tomple[ion, [ha owner�will have t
proving he tlitl not bulltl o� imOrove for the purpose
I. as �ownet ot �the prtiperty,� am exclusl4ely contrac
an own¢r�of.property•who builtls or Imp�oves thereon, antl wh0 Con-
t�acl5 from such project5 with a contrattor(z) lic¢znetl.�pu�suanl to
[he COn{ractOCs LI<!n5¢+Ldw). �. - ., •�. � '
❑ I am•exem0� untler SeGtlon � B. 6 P. C. for this
reason � ` ' � �
Date Owner � �
1 h¢r¢by certitythal I have reatl this applicalion antl sta[a that the above
intormalion is correcL I agree to comply with all ci[y antl county
orEinances antl state laws relating to cons[ruction, antl hereby authoNze
re0resentatl of Ihis Cily [o enter pon the above mentlonetl
property r nspection p oSCs. �
/� Si9naturc Date �
TV9E OF PERMIT . �
❑ GRADING,.� p❑ FOVNDATION STRUCTVRAL
❑ TENANT l.1VELECTRICAL OPLUMBING ❑MECHAI
❑ OTHER ��
PROJECT DESCRIPT ON
5�. FT. � Z . .
OCCUPHNCVp— CONSTRVCTION TYPE '
VALUATIONA�nOO ZONE
GRADING CU. V�S. ACRES
REMARKS: � / /J ��
PLUMBING . .
TOILETS- '
LAVATORIES
KIT. SINK$
SERVICE SINK$
FLOOR SINKS
DRINKING FOUNT/
INTERCEPTORS
SWIMMING POOL
WATER�SERVICE
GASSERVICE
WATEIi HEAT.ERS
SEWER CONNECTI(
PLAN CHECK
SHOWERS
URINALS
DOUBLE LAVS
'DISHWASNERS
SUMPS r.-�--
FLOOR DRAINS
NS '
,- GLARIFIERS ' �
PTRAP"
�AILTERATION
OVT�ETS
' BTU OUTPUT
15 � •
-',COLLECTORS
ISSUE FEE
MECHANICAL P�AN CHECK
HEATING SVSTEM 0-300,000 BTU _
AND �UCTING 300,000 + gTU _
REFRIGERATION 0-300,000 BTU_
SYSTEM ' . 300,000 t BTU _
BOILERS . ^BTU
SVSTEM REPAIR,AITERATION
EXHAUSTSVSTEM � MULTIPLE
� Drivers' License or 55 � � �SSUE FEB
CMF 0865-46 White-Bullding; Canary-APplican[; Pink-Accounting; Goltlenrotl-Assessor
2473 I/04/u.,
ZONING REGULATIOI
A.P. if I� Lp ^ O�
ZONE PLNGp. i3UEFL. p�
SEpTEBACK G ST.� ROPE�RT
1.EFTYARD /1,11'��I .
s.-1
�I�� � I �i�
REAR VARO (TO P/l)
PKG.SPACE REQ.
STREET WIDTH (O(
SPECIAL CONDITIONS:
ELECTRICAL
PROVIDED '.
PARK FEE E
PLAN CHECK'
Iµl.,��� T�.
• GENERATOR 0-1 KW_ I-30 KW �
TRANSFORMER �
' ' AGPLIANCE 30-50 KW_50 + KW
"MOTORS ' '0-I HP_I-30-HP ' "
�• (INC.SOLAR)_ 30-SOHP_- SO+HP �
' ' FI%TVRE53"': OUTL'ET58 SWITCHES
' ' GAS TUBE 510^�< � ' �- - � � -
POLE LIGHTS
PANELS
SERVICI
METERED SUB.
MAIN SVB
AMP
ISSUE FEE
APPIICATION APPROVED BV
UMMARV OF.FEES.
BUILDING' ry�
PERMIT E �^.� `J�V.� • �'SMIG � S �D. O
PLAN CHECK S—J_�i�lr PERMIT.
-- � ISSUANCE S
PLVMBING S
GRADING S
PLAN CHECK $ ' .
ELECTRICAL S� � � S � .
PLAN CHECK g �•%D MICROFII.M E
MECHANICAL $ TOTAL FEE E
PLAN GHECK §� � LE55 AD- �
VANCE PC b
- FINAL�FEE S / /•��
• Applieant to till in all zpaeas ezeapt those within �eary Dortler Iines anE sign all apP�ooriate tleclantions.
. . ' . ._. . . . . . . . ._ _ _ . . _ _..... . . . . . _ . - '.,"
�.CITY OF COSTA MESA •' � ' � • � PERMIT NO. - TRACT NO. LOT.NO. e . . � ' � r : I , � '
� CbNSTEiUCTION PERMIT � S S � 5030 3/01 /83 ' ' d.G_ Ti_
ApplkanYs MAiling Address . TYPE OF CONSTRUCTION � NEW AOD . ALTERATION - REPAI R • . . . . � , � '
PfojECt AddfeSS � Z ❑ CONVERSION ❑ DEMOLISH ❑ OTHER•� ' . . � - , . . - ' '
hona��-se� � �ESCRIPTION OF WORK
Owner's.Name . NN V .. � . � ._ . • - - - 1 G U 1
Addreu� �rn�' NNYGP.DnIC• � � " � TVPE�OFPERMIT GRA�ING FOUNDATION STRVCTURAL � ��+.P.9M' � ZONE �
AfthlEng.��� liten58 NO. � � ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ~ . PLNG. REF.9W ' � - BUILDING ' '
� O �OTHER REAR VARD (TO P/U' �
Addfess� ' � �� � TO BUILDING
COnbeCtOf'SNemP n^6 Phona �"PRQIECTDESCRIPTION SQ.FT. �OCCUPANCV . �EFTSIDEVARD RIGHTSIDEVARD '
AddfE55��meiling) ' CONSTRUCTION TYPE VALUATION $ .
. , ' � ZON� GRADINGCU.VDS: ;ACRES PKG.SPACERW. . PROVIDED �
license No. �
LICENSED CONTRACTOR DECL/1{iA'T��N ' ' Remarks: � � STFEET WIDTH .. �PqRK FEE $ � � -
� 1 hereby aHirm that 1 am Iicansatl under provisions ol Chartar 9(commenUng �
with sactlon �000) ot Dlvision 3 ot the Buzinesz antl 7rofe55ions Cotla, dntl � ' . . � � S�ECIAL CONDITIONS: ' � '-
my Ilcenia ls in full forca anC elfect. '' - � . .
� Licenu Class � ' ' License No. ' - PLUMBING ' � � , '
Date Signature ,. BarSiak � ' SewerCap ' ' ELECTRICAL
VORKERS'COMPENSATION DECLAAATION' . ' - - - ,
hereCy,a/flrm tnat I have a certlfiWte of consenLto SBINnwm.or a cartlticata � ' ' � AutomatiC.Washer �Met2r ❑over 10T) amps„
of workers' Compensatlon Insur6n<e. or a certitlea copy thereai (Sectlon , Backflow Preventer--'-; �- 'SeWer Connettion - . - - - . � - � -
� 3800, ub. c.) , • � i . ' Backflow Irrigation � $plar Collectors � , Construction Pole �Sub Panel� - '
PoII<y No. � � Gompany , � . Bathtuhs � � Solar Pi m ! 1 Cooking Unit � Sub Pole i ; 1 ' i
� BCertifiatl copY is hereby furniihatl.. P 9 .
Certlfletl copy Is llletl wlth tha city Builtlln9 DIvlSion. � - � DishWashef MotOrs OO-1 HP 01 X-8 � � '
�ate � ' ADOliwnt � � : � QarifiErs � . So�ar Tank � t
EXEMPTION�FROM WORKERS' COMPENSATION DECLARATION ' • . - Orye�s ❑G25 �OElectric .
(This sectian neetl not be comD�etetl i( the permil I5 !or ona huntlretl (5300) or . OishwaShEr • • Swimming Pool w�Spa , � ;�nc.5ola�� �9-,15 HP �16-15+ �
less): , . t ' '' � � � , ' � - � Fan' � . Microwave � ' '
1<ertify thal in Ihe parformance ot tpe work for whith this permH is issuetl I � Drinkiny Founteins Urinal
' sna�i,not employ any person In any�manner so as to become sub7ect to t�1e 1 . -� - F.A.U. � . Pole Li ht • '
Workers' CompensaHon laws o/ California. . � FIOOr D�ainsl ( Water poset' � � 9�
Date� • � • Signattire _ ' � ' � � . - � � . '
NOTICE:�If, after makluy�this tledaratlon, you-Shoultl batoma 5ub7ect to tha -� � FIOOcSinks- - --- 4---�-• - - -WatEr H2atef � �� • - � - �- . � _ __ Fixtures _ � RengE.. � _ _ _ _
Workers5 Compensatlon Orovislons of the l2bor COCe, you.muit./orthwith � . � . _ � • . . DeVICe Box25 {
, ComD�Y .`H�th. Suth �piOviSion2' or thts perm5t.sfiall ba 6eemetl revokee: - � Ga552rvice ;Outlets - �Wa22rSErvice �� . 5�9� � � i
CONSTRUCTION�LENDING AGENCV� . � - ` � , i
Outlets
. i neretiy aiTirm tnat thera is a.construc��on ientliog a9ency for tne� parrormance , Interceptors «�- j �_ _ � - -� �„ - � ' � Standing Sections ' l
oi the �work for whlc� thls� perrr��� is IssueC (Sectlon �3097 Civ. C;: ; ' - SwitchCs. � - �
� Lenaers Name. � . , _ Kitchen Sink ' � I -r , � � i � � � ' Trash Compector �
. txn08r'S AEGress � - . � �. , - - 1 ; � .
OWNER BUILOER OECLARATION � - Levetofies'. . ' I , � � ! " . � � C Gefbege DISpo581 �� j
� ' � . '�
1 hereby,affirm that I am'ezempt Trom tha Contra6tor'S Llcense Law for tne � _. , -� _ . _ . - Generator �0�5 KW �5-15 KW
tollowing reason' (Sactlonr7031.5 Bus��ess antl Prote551onal,Cotle: Any city or ?-Trap � � - -" � �.
county whi<h requires a parmit to construct, alter Improve, tlemolish�or repair , -. , i- _.„ � Transformer ❑�5-50 KW �
any structure; prior to Itz issuance, alSa mqulres l�e applican4for suth permlt � RoOf'D�ains - . ,�' . , �
� to file a signetl itatement that he/sne Is ticensee pursuant to thelprovisioni of � '- " ' � ' �
�';he Cont�att0�'S LicanSB Law (CbaOteY 9 (�ommancing wlth;$action 7000) o! ` i - � - � ] I ,- � - ' • - - - ❑5U+ KW � , � qeinspection Fee - �� $7g�'
� 3lvislon -3 of the Business antl Professlons Cotle) or that he/she�is.exempt ' ShOw¢r5 '- . ' ;. � Reinspection Fee ' $15 ' '
��herefrom antl the bazis for t�o allagBC exemption. Anyylolation�of'Sectlon '. - ' , " Meter up to 100�amps �Iaue Fee � • �$ 3. ,
"7031.5 by:'any apPlltant tor.a,peYmlY-subjects the applicanl to a civll �' - I _i � � .. . ._ �
"eenalty of not more [han tive hunCretl Oollars (§500)�. � •, - , � ,. � Serv�ce Siok � , � laue Pae . I ? 3 Zaninq Approved By � � � � � � Date �
LJ I;� as owner ot the �property or'�ny employeas wlth wa9es•as their sole . MECHANICAL' ' ' I � ' � � ' �
mmDensatlon' wtll tlo tha work, antl Ihe �structura is not Intentletl o� offeretl _ I _ , , Application Approved By � ate +
for wle�(Sec4lon 7044, Business'anG Professional Cotle: The�Contracto�'s � , , � . �
� License Law 0oes not appry to an owher of a proper[y �who bulltls or Improves Boiler • r Refrigeration System , . � ;B, j' � � .3 �, L���,3 t
thereon, anC who �tloos�such work hlmself/herself or through his or her own i � ' '� �� ' � ' �� � ApP��mtion laued By , nate
employees, provitlea that such Imorovemants ara�not Intontlotl or o(tered tor , , Duct='Under,Ground � � ❑0-100,OOOBTU ❑1000008TU � .
sale. If, however, the bullaing or ImpYovement is soltl withln ona year o/ com- , . . � 1� I I . � SUMMARV pF FEES � ` . � .
� O�etlon, the owner�will have lha burtldn of proving he/she ditl not builtl or Im- i . , � ' � � . . �
� ��romforthepurposaoisa�e)t. • . �; ; � '� Diict-Structurel � ; � � SystemRepeir)Alteietion �BUILDINGPERMIT $ � � SMIP ! .�$ , � �
1, as owner of the property, am e%�lusively contracting�wlth.,llcensetl con- � � � � � ' � � ' ,
. tractorsto construct the project.(Sectlon 704a, Business antl Professions Cotle: .' Duct- Ventileting_� I,� ' _ I �� � � ' � �PLAN CHECK� � $ � PERMIT � � ' �
� The Contra<tor's License law does e�ot apply to an owner of O�operty who -;� t , ' PLUMBING , ' $� � ' �SSUANCE � '$ �
V builtls or improvas tharean, antl who <onVacts for zuch projecls with a con- Exhaust Sy5t2m ❑ MW[iple O. � , ' . ,
tractor(s) Ilcense pursuanl to the ConVactor'S Llcense Law). ; �
� - � 'PLAN CHECK . $' � � GRAOING ; $ �
`� 0 I�am exempt untler Saction B, d P. C. for tnls reason � f'� FiiepUFaCt. BI[. IC80 �h � . � � ' , . . Q_, '_ �� .
- ' - ' � � ' • ELECTRICAL � $ � � $ �
� � Date � - � � � ; Heatin S stem & Ductin ; � � . . , $ � �
- Owner � � i 9 Y i 9' � �PLAN CHECK $ • . � MICROFILM
I hera0y-ttrtHy [hat-I have reatl th�s�applicatlon anE stete that�the above--1� -� 00�100,OOOBTU �100;OOOB -- ��-� .
� Information 1 rect. I agree to comP�Y 'M��� all city antl county ortllnance5 � � ^� � �' . �� � � I � � � TOTA VFEE �$' �
� antl'state s re ating to builtling canstr ilon, antl heraby authorixe repre- I , � �MECHANICAL $ � ; � ,
sentaUvas o s'clty to enter 0^ above- ntlongtl pro0erty tor Haod oi Type I ❑. Reinspection Fee. $15 ! � LESS �
. Cano . �T' e 11 ❑' � ' � PLAN CHECK $ ' � qD,VANCED PC � $ ' Q'
Inspection Pur � I p�� . � t '
Signature _ Date d i . Registers , i i � laue Fee . $ 3 ' � � � FINAL FEE � $ ' �+ �
Drivers' canse or�55 � � � ' '
CMF OB65-06 rav. 12/82 While - Builtling; Canary - ApDlicant; Plnk - Accounting; Goltlenrotl - Asussor
S' r'C.ONSTRUCTION AND PLAIVNING' � � '�• `_ ' �, � , � �r. - - �O�_� SPA _ . � -; . . ,
. � z'Date 'lospector ` " � � � Date InspecMr
' �APPROVALS - Perfnif# - - -APPROVALS- Permit#
tu Semporary Electrical SerJice or pole - �' ��. ° � � � �'.52. Pool &_Equipment Location' �� � " ... - •, �
.y 2 ,Soi1 Pipe-Undrgrnd:[ � �= � '; _ .� "; � � a _ _ 63 Steel �Reinforcement - ' . - -
; -3. Electiical Contluit Utilitv-Undrgrnd; � - . - - �.54.' Forins %- =�. '=.` =' : � . _ � �
... �.
� ;4: Electrical Conduit-Undrgrnd�. �: > ! �, � . � = f � � 55:. ElectricaCBonding - . � �',� ,
� , �1
5�, St�el'.Reinforcement ; {; , ' ' '. ;, ' 56 �Rough Plumbing.& Pressure Tesf - � ;
' 6: �Elecfrical UFER �Grnd: ' ` r= � � " ^ ~ � o � .57.' APPROVAL TO COVER-GUNITE. . . .
� -22-is .0 C:_ ,
7. Foovngs � ; i � _ ,.,� � � , � R _ .'58: Electrical �nduit=UndramN. - � �
8. �Foundation ' ' � - • � ��59. Gas�Pipe, � Undrgmd., Test - ' ' � ` � j
9. WaYer Pipe-Undrgrnd. ' � , - �� � �, :•.60. Backwash �ines, P-Trap, O Undigrnd.. - ' - ' •
10. Structural Floor System � : z _ s'' 61. APPROVAL TO DECK ' � '
1 L 1Property Sewer Line & House�Connection� _ .62. Backwash �&'Receptor-Pinai _ . � ' .
12. Sewer CaP ' . � � ' E �: ^ .�63. Heater &�Vent-Final _ . . . . � .
13. RoofDr;ains • � ' . � ' � . �s64. Plumbing'SYstem-'Final�. - `
14. Rough Plumbing ' '- �� ' � � ` 65. Electrical=Final - ' - � - '
�
a' �15: Rough Electrical=Conduit'r' k �� � - -- , � "-� - �" '�" -66.; �SolanSystem=Finaf�� -�� � - ' -' ' -�-
:�+1�6.�Rou h Electric Wirin - ' � - -i:'' --t�' �- - . - � �- � -
. 9 � ,., , 9� ' I � � -- i ; _ , : ; � j67.i Fencing &-Access Approval. -.'; ' - , -
- 17:� Rough�Wiiing Sign.�: _ � �= ' ^ I . � ' �gg, qppROVED FOR PLASTERING ' ' �
_, 18.' Rough Electrical-T�Bac Ceiling` �i � - i , i'; ,69: P00 VSPA SYSTEMS FINAL ,-
� 79, �Rough�Heating & Air Conditioning �, � � -. ! ' ' �FIRE DEPT,�.REQUIREMENT _ - �
i
' 20..Rough. Factory Fireplace ` � ' � ., � � �. ' APpROVALS , Permit # ' , - . �
i � i i
__ �_21. Ducts, in Structure � ' i",.� �� '' � ' � � � JO.. Underground Hydro � �
o. , , �
; ,'22. Ducts, Ventilating' ' ' . ' � ' '7�1 � Product Pi in ❑Gas ❑Oil ,
i P 9,
'. r23. Gas��Pipe-Rough & Test ` � jg , � � � f �7�Underground Flush ' .
. �-24. Roof Framing � ! � � � " .'.� ' � ' �� ' � � : 73 � Undergmd. Storage Tank � Gas ❑ Oil� ' �
> .1' � � � y �.
� 25. Roof Sheathing ' � ' � ��?r. - ... � , ` � ` + - 74.� Overliead Hydro �� , ' . - � � '
- : . _ .,. - , . , _ , . .
+ 7: 26. T-BaF Ceiling (Structural�, & Mo�ocoat' ; `. ' I :� i � � �75. Dry Chemical - � • � ' � , ,
" �, 27. Frame and �Flashing � � ; " ; � � i ' � ;76. Dry Standpipe ' - � � .. '
� 28. � Lath�ing & Siding' �� � � , �� , � � . �, i � 77, FIXED SYSTEM FINAL � �
�_29_�Insulation : �- � � ' ' . � � � i ' 78. FIRE PREV. FINAL �
: i
� `30. Drywall Nailing . ' � � � � ', ' �Notes: , � � � '
,'31. Plaster Brown Coat � ' �� -� � � �- ' -- � � - � - T� -- - -- � - �- - � - - -- ��- -
; 32. Electrical Power Meter-Final � '� i�� � � ' ' � � � , . � - •
� 33, •Final Electric ' i � �� �� � ; i ' � � ,
. _. . ...,._ . _ _ . . .. �
34. Final Heating &-Air Conditioning � , � ! ' � � ; � '
�F
'� , '_ � �, . . _
35. Final Gas Pipe-Teft � �i ..� i ,� ,_^ , , - ' .� - . - . ' � :* . .
L
.. � . 1 i t . . .
36. Hood or �Canopy : . � � i� , � � - � �
- - '' �
37. Final Factory Fireplace4 � ; • �� 1 _ , � ' � , ' � � , ' � . '' �
; 1
38. Final Plumbing � � �� ' � j � � - . � �
�
39. Water Service-Final � `�� � � ' ' � �
�
�� � �
40. Gas Service-Final • ' �
� �
41. Solar pomesticFinal . � � � � ` i � _
, - � - ---� -� ---
, . � : . . ,, � .
42. Backflow� Preventer ,. ' i �', - -_ - - �-- - J � . -, . .
� � �
43. Backflow Irrigation �. � . - � " � � "� j ' �
.' `,. '� � �i i _� {' ' � i',- ' ' . , . �
44. Landscape liiigation System � . . , , I . . -� ; ,^ � � � , � -
45. Sound �Attenuation',;.; i i � �,� ; ' � � � „�' - � i - . � : � , . '� _ . ' .
_ �
46. Handicap Regulatiods , � � � ' ' ; � : ; � � � � � ' � � � ,
� -
47. FINAL STRUCTURE & BUILDING , i r � , _ � � �' � � ' � -
i
48. Special Requirements Completed . , � � � . � ' � .
� i
49. Elec[rAc Release to �Edi'son � � . '_ _ T__�_�. _� _ ' �__� _ � �_ � _ ' _�. �
50. Gas Release to Southern California Gas Co l' � � 1 , ' ' '
� � � �,.
57. CERTIFICATE.OF.00CUPANCY _ . _'_ , . � . __ .__,_.�-_- ._ _ � ,',
No N � � Date I i � ' . i ' � '
, AOP�leant to fi11 in all spaces ezeept those within neavY bortler Iines antl sign ail apDraDriate tleclarations.
_. _.. _ '"_" ''_ . . . ._- _. ._. _. . . _ .
; C�tv oF cosra nnEsa . �. -- _ _ . . _ , , . _ . ._ . .
PERMI NO._ ,,/ TRACT NO ' LOT NO. BLD . . ; • ' i .
CONSTRUCTION PERMIT i . ' . SgSb' ' ' " ' ' � � = ' •' � 1 , ,
� " '- , ' i _'
AppliCenY5M3ilingA�df¢SS ,� y 'e� TYPEOPCONSTRUCTION ' .NEW � ADD' ALTERATION .REPAIR . ' , . � � , . 6.hi�I -J�tI-I��i:i IJo�i.� � TL
Project Addre55 � ��' ' ' ' _ � GONVERSION -:❑ DEMOLISH� O�THE/R'' � - . ,� .
OWne15 NemO ' �T�'f �� � ��� �U�L--K Phone'sysgg�� �DESCRIP,TION OF WORK ' , � , � - � ..
. � . . - ' � i � _ � � . ' � ' Z NI G R GUL TI NS
' C' •r4 r'vl f. . � � -
Addreu ' . � TVPE OP PERMIT ' GRADING � ' FOUIJDATION STRUCTURA� ' �A. P. # ' � �' . 20NE -
ArCh/Eng. � � � LiCEnse NO.� . ❑ TENANT � ELECTRICP.L .❑�PLVMBING; �-MECHANICAL ' pLNG. REF.#' °= . ' BUILDING - - . ' �.
. Add1255 � � " � ' ` ❑','OSHER � `� . �� � . - ' . ' � ' -- TO BUILDING- � ' ' � , �,_.
PR PER Y LI E �'REAR YARD (TO P/U %-
. Contiector'sNem� W G � hone• Sys�� PROJECTDESCRIPTION SQ.IFT. - � �"''' �OCCUPANCY �LEFTSIDEYARD RIGHTSIDEVARD �' '
-Addless'Imeilingl' � � CONSTRUCTIONTVPE VALUATION$�% I _ �:.
�� ' � ' t , i , ' � • ' ZO,N$ ' ' GRAOINGCU.VOS: � ,ACRES PKG.SPACE,REQ. ' � ' PROVIDED '
License No. _
LICENSED CONTRACTOR DECLARATION �' � � ' ' � Remarks: • � ' � S � � � ' STREET WIDTH � � • j ,PARK FEE-$ � � . '
� I;hereby�affirm that I�am IlcenseU untler provlslons ot'Charter 9 (commencing , ' � - . . ' �
' with secHon 7000) oT Divlslon 3 of the Busineis antl Professlons Cotle, intl ' � , 1 ; • I , ' � � .r"� ' . �, SPECIAL CONDITIONS: � ' ' 1 ` : - ' �
my Ilcense'Is in (WI forca antl�aftect. � � i • � � � � f, i i
� LJcenie Class � � License No.' ; . . � PLUMBING ' � � f < < � � � � , , !
. Date � � � 519nature � � � � � ' � 1 1 , , . . � . . � � • . .
�`NORKERS' COMPENSATION DECLARATION i � � 1 � Bar Sink ' � � Sew¢f Cap : �
hefeGy a}iifT,i�di I hdVe d CertlflCdLB Of,COnSentt0.581f-InSufB Or.d.CBftlilcat¢..;_ ' ' ' ' ' ' • ' _ _ .
,f Workers' Compensatlon Insurance,'o� a certifletl coov tnereof (Sectlon • � ' Backflow�Preventer-� - ���-�-�- �SewerConnection!�-'- k �t � �. i �
; 3800, Ldb. C.) � ! � � � � � � � � ' � Backflow Irrigation i � i Solar Collectors ! � j �,5;
� PoII<Y No. � � - � CompanY ' i I - ' "' ' - - "
BCertiTietl copy ii hereby furnlshaE. � 4 i � - � � � Bethtubs � ' Solar Pipin9 ; � req
Cert(}letl copY is flletl with the city Builtlin9 �ivision.
i n�m . . 1 . o,,,,u���r ' . . _ � . ! , . Clerifiers , . � � . Solar Tank , t . . "`..
CONSTRUCTIOIV;IEDlDING AGI
I herlby affirm that there Is,a�constr
of the ,wO�k fo�� which � IhiS pE
� lantler'S� Name:- � �,
Lentler'S, AtlOYess � � , � ' -
OWNERiBU1�DER DECLARATIO
I hereGy�atfirm tha[ I am�exempt'1
following reason (Sectlon.7031.5 E
county whl<h'requires a permit to'i
any stluG[Uv¢� pflol to It5'ISSllance,
. to Tile a slgnetl statement that he/5
:�the Conhactoi's'License Lawi(Chap
.P��ivlslon •3 of, the Business antl. Pr
;�erefrom •antl tne' ba5i5 Tor tha all
.:%031.5 by`any applicant for a �,
� enalty of not more than flve:huntli
, � I;�'as owner ot�the:property o
compensation will�tlo the work; ar
! for sale!(Sec{lon 7044; Busine55S
� LJcense Law Eoes not apply to'an o
thefeon, antl Who tloe5(Such'work
� amploYees, provlaep tnat sucn ImC
I sale. If however, t�e �ullaing or In
; pletion, t�e owner;will have tha bu
���rovafor,the purpose of.saleJ: i
I d5 Ownef ot th8 pfop¢fty, am
{orsto conztructthelproject,(Se
i The-Contiactor'i-License Law doe
; builtls or. imptovez;thereon, antl w
; tractor(s) Iirense pursuaM to the Cc
I � 6�am exempt unUer Se<tlon—
: i f °
� Date, � f Owner'_
' 1 her¢by cer � I.hare� reatl
' informatlon is mrrect. I� agree to 0
� antl;5tate 1 ws relating to buil
Sentatives t:this dt �t0 E er a
�Inspection urpo �s. +
' Slgnature . � +
, Drivers' License or 55 9F.
/l � `. : - � -. � `t-,
n lentling a9ency.for the�
�Is�i55uetl (SeCtionti30
i
c !
, � ; . �.�-� - .
the ,Con V actor'S.Llcense
Builtling;
a
�� - I
,with wages
; not intentle
Gotle: � The !
m!) or
i ;
'uetl 1
�to tRe �
� �
� �
t0 thB� y
�nwitn .
�oketl.
mance
vr CJ :
., rv .
for the' '
dtY or 1
crepair '
permib �
ons of' �
o) ot
xempt �
ectlon
a' civll
:m ;
ii sole
fteretl ;
�
imin ona year or com-
ie tlltl not bulltl or Im- ,
� � ' �
Ing with�licensetl con- � .
antl Protessions Code: _
vner of property who �
i p�oj¢Cts wit� a ron- � �
iw); i �
& P. C. fOr thls reaSon �
i
-state that-the above-',- •y
mtl countY ortlinances , .
�raby autM1orize reore- � i
iHoned property Gtor .
O ,
Date�!�_._� � '
{ � i
ilicant; Pink - ACtountin9; Gol
Floor
(5 -. L _ • _"
:�ei � Outlets � .
�rs ' : i �-� , .�
ink: ' - ` j
;,�! � .
" 1 i
ins � �- "' i � ...
i
'� 'i '" ! " (:1
i � 1
nk � - � ;
_ i ! '\
�. i: f � j
r.Ventilating, __1.V �
ist�System ❑ Multipl�
I/Fact. Blt. ICBO #
og.System & Ducting :
00;000 BTU' O 100,00(
- Assessor
�rvaterservica iL ;
r� � �
_ � 1 i ,
^ '' � }
� � f I
� . .
_ ; Heinspectiqi
c' i ' I�sue Fee t;'.
ANICAL' . �
iefrigeration System
70�100,OOOBTU �1(
�
A
r
_..'- ; _ ..1 t
f
� � '
"' ". `,_ _... i
1
Reinspeaion�Fee; $15
�
Issue Fee $ 3
h.A.U. ` .
i
Fixtures_+ ' _
Device Boxes ' �
OuUets j ' ! �
c�. � nwia� �
�Meter...�over_100.amp5.1_,._..�_. =-`.:..r '_ {
� i"
�Sub Panel; !� � . t ' i
�Sub Pole ' j ; i ; ! � � �.
.Motors �0-1 HP ❑iX-8 � . 1 �
, � t
'InaSolar[09-�15HF.O16-15+ � � �
!
.MicrOwave { � � �
;Pole-�Lighf - � j t
� i
�Ran9e""... _�__� _..y�.. .__r. .. _ .
'S19n � ' !� ; ; f
i
�Standing5ections � F �
f �
�••'����_� . �Trash Compactor � �
Gartiage Disposal ' ' . ( ! � 1
Generator �0;5 KlN �5-15KW � i ' ; ' �
' 1 � � �
ITren's4armer �15-50KW � 7 ` f �
, t ( �5U -t KW; 'Reinspection Fee �$76' �
��� Meter ❑up to 100'ampi � �laue'Fee : � ' ' $ 3 �
ing Approved BY � � � ' Date � + 1
lication APProved BY ' � , � ' � �Date ( � � �
t f � '/ i 1 � '
IimtiOn IssUed By !�' ` s � 'Dete �
' j j ' � ! SUMMAHV OF FEES � ' • ' ' � 1
�BUILDINGPERMIT $I �-�.'t'i� � SMIP � � $ � � �
� [
;PLAN CHECKj I $! � , PEFiMIT, . ; . �
1 j t ISSUANCE ; i$�
'PLUMBING � $: , '
'PLAN CHECK� � $i � , GRADING : ; $ � �
�ELECTRICAU � $� � � � $ � .
�PLAN CHECK� � $� t ' i � MICROFILM j$� 1
' � ' ' : TOTAL FEEi :' $ ' ` �
MECHANICAC '
tPLAN CHECK'� ' $; � 7 { LESS � '. � i � ! �
� I � ; . ADVANCED,PC $ � �
�. !n �• �j'
�� I AI_� YFl9 f I iDN � � FINAL FEE �� i$ �1J-: �
�_.
�_CONSTRUCTIONANDPLANNING ��,;, �� � • ���' ='� . ' .��L_SPA• �� ,
, APPROVALS � Permit.#�- � ' � Date . � Inspector � - ApPROVALS . Permit # Date � Inspector
„ ' - �
1. Temporary Electrical Service or Pole - � ' �.• ; � , 52l Pool &.Equipment Location . _ . �. '
� . 2. �Soil Pipe-Undrgrnd. -� - ` , � � . � ` 53; Steel Reinforcement � . _ �-
- ��3. Electrical Conduit Utilitv-UndrgmA! _ . � � 54. Forms � �� - � � .
4. Electrical Conduit-Undigmd: � . � ''/ ' 55. Elearical,Bonding ` . ' �
;�
5. Steel'Reinforcement � �- � • 56. Rough Plumbing & Pressure Test . r �
• 6. Electrical UFER Grnd. ' I- � � �� 57. APPROVAL TO COVER-GUNITE - '
7. Footings � . ; - � .. _ .� .� ' 58. ,Eleotrical �nduit-Undror�d. _ �
' 8. Foundation � � - � i �' ' � _ . 59. Gas Pipe, � Undrgrnd., Test .
,.
9. Water Pipe-Undrgrnd. ' , _' - �60. Backwasli'Lines, P-Trap, O.Undrgrnd. ;
70. §tructural Floor System �'; `� � 61. APPROVAL TO.DECK -
1 L�Property Sewer Line & House Connection' � � � 62. �Backwash & ReceptorFinal �
12. Sewer Cap - � ' � ; ' � 63. Heater & Vent•Final ' ' �
13. Roof Drains . . ' , � � �64. Piumbing System - Final � -
14. Rough Plumbing � � ' ' - � � " ' � 65. Electrical=Final � � � •
15. Rough Electrical�-Conduit'� ' `� -- - � '" ' ; """' - �66. Solar System-Final� . � �
16. Rough Electric Wiring� . � ' ' �,- ,� ' . • : i � � �67.� Fenciny�& Access Approval � � �
�
17. Rough.Wiiing Sign. , �� • ' = � '- � � gg, APPROVED FOR PLASTERING
18. Rougti Electrical;T Bar Ceiling �' ! �� �'. 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating &:Air Conditioning . ! � �FIRE DEPT, REQUIREMENT. -
20. Rough Factory Fireplace ' '�� ! � , APPROVALS Peimit #
21. Ducts, in Structure ., � � 70. Underground Hydro �
22. Ducts, Ventilating . , � ' �• � � ' � �71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & T,est �, �' � 72.� Underground Flush �
24. Roof Framing. ' ,� �, , � . 73. Undergrnd.StorageTank OGas-OOiI � •
25. Roof Sheathing , = i � � �74. Overhead Hydro
26. T-Bar Ceiling (Structuralb& Monocoat � . � 75. Dry Chemical _
� 27. Frartie and Flashing . � i ' � � . � �76. Dry Standpipe .
26. Lathing&'Siding , ' � ; 77. FIXEDSYSTEM,FINAL
29. Insulation ' � ' 78. FIRE PREV. PINAL �
30. Drywall Nailing ' � • � � , Notes: � , '
31. Plaster Brown Coat � , ' �/�j� �
32. Electrical Power MetPF-Final � ' � � � �
33. Final Electric � . � � � �
34. Final Heating & Air Conditioning � � � ' '
�
35. Final Gas Pipe-Test � . . . ' � , .
�
36. Hood or Canopy � . . � , � ' � �
�
37. Final Factory Fireplace �� - � � . �
38. Final Plumbing . � � � �
39. Water Service-Final � ' , _ , . . '
�K.
40. Gas Service-Final � ' . � •
41. Solar D'omesticFinal � � � , _ �_ _ __ _ � �_ __ ' � ,
42. Backflow'Preveriter ' � . . _ _ _. __ -
43. Backflow Irrigation ' - � � ' � � .
i � �
44. Landscape Irrigation SYstem , , � �. � ' �
45. Sound Attenuation , �. � ' � � . � �
46. Handicap Regulations ' � �� � ' � �
47. FINAL STRUCTURE & BUILDING ': : 3' g6-'
48. Special Requirements Compieted. � � � � ' , ; ' . • ,
49. Electric Releaseto Edisonl ' � '. ' . . � �_ ' ,
- - �-
� � � �
50. Gas Release to Southern California Gas Co , '
51. CERTIFICATE OF'OCCUPANCY � __ _ _ _ . _ . ,. ,_. -, ._ _ _ '
No Date ' � � ' ' '
�oon�sswnm�rm: 3022 DONNYBROOK LN
QYNEHSNWEIFRqNN: LUSK, GLENN WILLIAM TR
y monEss: 3022 DONNYBROOK LN
COSTA MESA,CA 92626
APPL. MAIIING AOONESS:
AXLNRECT OX ENtlNEEN:
MCN.OH ENG'S I�DDFESS:
uc. No.:
UNT:
UNT:
C0"'""CT01SN""'E' CRANK BROS ROOFING CO ( 719 ) 548-5569
CpRH�Ci0R4YYt1N0 126 COMMERCIAL WAY
�noness COSTA MESA CA ��� 408677
92627 uM:
LIC 5 COM TOfl3 DECL�P�TION: I heraby aM'vm under penYy d perjury IM1m I em Ikanaetl unEer povidona ol Cheqm 9
(m men np xi�h Wn ] ) d Oivision � d ihe Buairon eM Prdavona Coda, eM my lio u in lull lores e�k �
c ucno.: 005.�9 3 uc.cuss: C39 "0 40 7 EXP: 0/9� ,
ete� i ConVaUa: �� ��
WNEN BUILDE OECIA TION: I hereEy eNrm unEer penetly W perlury @et I em ecempt Irom Ihe GonVepon Licenaa �ew lor �he
dbw'vq reeaon (SWbn ]031.5 Bwiwa� end Proleeaiom Code: �nY c'ry a oounlY �� �Vuirea e pefm� to opnw�M. elix. imprwe.
mola�, or mpeir eny slruclum, pmr io na ueuence, ebo requiroe tM epplirent lor auch permil lo file e eipned elelement thet he or ehe
b IiceneeC WA�� lo Ihe 0��� d Ne Gonlrec�wa Licenae Law �Chepter 9(mmmentlnp wnh SeUbn ]000) d D'vulon 3 0l itr
Burnaee eM PrMeaeions Code� or �htl he a eha ie exemq �Mehan eM �ha bsva �w Ne dbpeE ezemqion. My violelon d SeAion
]0�1.5 W eny eppliunt lor a permil aubpdv Ihe epplicen� �o e civil penelry of ria mwa then Irva hundred dollen �5500��.
� I.eao�mardiMpioperlywmyempbyeeswlhwep»miheieolemmpaneeiun,willdoNaxoA,end�MeWClureendinlendeE
a oflerad for eeb (Se Yion ]046.6usnees end Pro/eaeiane Cotle: Tha Coniredors Liwros lew does not epplyto en owner M propMy
wla buWe a inp�ovee �hereon, eM who Eoea nuM wark Nmsell or hane� u thr«qh he a her own emplv+aes, provided ihm wch
improveman�s ara roi inteMed a dlereE for eele. X, howevar, iM Wikinp a inprovemem ia soN wnhin one yeer W completion, tM
owrerbuiNer �.ill heve the buNen d provi�p M w aha did nd Wik or improva Iw �he Wmme d eeb).
� I, ea oxner W Iha propeM� � exdusively canlre 1in0 �h limnaed conlreclon lo cros4ud Ihe projed (Sedion ]041, Buainavs arW
PMeaions COEe: TM Coniraaon Licenae Lew dma rwt eppFy �o en owner d popMY ��iks a impoves ihereon eed who
convena for euM prqene wdh e wnvedw�s) Icemed Oursuem �o the Conireeme �nee Law).
� I em uemq uMer Seclion: B. 8 G.C., M thu ieawn:
De�e: O�mar:
I do hereby cetlify Ihat I em ewere d aW underetend �ha reQuiremantz W CelRomie Haetlh eM Safeq Code Secibns 25505. 25539, eM
25530. ard Ihm I« eiry Mure Wikiip ampenl will / will �ql (dreb are) �� to canply wih veid qale codea eM tM �equiremenu for
epermillamnstructionvmodi(WimhwniheRr uaTl.renepamemDis�na.RaeiEeMielcan��ueionepplira�ioneereeaemqimm�heae
pION5q119.
oa�e: Aod�+��
WOXKEN'S COMPENS�TION DECL�fl�TION: I hareEy elfirm uMer panelry d perj�ry ma M Ihe Idlowirp Eetlermions:
� 1 here ud xil meinten e cenGicme d mmmt �o saMinwro la waMan' cwnpensetion. m provided Iw by Semon 3)00 d tM Lebar
code, ro, m. wno,manoe or me won� �« wmm� mle oa�A m ha�ea.
f[T� �ne�s.�dxi�meimen.mknn�mmv���m�.mrea��reeMseaims]ooame�.n«coa.ro.�nero��ea�ne
l` wOlk for Whid1 IIli9 pBm111 is i6SUBE. My wakel9 compen99�qn in8urancB fERl9! BM Vd�yAYmb81 Ble:
��� � EXPIRES
Polby Numbec — � �p 1/ O S/ 9 6
( is ion rreed be canplerod i tM1v pemi! is /a are huMieE W /SIWI bss� ��� �
cenAy Ilat the pa rmence d iM wwk Iw wM1ch Ihie pa ia i ued, shell ral em iy penm inar�y.mgpper m as to
a ee �o � v.oikare' canv���ion lewe d celif a. . �hm il vhwk .c•ma�wblae �o �M xoMen'
com i n o�s' ol 3]00 oi ihe Lebor cod.. 1 I 1 n �y m �hoae � v om.�
ele: I �' AppfranC
WeminO� F�Nu ro aecu weilrn�'rompwaatlen cevereps b✓nMMul, en �lull s ! an �mp/ ro ctlMlul p�neMs� siW
c/vll Mrc� up ro ons M1unars0 eMunM Lollm lS/00,OOo1, ln WOltlon ro M� rost ol eiwtbn, vups u provlrled br /n
SxHon Jtfb ol tlrs Gbor COJe, Inlawt, end ettomey i Iws.
CONSTRUCTION LENDINO �GENCY: I M1eraby elfirtn under penely o/ parjury thel Ihere b a canst�ud'wn bMinB egericy la Iha
Def�Ol111LICB W�f1B MOfk�IX Wlliillhu pelnli q 49uBd�$BUqf13031.('iN.fi%.
I cenM �Iw 1 have eE �nis eodication eM m p ihm �M ebove inl«mmion is wnea. I a0ree io wmVN witn ell rnY enE coumv «direMea
entl teiete rplwi 'kingmnmmdia E�arabyemhoraempmsametiveaN�hiadtyioemerupanthaebwe� ntonep�propaM
fori spedi r�Wrpma /
O'BRIEN � `
� � \
e �r
�
o�<: �
sienelu orOwnetl APolicenUGon a '
(Si5t�46.WP) While-BuilEinp b Sel@ry; areeo-Fle; Cenery-AppFfant: Pink-Rerenue: Gakenrod-Aaemsa
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 075528 PLAN CHECK NO:
CONSTRUCTION TYPE: PERMIT TYPE: STR
JOB DESCRIPTION ; T/OFF & REROOF W/COMP.
I�l
PERM NO: B 075528
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT: 4,591
CLAIM VALUE: 4,591.00 CALC—VALUE: 4,591.00 GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTORS ARE RE�UIRED IN EVERY BEDROOM 6 HALLWAY
***x�*****x�*�r�r�tx�x*�r**�r�r**+rx�x�***x� �r+rxx�x���rx�+r*x�x�x�*x�****x�+r+rxx�***+�x�+��+r*�r*�r**+�x�*****�
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 BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARRING REQ• � PROV: PARCEL: 14116605 ZNE: REF NO:.�
PLANNING NbTES>
i
ik ik 1i'1f �f"If 1(' iE 1E 1E iE 1f 1E ibiE if ik it'IE 1E iF if� iE M if if 1E ik iE 1E 1f ik if if iElF IF 1f 1F 1F 1E 1E iE 1E IE 1E 1E iE 1E 1E iE 1E iE 1E iE 1i iE iE if �II� 1E If 1E IE if iE iE If ii if 1f 1E if 1E it 1E 1E �lE IE
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 HY DATE:
BUILDING APPROVED BY : DATE; '�"
s��
APPLICATION ISSUED BY: DATE:i •
i!lFiEiflfiE1E1F1E1FiEiFifiFlElfifififlfiEK 1f1f'IfiEiFlFif'IE�IFlf iE1f
LEGALIZATION:N F E E S U M M A R Y STAUCTURAL�SE MEN :Y
� �
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES� GAADING
PERMIT 72.00 50
SMIP/NON—RES
PLAN
ISSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 72.50 0.00 0,00 72.50 72.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 72.50 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
72.00 .50
iEiE If 1E 1f iE 1E iF K iF 1f 1f iE iE 1f if iE �If iF ii 1E IE iE 1i 1E ii iF 1E 1E 1f 1E 1F IE iE iE 1E if 1E 1E 1E 1f iE if')E iF if iF iE if 1f� 1f i(' iE 1E iE iE if iE 1E 1F iF IE 7E 1E iE iE iE 1f� 1E iF iF i(� 1F iE 1E {E if iF iR
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 4591 REAOOF BY VALUE RESIDENTIAL NOZONE 1.00 4,591.00
END OF FEES
�1 L��i�'�,�ti,�i'7]�ji.�'6iA? 9:�L�
DtiTE: +•,,�' ,y' `i�,�s s';pg
�.
CONSTRUC710N AND PLANNING PO„OL � SPA
.�`vPPROVALS P¢rmit #� Date Inspector pppROVAIS Permit =# �
1. Temporary Electrical Service or Pole 52. Pool & Equipment Locatiop'
2. Soii Pipe-Undrgrnd. �, 53. Steel Reinforcement .
��Eiectrical Condu� Uf�ity-Und[grnd. 54. Forms - '
'':'4���ctrical ConduiY'rU�rgrnd. ' 55. Electrical Bonding j'
a .
J SvS�eel Reinforcerr,�gtg � 56. Rough Ptumbing & Pressure Test
J;�SEtectrical UFER�k`iF'+�d. 57. APPROVALTO COVER�GUNITE
---�� �
.�y 7��.F�otings x�' '�"_", 58. Electrical Cond�ndrgrnd.
jrB�Foundation jr+ y W 59. Gas Pipe, O U��rgrnd., Test
c. �
x� �Water Pipe�Undrgcnd. T ' ' 60. Backwash Lines��rap, Q Undrgrnd.
.� .
S� Structural Ftoor,S�stem 61. APPROVALT�AfiCK ��
Yf. FWperty Sewer Lrne $� House�Eonnection 62. Backwash & ReceQ4or�Finai
s, i . w^
12. Sewer Cap � 63. Heater & Vent-Final � '
13. Roof Drains � � ` 64. Plumbing Sysiem � Final
14. RoughPlumbiny�. .; 65. Electricai�Final -+
75. Rough Electricaf-Eora3u;t a� 66. Solar SYstem�Fi4aL
�� y � �
16. Rough Eleciric4�rin`�'� C � �"
c 67. Fencing & Access ApProval
17. Rough Wiring Sign � 68.. APPROVED F(SR`f'IASTER WG
, i
18. Rough Electricai_T Bar Ceiling� 69. POOUSPA SYST�4S FINAL
79. Rough Heating & Air Conditioning ^ C FIRE DmEPT. R�EQUIR� MERf,T n.
20. pu�jiF�or �FiT� Iace ' �r � � C � �T`•. PP �V i����Periiiit# { � T
�. �. �'�k � S !^ * S r. c � i . �{.. �^v.... F- F -�--^-�-
21. dacti;•in$truQure'�?� i�• •• H S C7 �* 70. t7ndergioa�� H�dro k
cr
22. �ucti,N�qUla&ng� �: �� �U ,r � Fx '71. Produc�F�r.pinq�7eas �:Oil
23. Gas P�pe- u, & Test "' � � � `" `
�a c�tj '-7 �i�.�� c� d vt �72. UndergroimdFfu.iav * r^-
24. �bof�rair�fing" �* -'r"' � * �' ;� �� "� 7 �Under md.Stora �, nk''OGas ❑Oil
.. * � �, x • � 9 9��
25. Roof� hea�hin9 n#. C Z'� ��g.-�� (.eCy� 74CJ@verhead HYdra.Hv �.
v; 2 G c" A� "� y' ri �"J �
26. �$ar.`•Ceiling (Str�Ictdra1l & N�i��at * �.� "� 7�piy Cher�ical _, # Y
27. F'ameandFl hio`��• ' - "' r... , „�, - ,., �
.I, d�i, 97* :���, f: c' .�+ 'a.r� 76. Dry StanQpioe = x O
. � v
-�28. Lathing &=SidPdg� F'� `'- �='�="` � '� £ "* 77,� FIXED �j'.STEA 'F,INAt�, '
m J. �K i r c, p ,* ..� � t � r-� Cl
'29. Insulation y w+: �� S . '� ' I � 7� FIRE PREV. FIN�L '=' � %'
` 30. Drywall I�ailing' �* H , � F, I .�y*. �,.'. �3�,ALTFf.�DEP�. ii'EQUIR�MI
't r*; r•. * � : � �„ �.. � � � .
131. Plascer Brpwn,Eoat t^ . R+^� * � 79. FINAL INS$ECTKJN x �
,. * .-. �. -�
� 32. �-tecirical�ooJ'e"r A�?r�i�ai � � �*''-` 1 � � 8DyFOOD CERTIF��4YE l�SUED,., �
rf p�x u � :.t r t*� � .. � z. .•
�33. Finai�lecKic j :-��x ts7 i y x j �K Ndtes: ti �-±�,7 t. •7 ^ r_ (+:
r.
"`34. Einal:kleatfig8dAi5'YC±onditioning.S '� Y� � �* �C S C'�.'.: .e: S O�,
rf ' f- r. r r n., �r x'� J r-� � t-� eC � ITl
. . ; ' r ' �L � +" r t � r, _
35. Final�Gas�iPeTTest�.+ �R . ;: r, I�,, ,xo vr-i a� F!�-
�
'n36. MoocDo� CanoPY �'r � i[T'^� - s. C1 � FVc ., 'E l'�o %c �IT
-nr, � �t*. �. � � m �'c r m ^:tn
.`"j37. Fjnai Factory FireP;dFe ;^ r,F x` I �. " X :� ni
_. • `_ .. y� �. Z
c38. FinalFlumbing >''* ,.�c� � . '� W I tr V ~ �� � •
�-� �r * r.
r39. 4Vatei-Service-.�na},j�* � n' *,x � � � ' e," x" •
r � � c
�,40. Gas Service-Final �T + t*; ¢:*'-� S � m � O�' ��n% �k T
r; r -, c.. _ m +: �.. . o$' x rt;
;�41. Solar Oomesti�Firiai� S .'� . * ��' ' ,� " t.
♦ rt '.% I � I':+ "7 G C 1:
r'
42. 6-ackfloav Preventer�ic '.v � ✓ � � Q: � (� • •r ,� �
� ! i.1 [Ti �� � J M' (-
h' . A: � C..`> 5 T. t u, t+ '
43. Backflow'Irriga�wf�f.,r,� ;. * c� *• i .y r •
(, ..
" ' �;* .-i .� � r rJ c:K cu n: :.. � x rJ
4d. LandscapalrrtgatioO�Fys[em - -
.> � -• ..� �.• n, a : r k S_' L- Q CC fi S �'
� -� y, �� ^ . .
r�
.F F F F F- •: � r+ r+ �:n
45. 5qund Attentsa,tio3.;; ... .� n_,� r �• t-,v x
4,�. Handicap�Regu4ationt �-+ O * � � - s •" =e �' *
' c �_ � r^J"1 CJ X
47,. F'IfiV� STRU�TUR�& BUIL`�ING / l�-�S i� ,'* '�`- - �, � �.
� ,
48. NAL` PI.ANNING Y• Fe+ x;� "'� 7 "' u; �' r"
• ;: � �� f ; � t •
49. Electnc R teas2 fo E�fison * ��'rK ; � .� , ' ' �,
$0. Gas Rplease to Southern Glifor ca-6as Cn � � �?% ` �+ � • � � �� �: •
pc � � N c
5f. CERT7IFICATE OF OCCUPANGY x -'� •� � � • • �
No. Date
Date inspector
�
��
r��
-: i
r —
OWNER College Mesa CO. DATE s/21/55 -
JOBADDRES3 �022 nnIIII�Y•Onk�,ane BUILDINGPERMITNO. 3fj��_
GENERALCONTRACTOR ��.e CO, VALUE $ 8•OOO•i1O
LOT 9C BLOCK
GROUP T TYPE
INSPECTIONS
Footing Trench
Foundation Forms and Grade to Garage
Rough Freming � �,�—}�
Plumbing, Rough to Slab _ lti��/ /y
Plumbing, Rough Complete ��
Temporary Pole �, e
Wirinq. Rough p�'�
Heating, Final
Sewer, House Sewe
SepticTank or Cesspool
Lathina. in ��/U�-_� Out
Plumbina. Final. Fixtures
Wiring, Final
Occupancy
F'nrm 2l0 (
St.
DATE
� /'
' ��-..1
ZONE p)�
SUBCONTRACTOR
41CT l ii'j7
PERMITS ISSUED
I NUMBER
�Cpsta Mesa Building Departmen f� r.,,� APPLICATION FOR PERMl'1'
' 171 EAST 20th STREET `-'� � g U I L D� N G '
- � ' COSTA MESA� CALIFORNIA
FOR APPLICANT TO FII.L YN FOR Ok'FYCE USE ONLY
• . Receipt No. pprmit N
Building ' /QS
Address 3022 Donqybrook i.ane / O
Costa, Mesa, riallf017113 Re i by Date Rec'd. Date Issu
�1
Nearest yjgtSOII SE 1 9 � ','
Cross St. Building
Address
Owner Costa Mesa, California
Mail 8002 Central' Ane.
Address ► Nearest
' Tel. Cross St.
City No. � Zone I No. of I Type Group
Arohitect or Lic. P�a^g
Engineer D8V19 & ui le No. C� Q Approved
b Date
nddress 43 Halag Cwe 'Plaza_ Pa7oc 4arda CO$RECTIONS
ity Lfc.
contractor The Hale Compaqy nlo. 3422
Address
Legal Lot I �.,.,� _
Description No. g8 Block � Tract 2341 .
�� 1_
(AtWch Metes and Bounds)
No. of Bldgs � � �
s�ze of �02 6617 ' I Nowon Lot None ' i
Useof I No.of I No.of -- P�)T��
Existing Bldg. Families Roome �—Z
Setback Line from ., Rear Vard $S �
Center of Street 50 � Side Yard 5� �
DESCRIPTION OF WORH
. �
New I R I qlteretion I I Addition I � - ' ��t
Repair � I I Moving I I Demolish I
Building No.of.
Size 1260 Rooms 6 Stories 1
Exterior Wall I Roo1
Covering $tUCCO Covering (�PPR,QV[���'
Use of New
9uilding Single famlly dxelling with Foundation Location Inspector Dat
Forms, Materials,
• attached garage, u�de�-P�nniny
Frame: Fire Stops,
Bracing, Bolts
I hereby aclmowledge that I have read this Application
arid state that the above is correct and agree to rnmply Lath. Int.
with all City Ordinances and State Laws regulating
building rnnstruction. Lath. Ext
Signatureof TFIE HAI.E COH '
Permittee Plasler, Int.
Authorized Agt. J�-7�_ plaster, Ext
S7LpIA'�LARDNEE
Vafwa4lon Permit Fee $ 0'� Masonry Relnforced
`�C/ D 0 p Plan Check $� 3 � Bond Beam
$ Vl TOWI � .5
Fee $ �(� ` 'FINAL
FOAM 20�1 S-SP 'dM B-55 � �
Show location and distanees irom
propeMy line and between buildinga
� • F�, p cosrn n
.[i Zj"-�.r71�H�9A r..�'��a {r.71;����.11�
tK
No.
T
PROP. SWP. LINE U HOUSE CON.
lu
ROUGM MEPTING ANo AIR CONOITIONING
TEMPORRRY SERVICE OR POLE
UNOERGROUN� � POWER �
ROUGH WIAING
TRENCMES FORMS STEEL REINF.
FLOOR SYSTEM '
REINF
FRAME FND FLASH
REFRIG. AND �.C., FIN
ANO GAS TEST I—I
UAIt
DING PERMIT N0.
SUBCONTRACTOR
9
i• 40
' COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COS7A MESA, CALIFORNIA 92626
For Applicant to FHI in Completely — llse Ink Only
BVILDING �p.1� � �„_ __ _ „� � �
OWNER
MAIL
CITY
BRANCH
ARCH�TECT TEL.
OR ENGINEER
ADDFESS /
CONYRACTOR /�
ADDPESS 3 93 � � �'L
i El. �/
CITV / �� �/,
F STAT CITV
i LIC. NO. 9 /f-/f �, UC. NO. '
a OF LOT � /D • NOW ON LOT
a USE OF
.,�. EXISTING BLDG.
�
�S Separate permits are required for
� electric, plumbing and heating work.
[.W. USE OF BUILDING AND WOFK TO BE PEFFOFMED
a
C1
:J �
> 3a�
r
�
�
w
�
A.P. NO.
BVII�ING
ADDRES:
OWNER
FIRE
ZONE
APPROVE
�A�o �. ���,: v,
�f� � i- r��„—�; 00 ses • 5 50
�N FOR STRUCf'URAL PERMIT
DATE RECEIVED DATE ISSUEC
�3 /O-7G 3—/O- %
� PERMITNO.
�. / �l. � ti �.
VARDS APPROVED
MAIN BUILDING
(FROM C/L STREET%�) � 1
FRONT � FT(/%%
I J
i /�
�. SIDE '/� KT�n
REAR � (y FT�
DISfANCE BET.
MAIN BLDGS.
VAR. 4E
� 1 hereby acknowled9e ihet I have read this apPlication antl rtate
y� that the ebove Informetion is correct entl apree to comply with
4 all lawc regulatlnB builtllnB construction, end I ahall not amploy -
Wany person In vlolatlon of the workmen't compenmtlon lawa of
� the Steta ot California.
3 I herebY cartlty that I em properly Iicensstl ea e conttector untlar ' Sn
tha Stete of Califo�nla 6usines� end P�ofeulons Cotla, Dlvlsion 3, THE AMOU�
Chapter 9, and that euch Iicanaea ere in full forco ontl eftect, or I THE PURP06F
am axempt from tha/ pr Isione ot the SteSe. i Celifornie Bu�iness V AIVATION
end Profoselone Co e, 'vislon 3, Chap a(9.
Signeture of ���
Permit�ee $
Authorized Apent � �� �� �a���
F
BLOCK
VALUE
USE OF NEW
BUILDINGM�m ��
(�"
YARDS APPROV ED
ACCESSORV BUILDING
BEf. MAIN &
ACCF�. BLDCS.
DATE � IO'�%
APPROVED
n
m
i
m
� m
N
VN UNDER VALUATION IS FOR m
'ABIISHING A PERMIT FEE ONLV: �
PERMIT FEE � a
n
n
PLAN CHECK S .� ^�
0
LL
TAX S �
U
TOTALPAID
OWNER wiGMORE & BLODGETT � �AN 11 tg57 DATE g_o_56
JOBADDRESS 3022 Donnybrook &"3019 Fernheath BUILDING PERMIT NO. #31�L{'7
GENERAL
BLOGK TRACT
PERMITSISSUED
INSPECTIONS I DATE � SUBCONTRACTOR
NUMBER
Grade to
Rough Framing _
Plumbina. Rouqh to Slab
Heating, Roug
Heating, Ffnal
Sewer, House
Septic Tank or Cesspool
Lathing,ln
Plastering
Plumbing, Final, Fixtures
Plumbing, Fin.al GasTest
Wiring, Final
Occupancy
FORM 2�0 3M 10�55
Costa Mesa Bnilding Department :�PPLICA7ZON FOR PERMIT
P.O.Box3�� �4'�8 BUILDING, �
COSTA MESA, CAIIFORNIA
FOR OFFICE USE ONLY
FOR AP �it1N IN Receipt No. Permlt No.
Building � I .
Addresg
Costa Mesa; CiS�OPIII$ Received by Date Rec' � Date lesue
�vearest . G AUG 919
Cross St. Building
, � Address '
MW ier , � .� Costa Mesa, California
nronrcector
Engineer
Address
ContracMr
Address
8
Size oT LM----j--=�
lJse o1
Existing Bldg.
Setback Line from �_
New
Rooi
Plans
�
� C�`f
.�
N o. of
Addition � ' ' ' ' �
Demolish I
.�, �,_ ._. -
Stories - � �^ ' "" ' " "
ArrRov�r.s
� Foundation Location Inspecto
Forms, Materials,
� `, O Under-Pinning
Frame: Fire Stops,
Bracing, Bolts
I hereby acknowledge that I have read thts Application
and state that the abme is correM and agree to comply Lath. Int
with all City Ordinances an State�Laws regulating �
building rnns G"�1� /i./ „/ Lath. Ext
8lgnatu�eof �v"'�
Permittee Plaster,lnt
Authorized gt Plaster. Eut
Valuatlon Permit Fee $ p� �
'� Plan Check $
s �' 3 rcwi ____.
Fee $ �
FONM 209 lO�sS D. P. 8 5. '
—O
A
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—Z
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PLOTPLAN
Show locatlon and distancee fram
property Iina and between huildinps
.- � - ;:i�c-�-ss �o5Tf7��� : ,. •z.r�
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