HomeMy WebLinkAbout2520 DUKE PL - Building Permits(714) 754-5273 • Fax (714) 754-4856 • wvrva.cl.coste-mesa.ce.us 77 FAIR ORIVE, GOSTA MESA, GA 92626
ELECTRICAL PERMIT
Job Address: 2520 DUKE PL
Suite No
Vicinity:
Parcel Nunmber: 14141246
Applicant: JACKSON, TIM
Address: 6441 BROWN CIRCLE
HUNTINGTON BEACH, CA
Owner: LONG, CROFT
Address 2320 DUKE PL
Contractor:
Address:
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighdng Fixts
Recept OutleLs
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 1000a
Motors to ihp
Motors to 10hp
Molors to SOhp
COSTA MESA, CA
QUALITY CONSTRUCTION CO
6441 BROWN CIRCLE
Phone: 714-612-8460
Zip: 92647
Phone:
Zip: 92626
Phone: 714-612-8460
HUNTINGTON BEACH, CA Zip: 92fi47
License: 569165
ISSUED BY:
Status: ISSUED
Applied: 02/24/2004
Issued: 02/24/2004
SCOPE OF PERMIT
INTERIOR REMODEL TO INCLUDE: REMOVE EXISTING CEILING AND RAISE CEILING, KITCHEN
REMODEL, MASTER BATH REMODEL, NEW HVAC IN ATTIC AND RE-WORK DUCT WORK, DEMO EXISTING
2-WAY FIREPLACE AND ADD NEW FIREPLACE IN CORNER OF l(VING ROOM. MISC ELECTRICAL AND
PLUMBING WORK. NO ADDITIONAL S�UARE FOOTAGE. REF: 804•00165.
ELECTRICAL TO INCLUDE: 26 LIGHT FICTURES, 15 OUTIETS, 6 SWITCHES, 1 200 AMP SERVICE.
523.50
$0.00
$0.00
$0.00
ao.00
$0.00
526.38
$16.50
56.60
50.00
50.00
$30.50
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
0
0
0
26
15
6
0
0
1
0
0
0
0
0
FEE SUMMARY
Temp Dist System / Lighting
Busway /100 ft
Standing Section
Misc Electrical Equipment
Transformers up to 1 kva/kw
................up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misc. Canduit
Misa Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Chrislmas Tree Stand
Fireworks Sland
Quantity
$0.00 0
$0.00 0
$0.00 0
so.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
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related
regulations. (Ord. No. 92-28, § i, 12-21-92)
EXPIRATION: This permit shall automatically expire antl become void if work is not commenced wlthin 180 days, or if work is suspended or abandoned
tor a period of 180 days.
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codea, and all
required Inepeetions end finel epproval must be obtained. Failure to obtain inspections and finel approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (71q) 7545626
2aa&48 (fi/00)
WORKERS' COMPENSA710N DECLARATION: � � ,
I hereby ettirm under penelry at perjury one of the lollowing declerations:
❑ I hava end will maintein a ceniticate of consent to seli-Insure for workers' compensatlon, es provltle0 for by section 3700 of Ihe Lebor Cotle, tor the peAormance of the
rk far wNc� this Dermit is issued.
I have entl will maintain workers' compensation insurance, es require0 by section 3700 of fhe Lebor Cotle, for Ihe peAortnance of Ihe work tor which �his pertnit is Issuetl.
� My workers' compensalion Insurance carrier anA policy num6er are:
Carrier. Policy Number.
(RMs secf/on need not be camplefed il fhe pemtit is valued ef one hundred dollars (5100) or less.)
❑ I certify I�aI in ihe peAormance of iha work for which this permii I5 issued, I shall not employ any person in eny manner so as to become subjeci to Ihe workers'
compensation laws of California, an e thet II I should become su�ject to the workers' compensetion provisions of S ction 3700 of Ihe Lebor Cotle, I shall forihwith
comply wit� these pro %'� s. � �� I O�
Applicant Signeture: Date: ��
WAFNING'. FAILURE TO SEC WORI S' COMPENSATION CAVERAOE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINA� PENA�TI 5 AND CIV FlNES UP TOONE HUNORED
TFIOUSAND OOLLARE (5100, ), IN AD ITION TO iHE COST OF CAMPENSATION, OAMAGES A$ PROVIDED FOR IN SECTION 3�OB OP THE LABOR COOE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hareDy aNirm t�at I em Ilcensad under provisions f Chapter 9(commencing with Section 7000) oi Division 3 0l the Business and Profe%�ions Cotle, entl my license is in full
forte end ettetl. Lic. M � Class k /
Contrectors5igneture: Dete: �% l% f � .A /
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirtn Ihat there is a wnstruction lending agency lor the peAormance of the work tor which ihis permit is issued. (Sec. 3097, Civil Cotle).
Lentlers Neme: Lentlers Atltlress:
SignaWre:
Date:
OWNER-BUILDER DECLARATIONS:
I heraby eNirm Net untler penalty of perlury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW br ihe following reason (Sec. 7031,5, Business end Professions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repeir eny stmcWre, prior to its issuanca, elso requires Iha epplicant for such permit
to file a signed statement Ihat ha or she is Iicensed pursuem ro the provisions oi ihe Contracbrs License Lew (C�epter 9(commencing with Sectlan 7000) of Divislon 3 of the
Business entl Professions Cotle) or that he or 5he 19 exempt ihorelrom entl tne basis Por the ellegad eaemption. Any violation of Sectlan 7031.5 by eny epplicant for a pertnit
sub�ects the epplicent to e civil panelry of not more then five hundred dollers ($500).):
❑ I, es owner of ihe properry, or my employees wl�h wages es their sole compensation, WILL DO TME WORK, end the structure Is not intentletl or oHeretl for sale (Sec.
7044, eusiness and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves ihereon, and who Ooes such work
himself or herself or Ihrough his or her own employees, provided ihat such impwvements ere noi Intendetl or oflered lor sale. It, however, the builCing or improvement is
sold wilhin one year of completion, the owner�builder will heve the burtlen of proving ihat he or she did not build or improve for purpose of sale.). '
❑ I, a5 owner of the properry. em E%CWSIVELV CONTRACTING WITH LICENSED CONTRACTORS lo construct the project (SecJ044, Business entl Pmteuions
Cotla: The contractors License Lew tloes not epply to an owner of property who builtls or Improves thereon, and who con(racts lor such project wilh e wntrector(s)
license pursuant ta the Comracrors License Lews.).
❑ I am exempt undar sec.
Signature:
Owner ID verilietl by tlriver's license. ❑ Ves ❑ No
BuSinesS end PrOfeuion5 Code tor this reeson:
Verificatlon ol Ownership by (type ot dacument, i.e. - propeny tex �ill or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
Driver's License No.
Date:
Eapires:
❑ I hereby cartity thet no ezcevation five (5) or more feei in dep�h into which a person is requlred to descend, will be made in connection with work authorizetl by Ihis
permiL and that no building structure, scaflolding, falsework, or demolition or tlismantling t�ereol, will be more than ihirry-six (38) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title B, Calibmia Adminis�rative Cotle).
❑ As owner-builder, I will not employ anyone to tlo work which would require a pertnil Irom ihe Division of Industnal Sefery, as notetl ebove, unless such person has a
permit to do such work tmm ihe division.
Signatura: Date:
Division of Industrial Setery Partnit Numbec
CERTIFlCA7E OF COMPLIANCE AND AUfMOR¢AT10N OF ENTAY: I cenify under penalry ol perjury that I heve read this applicetion and stete thet the infortnation given is
correcL I agree to comply with all slare laws and ciry ordinances relating to builtling consiruction, antl au�horize representatives of �he Ciry ol Coste Mesa to enter upon t�e
ebove-descnbed property for inspeciion purposes. I egree not to occupy or allow occupancy ol eny building authonzed by Ihis pertnit unlil finel inspection.
to6e �. INSiELTIONflPE
1616 Fixad System Final Fire Prevention
1266 Pool Spa Finel
200 Finel Re-Roof
201 Flnel BIocWRetaining Wall
202
203
204
Final Fectory Fire Place
Finel Sign
Final Demolltion
��a�cs,
Applicant
pL7E ��
�� �a,a
ate
CO�E I INSPECTIONTYGE
206 Finel Mechanical
20B Finel Plumbing
210 Finel Electricel
212 Flnel Fire Prevention
220 Finel Planning Approval
222 Final Site
250 Finel Building/Occupancy
QE� 1[�!L$
(714) 754-5273 • Fax (714) 754<856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, GA 92626
MECHANICAL PERMIT
JobAddress: 2520 DUKEPL
Suite No
Vicinity:
Parcel Number: 14141246
Applicant: JACKSON, TIM
Address: 6441 BROWN CIRCLE
HUNTINGTON BEACH, CA
Owner: LONG, CROFT
Address: 2520 DUKE PL
COSTA MESA, CA
Contrador: QUALITY CONSTRUCTION CO
Address: 6441 BRpWN CIRCLE
HUNTINGTON BEACH, CA
Phone: 714-612-8460
Zip: 92647
Phone:
Zip: 92626
Phone: 714-612-8460
2ip: 92647
License: 569165
ISSUED BY:
Status: ISSUEO
Applied: 02/24/2004
Issued: 02/24/2004
SCOPE OF PERMIT
INTERIOR REMODEL TO INCLUDE: REMOVE EXISTING CEILING AND RAISE CEILING, KITCHEN
REMODEL, MASTER BATH REMODEL, NEW HVAC IN ATTIC AND RE-WORK DUCT WORK, DEMO
EXISTING 2-WAY FIREPLACE AND ADD NEW FIREPLACE IN CORNER OF LIVING ROOM. MISC
ELECTRICAL AND PLUMBING WORK. NO ADDITIONAL SQUARE FOOTAGE. REF: 804-00165.
MECHANICAL TO INCLUDE: INSTALURELOCATE FAU TO ATTIC, 1 FACTORY FIREPLACE, AND
1 KITCHEN HOOD.
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >100 k BTU
Repair / Alt Cooling/Heat
Inst I Rep. Recess Wall HV
Refrig Sys <100 k BTU
Refrig Sys >100 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhausl
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < 10000cfm
Air Handlers > 10000cfm
Floor Furnace
Floor or Suspend Heater
$23.50
$14.80
$0.00
$13.70
50.00
$0.00
$0.00
50.00
$10.65
$10.65
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
FEE SUMMARY
Repair / Alt Absorbtion Unit
Repair / Alt Refrigeration Unit
Ventillation System
Evaporative Cooler
Commercial Incine rator
Domestic Incineretor
Comoressors / Absorptlon Systems
Uplo3hp/100kBTU
3To15hp/500kBTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750,BTU
Boilers
Upto3hp
3To15hp
15to30hp
30 to 50 hp
Over 50 hp
Other Mechanical Fee
Investigation Fee
Quantity
$0.00 0
$0.00 0
$0.00 0
50.00 0
50.00 0
$0.00 0
50.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord: No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced wlthin 180 days, or if work is suspended or abantloned
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
� requlrBd Inspeations end finel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2a646 (fl�00)
WORKERS'COMPENSAnON DECLARAnON:
I hereby affirtn untler penalry ot perjury one oi ihe lollowing declarations:
1 heve end will maintein e certifiwte of conseni to self-Insure tor workers' compensation, as provitled for by seMion 3700 0l the Labor Cotle, tor the peAormance ot the
wark tor which I�is permit is issuetl.
ave and wlll meintain workers' compensation insurance, as required by soction 3700 oi the Lebor Code, lor t�e peAortnance of the work for which Ihis pertnit is issuetl.
y workers' compensatlon Insurence cerner end policy number ere:
Carrier: Policy Number:
(Thls secfion need nof be comp/ered i! the permit is valued et ane hundred dallnrs ($100) or less.)
❑ I cenity that in the pertormence of the work tqtwIpch Ihis permit is issued, I shell not employ eny person in any manner so es�to become subjact ro the workars'
compensatlon lews ol California, end agr e'f� 11 shoultl become su6�ect to the workers' compensatlon provisions oi Secti n 3J00 of ihe abor Code, I shell lorthwith
comply with these Droyieio� �
Applicant Signature: � i� �� Dete:
WARNING FAILURE TO SECURE Vj� RKERS' MPENSATION WVEPAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CiiIMINAL P NALTIES ANO C IL PINES P TOONE HUNDRED
THOUSANDDOLURE(5100,000),INADOITIONTOTHECOSTOFfAMPENSATION,OAMAGESA$PROVIDEDf-0RINSEC710N3]O60FTMELABORCADE,INiEREST,ANDA ORNEV'SFEES.
LICENSED CONTRACTORS �ECLARATION:
I hereby aNirm that I am licensetl under pro �'�f
forca end ettect. Lic. N_-- J�
ContractaYs Signature:
CONSTRUCTION LENOING AGENCV:
Chapter 9(cammencing with Section 7000) of DiNsion 3 of the Business and Profes ions Cotle, antl my Ilcense is in tull
Class # � 1
� Date: __ _�. 1_�. n 1 n
❑ I hereby aXirm that ihere i5 8 con5truttion lending agenty For Ihe perfOrmante ot Ihe work tor which this pertnit is i55ued. (Sec. 3097, Givil Code).
Lenders Neme: Lentler's Atldress:
Signature:
OWNER•BUILDER DECLARATIONS:
Date:
I herehy eNirm �hat untler penalty of Derjury ihat I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, 8usineu entl Protessions
Cotle: Any ciry or county which requires a permit to construct, alter, improve, demolish, or repeir eny stmcture, prior to its issuance, also requires ihe applicant for such pertnit
to file a signed stetement ihat he or she Is Iicensed pursuant to the provisions of the Contrectors Llcense Lew (Chapter 9(commencing with Sectlon 7000) ol Dlvision 3 oi the
Business end Professions Code) or thet he or she is exempt therefrom end the basis lor ihe ellaged exemption. Any violation oi Section 7037.5 by any applicant lar a permlt
suhjects the applicent to e civil penalty of not mora then five hundred dollers ($500).):
❑ I, as owner of the property, or my employees with wages as iheir sole compensatlon, WILL DO THE WORK, entl the structure is not intentletl or ottered tor sele (Sec.
7044, Business antl Professlons Code: The Contractors License Law does not apply to en owner ot propeny who huilds or improves thereon, and who does such work
himself or herself or ihrough his or her own employees, provided ihat such improvements are not intendetl or oHerea tor sale. If, however, ihe building or improvemam Is
sold within ona yeer of comDletion, Ihe owner-builder will have ihe burden of proving thet he or she did not huiltl or improve for purpose ot sale.). '
❑ I, a5 owner of lhe property, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business and Prolessions
Cotle: 7Te contrecmrs License Law tloas not apply to en owner ot pmpeny who bullds or Impmves thereon, end who contrects for such project with e contractor(s)
licanse pursuant to the Contractors License Laws.).
❑ I em exempt under sec. Business antl Professions Cotle for this reason:
Signatura: Date:
Owner ID ventiatl by tlriver's license. ❑ Yes ❑ No DnveYs License No.
Venfication ot Ownership by (type of tlocument, i.e. - property tax bill ar tleetl):
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hareby cenily thet no excavation five (5) or more feet in depth imo which a person is requiretl Io Oescen0, will be matle in connec�ion with work authorized by Ihis
pertnit, end that no building slrucWre, scattolding, lalsework, or demolitlon or dismantling Ihereoi, will be more than thirty-six (36) feet high. (C�ap. 32, Grp 2, Ar12, Sec.
341, Title 8, Califomia AdmlNs(rative Code).
❑ As owner-bulltler, I wlll not employ enyone to do work which would requlre e permit fmm lhe Dlvision ot Industrial Satety, as noted above, unleu such person hes a
permit to do such work Irom the division.
Signature: Date:
Divisian af Industnal Salery Pertnit Number:
CERTIFICATE OF COMPLIANCE AND AUIHORVA710N OF ENTAY: I cenity under penelty ol perjury that I have read this application and state �hat ihe information given i9
correct I agree to comply wlih ell ste�e laws end city ordinences relating to building consiruc0on, entl euthorize represantetives of Ihe Ci�y ot Cosia Mese lo enter upon Ihe
ebove-descnbed property lor inspec�ion purpases. I egree no� �o occupy or ellow occupency of eny building authorized by ihis permii until finel inspection.
�/��ture Of Legal Owner(s)
And/OrAuthonzed Applicent
7
COpE t. INSPECTIONTYPE Ij9jE IIi�9LS
1616 Fixed System Finel Fire Prevention
1268 Pool Spe Finel
200 Finel Re-ROof
201 Final BIocWRetaining Well
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
COOE I INSGECTION TYPE
206 Final Mechanical
208 Final Plumbing
210 Final Electdcal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final eullding/Occupancy
�� �
(714) 754-5273 • Fax (714) 754-4866 • www.ci.costa-mesa.ca.us 7I hA1H UFINt, GU51A MhJA, l:N tl[tiZ0
PLUMBING PERMIT
lob Address: 2520 DUKE PL
Suite No
Vicinity:
Parcel Nunmber: 1414�246
Applicant: JACKSQN, TIM
Address: 6441 BROWN qRCLE
HUNTING70N BEACH, CA
Owner: LONG, CROFT
Address 2520 DUKE PL
COSTA MESA, CA
Contractor: QUALITY CONSTRUCTION CO
Address: 6441 BRpWN CIRCLE
Arch / Eng :
Address:
ISSUE FEE
BackFlow irrigation
BackFlow Prevenler
Bathtub
Clanfier Syslem
Connect Qce,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
HUNTINGTON BEACH, CA
Phone: 714-612-8460
Zip: 92647
Phone:
Zip: 92626
Phone: 714-612-8460
Zip: 92647
License: 569165
Phone:
Zip:
License:
ISSUED BY:
Status: ISSUED
Applied: 02/24/2004
Issued: 02/24/2004
SCOPE OF PERMIT
INTERIOR REMODEL TO INCLUDE: REMOVE EXISTING CEILING AND RAISE CEILING, KITCHEN
REMODEL, MASTER BATH REMODEL, NEW HVAC IN ATTIC AND RE-WORK DUCT WORK, DEMO EXISTING
2-WAY FIREPLACE AND ADD NEW FIREPLACE IN CORNER OF LIVING ROOM. MISC ELECTRICAL AND
PLUMBING WORK. NO ADDITIONAL SQUARE FOOTAGE.�REF: 804-00165.
PLUMBING TO INCLUDE: 1 GAS (1-4 OUTLETS), 1 SHOWER, 1 KITCHEN SINK, 1 WASH BASIN.
AMT
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
FEESUMMARY
qTY AMT
Laundry Tub I Washer 50.00
0 Landscape Irrigation $0.00
0 P-Trap $0.00
0 Pressure Regulator $0.00
0 Process Piping (per 10 ft) $0.00
0 Receptors $0.00
0 Septic Tank $0.00
0 Sewer Cap for Demo 50.00
0 Sewer Connect $0.00
QTY
0
0
0
0
0
0
0
0
0
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr Bkflow(1-4)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Sel
Waste and Vent System
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$9.80
$0.00
$0.00
�N
0
0
0
0
0
0
1
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California siatutes and related
regulations. (Ord. No. 92-28, § 1, 12-27-92)
EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 1B0 days, or ii work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for ihe work authorized under this permit to be consideretl legal, such work must comply with all applicable codes, and ell
requlred Inapectlona and Iinal approval must be obtained. Fallure to obtain inspections and final approval will result in the axpiration of this permit.
FOR INSPECTIONS CALL: (774) 7545626
2a6-48 (fl�W)
WORKERS' COMPENSATION DECLARATION:
I hereby attirm under penalty ot perjury ona of the following tleclara�lons:
❑ I have entl will meintain e certificate of consent ro sel4lnsure lor workers' Compensetion, es providetl for by saction 3700 of Ihe Labor Cotla, tor the peAormence of the
�, /�w,ork for which this permit is issued.
�I have antl will meintain workers' compensa[ion insumnce, as requiretl by section 3700 of tha Labor Coda, for Ihe pedortnance of Ihe work for which �his pertnit iSlssuetl.
My workere' compensatlon Insurence carrier antl polity number are:
Cartier. Policy Number:
(lhis section neetl nof Oe comp/eted I! fhe permit is valued a( one hundred dollers ($100) or less.)
❑ I certify Ihat in Ihe peAormance of ihe work for which this permit is issued, I shell nol employ any person in eny manner o as to become subject to lhe workers'
compensetion laws of Califomis, and e at it I s�ould Uecome suDjec� to the workers' compensation pmvisions of actlon 37 ot the Wbor Cotle, I shall foMwith
wmply with these pr�rieiort . �
Appliwm Signawre: � Date:
WARNING: FAILURE TO SECUR ORKE COMPENSATIIXJ COVERAGE IS UNL4WFUL AND SW1LL SU6IECT AN EMPLOYER TO CHIMINAL PENALT ES AND L FlNES UP TO ONE HUNDRED
THOUSANDOOLLARE�S100, ,INADDI IONTOiHECOSTOFCOMPENSATION,DAMAGESASPROVIDEDFORINSECTION3l060FTHELABOqCODE,INTEREST,ANDA170RNET"SFEES.
LICENSED CONTRACTORS DECLARATION:
I herehy aKrm that I am licensed untler pmvisi<
brce entl eNecl Lic, a_-----�
Contractors Slgne[ure:
CONSTRUCTION LENDING AGENCY:
(commencing wilh Section 7000) of Division 3 of the Business and Profe�sians Cotle, �ntl my license is in tull
Class a �
Date:
❑ I herehy affirm that there is a constmction lending agency for Ihe pertormance of the work lor which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name: Lender's Atltlress:
Signature:
OWNER-BUILDER OECLARATIONS:
Date:
I hereby attirtn that under penelry ot perjury that I am EXEMP7 FROM 7HE CON7RACTORS LICENSE LAW tor Ihe following reason (Sac. 7031.5, Business entl Professions
Code: Any ciry or counry whic� requires a pertnit ro construc6 alter, improve, tlemolish, or repair eny sWCNre, prior to its issuence, elso requires the epplicant tor such permit
to file e signed stetement Ihet he or she is licensed pursuant to the Orovislons al the Contrectors License Law (Chapter 9(commencing with Section 7000) of Division 3 oi the
Business end Pmfessians Cotle) ar that he or she is e:empt thereirom and ihe basis for the alleged exemption. Any violetion ol Section 7031.5 by eny applicant for e pertnit
subjects the epplicant to a civil penalry of not more ihan Ma hundred Aollars (5500).);
❑ I, es owner of Ihe propeny, or my employees wlth wages as their sole compensetion, WILL DO THE WORK, and ihe sWcture Is not Intentletl or oHared for sale (Sec.
7044, Business and Professions Code: The Contractors License Law tloes not apD�Y �o an owner of property who builds or improves Ihereon, end who tloes such woM
himsetl or hersetl or t�rough �is or her own employees, providetl thet such Improvements ere not Intended or oHered for sele. If, however, the building or improvement is
sold within one yeer oi completion, tha owner-builder will have the burtlen of Omvinp that he or she did no� build or improve for purpose ol sale.). '
❑ I, es owner of ihe property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construcl the projact (Sec. 7064, Business antl Profeulons
Code: The coniractors Llcense Law does no� apply Io en owner ol propeny who builtls or Improves thereon, antl who contracts tor such pmject with a contractor(s)
license Dursuant to the Con�rectors License Lews.).
❑ I em exempt under sec. Business antl Profeuions Code lor this reason:
Signature: Date:
Owner ID venfiad by drivers license. ❑ Yes ❑ No Drlvers License No.
Veritication of Ownership by (type ol dwument, i.e. - pwperty tac blll or deed):
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby cenity thel no excavetion tive (5) or more feet in depih into which e person is required to descend, will be made in connectlon wlih work euthonzed by Ihis
permit, antl that no bullding sWcture, scaftolding, talsework, or demolltion or dismantling thereof, will be more than thirty-six (36) feet high. (Ghap. 32, Grp 2, Ar12, Sac.
341, 71I1e 8, Celllomia Admini5irative Code).
❑ As owner�builtlar, I will not employ anyone to do work which would require a Dermil from ihe Oivision of Industnal Safery, as notetl e6ove, unless such pereon has e
pertnit to do such wark tram ihe division.
Signature: Date:
Division ot Industnal Safery Permit Number:
CERTIFICATE OF COMPLIANCE AND AUiHORIZA710N OF EMRV: I cenify under penelty of perjury �hat I have read this epplication and stete Ihel �he information given is
correct. I agree to comply wilh all stete laws ena city ordinances rela�ing to bullding consiruction, and authodze represen�atives of the City ol Caste Mesa to enter upon the
ebove-descriDed property for inspection puryoses. I egree not to wcupy or ellow occupency of eny building authorized by ihis permit umil linal inspectian.
COUE I, INSPECTIONTYPE
7616 Fixed System Final Fire Prevention
726fi Pool Spe Final
200 Finel Re-Roof
201 Final Block/Retaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
b7.11�
�$ �Qp�( INSPECTIONTYPE
206 Final Mechanical
20B Final Plumbing
210 Final Electrical
212
220
Final Fire Prevention
final Planning Approval
222 FinalSite
250 Final Building/Occupancy
PAg L�ELS
_ • �\ ►
(714) 754-5273 • Fax (714) 754-4856 • v+ww.ci.costa-mesa. BUILDING PERMIT n FAIR DRIVE, GOSTA MESA, GA 9262s
Job Address: 2520 DUKE PL
Suite:
viciniry:
Parcel Number: 14141246
Applicank JACKSON, TIM
Address: 6441 9ROWN CI
HUNTINGTON BEACH, CA
Owner: LONG, CROFT
Address 2520 QUKE PL
COSTq MESA, CA
Contractor. QUAI�ITY CONSTRUCTION CO
Address: 644'I BROWN CIRCLE
Zoning:
Phone: 714-612-6460
Zip: 92647
Phone:
Zip: 92626
Phone: 714-612-8460
ISSUED BY:
Status: ISSUED
Applied: 01/14/2004
Issued: 02/24/2004
HUNTINGTON BEACH, CA
Zip: 92647 License: 569165
Arch : Eng: SHUCRI YAGHI
Address: Address: 112 E CHAPMAN AV
Phone: SUI7E C Phone: 714-7443676
ORANGE,CA
Zip: License: 92866 � License: C43205
SCOPE OF PERMIT
INTERIOR REMODEL TO INCLUDE: REMOVE EXISTING CEILING AND RAISE CEILING, KITCHEN REMODEL, MASTER BATH REMODEL, NEW
HVAC IN ATTIC AND RE-WORK DUCT WORK, DEMO EXISTING 2-WAY FIREPLACE AND ADD NEW FIREPLACE IN CORNER OF LIVING ROOM.
MISC ELECTRICAL AND
PLUMBING WORK. NO AUDITIONAL SQUARE FOOTAGE.
RE-ROOF EXISTING HOUSE, RE-SHEATH AND COVER WITH 30 YEAR COMP.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspectian:
Total
$509.44
$783.75
$7.00
$0.00
$0.00
$0.00
$1,300.19
SETBACKS
MAIN STRUCTURE Front 20- 0
ACCESSORY Front 0- 0
Rear 20-0
Rear 0-0
FEE SUMMARY
Calc Valuation: 370,000.00
Claim Valuation: S�o,000.00
PLANNING & ZONING
Left S 0 Right
Lefl 0- 0 Right
SO
NOTICE: The woric authorizetl by this permit shali comply with ali applicable handicap access requ'rrements under California statutes and related �
regulations. (Ord. No. 92-28, § 1, 12-21-92) i
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 7B0 days, or if work is suspended or abandoned II
for a period of 180 days. i
INSPECTIONS: In order for the work authorized under ihis permN to be considered legal, such work must comply with all applicable codes, and all
requlred Inapectiona end Iinal approval must be obtalned. Failure to obtain inspections and final approval will result in the ezpiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
244&68IW00)
WOHKERS' COMPENSA710N DECLARATION: '
I hereby attirm under penelry of perjury one of lhe following tleclara�ions:
❑ I heve end will meintain e certificete of consent to self-Insure for workers' compensation, es pmvidod tor by section 3700 of ihe LaDor Code, for the peAormance of the
�work for which this permit Is Issuetl.
have end wlll maintain workers' compensation insurance, as requiretl by section .f70Gof Iheiabor Code, for Ihe peAortnance of the work for which this pertnit is issued.
My workers' compensetian Insurence carder entl policy number are:
Carner. Policy Number:
(This section need not be camplefed ll fhe permitls velued ef one hundred dollers ($100) or less.)
❑ I certiry t�at in the pedormence of the work f hich ihis pertnii is issueQ 1 shall not employ eny Derson in eny mannar so as o become subject to the workars'
wmpensetlon laws ot Calibmle, antl egr t t If 1 should bacome sub�ect to ihe workers' compensatlon provislons of Secti n 3700 oi t Lebor Cotla, I sha0 torthwlth
comply with Ihese provisio . � /.��
Applicant SigneWre: De�e: U
WARNING FAILURE TO SECURE KERS' �MPENSAiION COVEfiAGE IS UNLAWFUT AND SFIFLL SUBJECT AN EMPLOVER TO CRIMINAL NALiIES AND CML , NES UP TOONE HUNDRED
THOUSAND Oq.L4RE (5100,000), ADDITI� TO THE COST OF CAMPENSNTION, OAMAGES AS PROVI�EO FOR IN SECiION 3]O60F THE LABOP CODE, IMEREST, AND AiTORNEI^S FEES.
LICENSEDCONTRAC70R5
I hereby aHirm Ihal I am lic�
force entl ettect Lic. a_
Comractofs Signamre:
CONSTRUCTION LENDING AGENCV:
9(commencing with Section 7000) of Division 3 0l the Business and Profeuions Code, antl my license is in tull
Cless q � 1
❑ I hereby aflirtn that ihere is e conswction lending agency for Ihe performance ol the work tor which this pertnit is issueQ (Sec. 3097, Civil Codej.
Lendels Neme: Lender's Adtlress:
Signature:
OWNER-BUILDER DECLARA710NS:
Date:
I here6y aNirm Ihet under penal�y of perjury ihet I em EXEMP7 FROM THE CONTRACTORS LICENSE LAW for the following reeson (Sec. 7031.5, Business end Professlons
Cotla: Any ciry or counry which requires e permit to construct, alter, improve, tlemolish, or repair any structure, pnor to its issuance, also requires the applicant tor such permit
to tile e signetl statement that ha or she Is Ilcensed pursuent to the provisions of ihe Contractors Llcense Law (Chepter 9(wmmencinq with Sectlon 7000) of Divisian 3 ai the
Business and Protessions Code) or Ihel he ar she Is exempl iherefrom end the basis for the elleged e:emption. Any violatlon ot Section 7031.5 by any epplicent For e permit
subjects the apPlicent to e civil penalry of not more then tive hundred dollers ($500).):
❑ I, as owner ol ihe propeny, or my employees with weges es their sola compensation, WILL DO 7ME WORK, and Ihe siructure is not intendetl or oHeretl for sele (Sec.
7044, Business antl Professions Code: The Contractors License Lew doos nol apply to en owner ot propehy w�o huilds or improves Ihereon, and who does such work
himself or herself or ihrough his or her own employees, provided ihat such improvements are not Iniendetl or oHered tor sale. If, however, ihe building or improvement Is
sold within one yeer ot completion, the owner-builder will have ihe burden of proving Ihat he or she ditl not builtl or improve for purpose ot sele.). '
❑ 1, as owner of the property, em EXLLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business and Protessions
Code: The comractors License Law does not epply to en owner of pmpeny who builds or Impmves thereon, entl who contracts for such pro�ect wlih e comremor(s)
license pursuent to ihe Contractor5 LiCense Laws.).
❑ I em ezempt under 50t. Business end Professions Code for Ihis reason:
Signature: Date:
Owner ID venfietl by tlriver'S liten58. ❑ Ves ❑ No Onvers LitenSe No. E:pire5:
Verification oi Ownership by (type of documenl, i.e. - pmperry tau bill or deed):
OIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certity ihat no excavation five (5) or more feet in depih into which e person is requireC to descend, will be made in connection with work authonzed by Ihis
permit, en0 �hat no buildinp sirucWre, swHolding, falsework, or demolition or dismamling thereot, will be more ihan thirty-six (36) feet high. (Chap. 32, Gry 2, Ar12, Sec.
341, 7tle 8, Celilornia Administrative Code).
❑ As owner-builder, 1 will not employ anyone to do work w�ich would require e permi� trom the DlWsion ot Indusirial Salery, es noted above, unleu such person hes e
pertnit to do such work irom the division.
Signeture: Da�a:
Division of Intlustrial Sefery Permit Num6er:
CERTIFlCATE OF COMPLIANCE AND AUTHORRATION OF ENTTiY: I certify under penalry of perjury thet I heve reaC this application and state that the information given is
correct I agree b comply with all state laws antl ciry ordinances relating to 6uilding consWction, entl eu�honze representatives ot Ihe Ciry of Costa Mesa to enter upon the
ebove-descnbetl property for inspection purposes. I agree not to occupy ar allow occupancy of eny building eu�hodzed by this permit until finel inspection.
CODE �.
1616
1268
200
201
202
203
Fizetl System Final Flre Preven�ion
Paol Spe Finel
Finel Re-Roof
Flnel BIocWRetaining Wall
Final Feciory Fira Place
Final Sign
204 Finel Demolilion
7 ,y ��oare
�—� � Date
CODE 1 INSPECTION TYPE
206 Final Mechanical
20B Finel Plumbing
210 Finel Elecincal
212 Finel Fire Prevention
220 Finel Planning Approval
222 Final Site
250 Final Builtling/Occupency
P.sIE I[�Lfl
�
,
ADDNE55 OFBNLqNO;,
OWNEAS IUYE IF IP10WN:
wowesx
�vx. iumaa �oo�ss:
�PCNRECT OH E1M1101NNEFA:
NCFL ON ENO: S ADURESS:
20 DUKE PL
G, CROFT`- -
0 DUKE PL
TA MESA,CA 92626
uc xo:
mNmACTws xu�:
carm�croxs �uinio
�onecss: uc uo.:
uxr: /7'"' CITY OF COSTA MESA - HUILDING PERMIT
PERMIT NO: B 087137 PLAN CHECK NO: 00792-98 S
CONSTRUCTION TYPE: PERMIT TYPE: STR
UMT:
urar:
LlCEN4ED COMN�CTOXS OEClAX11TON: I IimeEy ertim uiMs perely d ps�uy tlut I am licemed uMx pwma�e tl Cheqx 9
(mmmmd^0 wGh Section ]OD0) d Oiwion 3 W Ne Busroea ak P�deadms COM. eM mY limnee o in hA lau vd sllm.
cmuc.No.: uc.cuss: uc.No.: EXP:
IOWNER BUIlOEP OECIARRTON: 1 hereby dfirtn uMer pmNy d perjiry �hm I em a�emp Imm IM CaMredm Lioenee Lew la �he
Idlawmp roeaon (Seaion )0�1.5 Bueiwee eM Pmleaeione Cade: Airy ciry a counry Miich raqui,ee a permil �o oonnruct all«, Improva,
� demole�, or npei eiry sl�uc�ure, pnor W ila eeueMa, e6o requiree iha epplicent lor euch pamin to fils e aynoE etetemeM ihel M m eM
u licemsd Wn�� �o Ihe provitima d Ne CoMrepon Licerue Lew [Chepm 9(oommeia�q wi�h Setlian'lWO) d 0'vuion � d ihe
Bueire�e enE holwionn CaEel a Ihet he a+he u eaemq tMralmm end the beau ta Ihe albpaE ewemqion. My vidmion d Saaian
)W I.5 by enY eVG��� lor e permn abptlf IM epplicanl lo e dvil perielly d iwl mae �hen Me huM�ed EdWe �5500�.
�] I, ea ov,xr d ihe proparlY or my empbyees wih wegee av Ihei wb eanpeneelion, xill Eo Ihe wak, end IM svueiun a ew� intendeE
or ollereE br eele (Seciion )0«. Budnaae end Prolesaiona Code: The Comrenon Licensa lew tloea �wt epplylo en oxnerd popeM
wM Wida or inpovee IM1erean. eM Wa Eoea �ucM1�w'ak NmeW «Mreell a Nraph he n her oxn empbysu. pandeE IhM tuch
impwemenu ue M imeMed aWaeE Iw eeb. tl; howewr, iM b ldi�q «inqwanam u sald wn�in ana yeerW compMion, Ihe
owMrbuiNar r.iil Aeve tM OUNm d pmvq he ar ehe Etl M buJd a impwe la IM puepae M ulal.
� I. es owiw d �M O�M. � extlueiveF/ contrmip vAh IicmeeE conlrectae m mmbW IM qojetl (Sepun )041. Busi�w+� W
Prdeasiane Cade: TM Conlradon Lieenae lew doea �wl xpqy �o en o�mer d popeity w1w WiNe a impavm tAraan eed Ma
conlrecb br u h p�qwa wn� s mnlredor�e) Icen.W punuen� to the Canumws Liu�ua Lewl.
� I em eremq uMx Sea'vc B. �P.G.. M W I/
�w Uale: �'Z%�.-.Gifr .Ormer: Ia� �/�1'
J ti�
1 Eo MreM nMY Nu I em ewere d enE urdastad tln nW'vamaNa d Cellomie IlaaEh ud SNnY COEe Setliom 25505.25SU. ud
255],. W Nel I a eny Mure diMnq moryeni WI / xd mi (ade un) need ro wmWV wiA uid ma mdu ud �M mpuinmam br
aoxmalnm�umr�imamoGlTrdionkanNel�i�Y ���tria.RmkevielmnbuaionappiretiwneneiemqhanNne
om.: �oa�:
WOPKER'SCOMPEN4�TONOECI�P�TION:IMaEydf uMxpmel�ydprjuymedtlrlaWwinpAetivatbm:
❑ I hm eed xil nuNen. eaYfrn. d oanenl to utlarwrs b workae' eamD��. o nw'� la M Smion 3l0o a ilr leEar
Cade, ln �M pMmnenca d tlw xM la which thu panN u uvued.
❑ i n..�..�e wa meime:i wo��.� c�c«�mon In.,reMe. m�.a��rea M s«aian aroo a ine �.n« cod.. b m. w�ro,� d m.
wpk Iw wliich Ihn paimn e e�ueE. My wakxe' wmpen�ettion inaurar�ca mnir erd pdiry number era:
Cema:
Polry Numbr:
(m;s ssalon new �rol a mmweroe r rn. w�� n �a aro n�naree aarers /s,wl or bss.)
� I cMAy Nel in Ihe peAmrerce d the wak la whch ihia peimi� is paueC, I ehell m� employ eny penon in siry menrier �o s� lo
becpne eubjea io IM woMrs canpenaeiion kxe d CelGomu, eM epres Nel il I elwuk bxaro wbpd io IM worken'
canDa�tion pow'wn ol Swion �100 d iM Lebor Cade. I Jatl tanhrmh mmW wdh IMm p�wiiioro.
Deta: Apqicenl:
WamMp: Fellun ro��cun wotlrx�'rompxwtlon rov�rnp� b unlewN( antl ahl/ aubHct en wmp/oyn lo ctlM�ul pxuttlu entl
mm ��., w ro w�. n�.,e..a rno�nm eou,., lsia4aoaA m.rauw� ro m. �we o� �o�w�..�wn a�.�.. ., c��ea roi m
Sxtlon 3106 0l M� LeDoi Cob. Infwsa4 Nd �ttomq i Iw.
CONSTNUCTION LENDINO FOENCY: I MmW alfiim uMer penely d parj,ry iMt iMn 4 e mnmrvcion bMirp epency tor Ne
peAormeMe d ihe v.oM lor wM1iM Ih4 qrmY n 6eued (Swion 908). CM. C�.
LENOEF'S N1W E:
LENOEN'S AODFESS:
I cenM �� I Iwe raeE Ne appfrmian and qe�a tMl iM ebv+e iMwmmon u canan. l ep�ae to oomply rmh M ay erd ooumy adirwce�
ard e�ale lewa reklmp lo dnMvp rnW Wion eM MreEy eNla'¢e iepeeentelnm W Ilip tlly b mter �pon IM aEwe.menlianed popmry
�«��'�p�'�"�BRUCE HElfDRICK
(- ,�..,�rz—_I:ln�� om,: 2z't—R8�
sbw�� a o.�+ .�v�ao��co�vmo,
(5151d8.WP) Whae�-Buikip85elery;6reemFb:Ceiwy-APpifaN:Pink-Hevenue:OoWenmd-Nnmr
�-b�3DJ
PERM NO: B 087137
GOVT: N SDPP: N
PURPOSE: OTH
JOB DESCRIPTION : 139LF CITY STANDARD HLOCK WALL SQ FT: 139
CLAIM VALUE: 2,700.00 CALC—VALUE: 2,760.00 GROUP OCC: R-3 /
COMMENTS: CITY STANDARD BLOCK WALL
***it*it*+r*+r+r�eit*r*�rr*�r+r***+r*itit**it+ritit**�at**��r*�t�kat*�r�*�*at*�e****r*ie*+r*itr�t�t*�ritat*�*+rit
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 BUILDZNG --------
FRNT: FT IN REAR: FT IN FANT: 41 FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ• PROV: PARCEL; 14141246 ZNE: R1 AEF NO:
PLANNING N6TES> CONSTRUCT 139 L.F., 6' HIGH HLOCK WALL DIVIDED OVER THE
> TWO SIDES AND REAR PROPERTY LINES. '
if if ik if if if ik iF ik iF iE iF if if ik k!! ik if if if 1f if M if if ik iE 1E K 1f 1f if iF if N k M if if M iF ik 1F 1k ik 1F M K it iE if if iE %M 1k iF if 1f'If i{' 1F iF ik iF±f i! iF 1l� iE M if 1E iF M iF IF it
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T,S
ZONING APPROVED BY � IJ�� DATE: �==12-� �R.K
BUILDING APPROVED HY : DATE: /.�
APPLICATION ISSUED BY: DATE: z'�
iFMkikikikkiFifMikiFkkMiflEifiFiFMM MifiEMifKi4iFihit iEM
LEGALIZATION;N F E E. S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT_ 74.75 50
SMIP/NON—RES
PLAN 48.59 'i
ISSUE FEE '
BUILDING—DZV—> PERMIT ISSUE PL'AN—CHECK TOTAL PAID DUE
TOTALS----> 75.25 0.00 � 48.59 123,84 123.84 ,00
REVENUE DIVISION TOTALS--> COLI:E�CTED: 123.84 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
74.75 .50 48.59
% %
ik ik iE iF ik 1t it af 1E if if iF iE iF if ik ik iF i4 if 1k i4 iE M M M M ik i! ik Ik it iF M ik ik iF ik if 1f ik if'k iF ik 1! ik if iF M if if ik 1E k M it fF'IF 1E M k iF if iE 1E 1F 1F if if ik iF M ik iF ik if ik'14
I N D I V I D U A li/� F E E B R E A K D O W N
TYPE QTY D E S C R Z P T I O N UNIT COST TOTAL COST
SFA 139 RES—CONCRETE BLOCK WALL / FT. 20.00 2,780.00
END OF FEES
,� �� �
..� FEB 27 1998 �_
GITY QF COSiA MESA
�
• �-
CONSTRUCTION AND PLANNING ~ POOL & SPA
APPROVALS Permit # Date Inspector APPROVALS Permit # Oate Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steei Fieinforcement
`]c.q{1
�,�_�.-.,��3.;;EIecVical Conduit Utility-Undrgrnd. 54. Forms T
' �
V'4.�lectricai Conduit-Undrgrnd. 55. Electrical Bonding -T.
'-�;��tee1 Reinforcement 56. Rough Plum6ing & Press�re Test
� T 6.^-,Electriwl UFER Grnd. 57. APPROVAL TO COVER�GUNITE
cJ n. . �..
7:�ootings ..�//� _ 58. Electrical Conduit-Undrgrnd. �
$. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Structural FIOor System 67. APPROVAL 70 DECK
11 rProperty Sewer Line & House Connection 62. Backwash & ReceptorFinal
,�
12.'.5ewer Cap .� 63. Heater & Vent-Final
73. iioof Drains 64. Plumbing System � Firtal
14. Rough Plumbing � 65. Electricai•Fina�
15. Rough Electrical-Conduit �� 66. Solar SYstem-Final
16. Rough Electric Wiring 67. Fencing & Access AnProval
17. Rough Wirinq Sign 68. APPROVED FOR PLASTERING
18. Rough Elecv(ca��T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19.bRoyr�h Fjgatir9 &;-Ai( Condit��tiag m� .� m e'x: �-1 ^ R.f'WL?46PS"SSEQU1Fi£MEP4T c.
�� `:N�J ITI .R � �•
� J.^" � �c; ::: `S .-1 r. z� c.. t:
20.�;ou�ih f�ct +�/ F�e�lace �F ,.� � M � �* `� AP�O�?�� P�mit #�,=
21: uGt,s, ietr�$tru'ctu�,- s�..+ s .. r+ r�x � 701�Jndergroudd tiydro �k
�
22.-'Du4?s, entitetiny�.�• t �� ��J '� � �"'*'° 71. Prodsc','{�Pi� m as #� Oil
n �:�- e i a: � �-; #� . i P�}�-' k' �
23. ��ia ia o h est � ?l., x rn r �.� � H. « .: -,
�, � � �� � ;*:r !x0 � c� ,; �: . 72. Underground EiusFa. >.
24. floof Freming �^ y "� x ��'-� tt 73�. Undergmd. St0}''^�an ❑ Gas ❑ Oil
i .� x � a: m :�; �: � . � �
25.�io6iShE�athing N; �-i v �'7 � '+1 � t �d<Dvechead Hyd�7�
26'a'-Ba� Cei{ing (Str�oturall & MSn6coat O; ,� O >+ '��� 7�F�Drj�Ch ical � � � � � ��
27:`Framea� Fi�shi�g�` �'^°' c� �=� :" `'x l:, r� '
! �x �[�; � �F U.. >,x 76. Dry StaO�WPeSr-i .� �! N ; �
i w . .. �
c 28. Lathing�6�S�ingde� t7�F O:�• r I i � �. FIXEI�SS`ST�(M�FINPjL'" i1 ;;
:D �r S � F 'J .F u �r n, R .=• : .
29. Insulatiog .a •�.: �, q e S I I jx �$. FIRE PREV. P.Itd:4L � � :-1
30. DrywaIl��Mailing n* �- � x E- � K S a:�qLTFI DERf�EDUIR'EMENT
�. � i i� '1 K T
� 31. Plaster &ow�a•Coat� S � �',��"., •y. � ' � �" 79. FINAL;�tV§PECi10N ;; �:, -y
32.�Iectrira.CPoS�er hleter�Final � r�' �x u 861 F006CERTIFI�TE ISSt1ED� r,�
.. .- . . .- ° m . ti t �_����_�� J
• M ^ a �� ' �` t � , 1 '] /' qQ � � � �� �
33:=Pin� EI tri , , �:: (j�ptes:
� �". M :n. . .�� Y. %c � �.. /�(p,�G(!;(` �� � � �� �
34.�ina`E He.�tingy� Air.�Condiuoning ;r,-� Y> I � ,�: � � E�r:; i: - �,�,(��
.-y � i +.y ;� c +t � l
35.;�in�l G�Pipt+�Test,�*� ✓K '�i ?# "' � i fr ,.�....,`� bC y �., �"
� 36.�}ioo'f� or� nOPY yC` i cCC: �-y ^ t � I �+- '��] :ca+ k!�; i*t
:; 37.'Final'Fac�tory FireP�ace:: � F�" `�� � cJ I ,'��' a -L :*� r ���
_ C � r .
38.�ine�Pl�bin9 �. T+�J � �," � I '= ' �:
� i.. �, � ti
' 39.�Nater Service=Final�� z. � T '�� � � � '� '�' �: r•
c• _a �e c:3 W i I � i�^'f • k;r, .
' 40.;,�GasService- �nal � ' ' � ' �- ` "�
e nE•. ;*7 � x � ' ri F• aF i' <C
r
41. Solar pomesNcFinai n ' , �= [T' 'y � G' ; �' _+
E� �t x' Zi 'T.O iY. H p.- .. S
42. Backflow Prg�anter� v c,,..,:_ �� � J ' v j-; �p'� �,
r.. u �.
43. Backflow Irryation* >'x� i7 �� ��' � i� � '
::E �J *t? .^.
r• n� r. * � n ��� ,.. _ � n, . , �. . _,. ,.. „ . �
-04.� Landsca� Irngatioe Systertt,�,�, ..; �c .Z Ct = g g :n p^ r � �- -
- w. �. ,.
' ` � . .
45.:Sound Fitte'uation� '7 J •� ^ ! ! �T �T� +T'•x . C' �' '¢ • �^ x
�_ '}, x o sm + m �•: � �o •�-, �
;q6.'Handicap'Regulatio�is " .. ' `�' �' ' � �
s � ;* �iti� o n !:
�47.�INAL STRUCTURE & BUILDING �,%�A%YSI � ^ R � ^y w p
� K� �
48.�f, If�{i�L PLANNINGK . . � ' � I p :,; � � �; . ,
� •
-49. �Electric•Aelease to �dison � �� k�� +t •,��a t: -' '
r. .t: _ C O� -� w ^ o �
t ,�; ._ . � . . � .
�,T.>0.'Gas.�.Rele'dse to Sout{+em Califo�� Gas Co � � 5 = e x ^; .�
"51. CERTIFICA7E OF OCCUPANCY
No. Date
I�OTE
ADDITIONS, DELEfiONS, OR CORRECTIOfVS SHALL
BE APPBOVED BY THE PLF:�;�'i:'G DiV!3fGN
t�' �(�F� F >S _ - -- --
���e����
ciTv OF COSTA h.4ESA
pL1aNM�G DIV.
SIiBJECT TQ BLDG. DEPT. RE�.
BY`�(N�'" L DATE� ?
/3°r�f; 1� ' Gu yJu-
���G� `��
I �
N
z
, �
SURVEY OF L T LI�'E
MAY BE RE UIRED
�
W
W
¢
�
M
�dYOL1°�
11[�ID[MC[ 11[tID[MC[
� EDRKiC
Z_�2y 1��I�F
� STREET
2 5lq
DNISION QF B U1LDiNG SAEETY
CITY OF COSTA MESA
APPROVED
By— ��ti p� 2�2Z(�g
�sel ot plans aM �Ip�s MUST be k�t on �his job ffi e0 t6n�sand'1 is �lawful to
�rMSaf�ety,� �°�samewiUqNwr�tenP�ion6anAfeDhr'simo(&u7d'eig
��orm�p�,�,a�;r�au�swa�nrorn�n�aro �' �� I 3-1
of tha violalion of any provisions of any Cily of Custa Mesa Ordina�iiceory�d�or Sya� w.
AJ'l�"1�7f%Rr�N "
RFstDE*u€
- b
IIp10LMC[
W►.lE�
25z�, Dul�i
b
---. �^r�� �y �u�max�n �'�i Cecomy null and �roid i( the buiAing or
zM ma�lainc�) a!�, � K.; UEC �303 Id) wnhn 790 days ef issuante.
11[tID[MC[
Z � l-H
zScG, DUKt-'
TYPICAL 6�� CONCRETE BLOCK FENCE
Cement Coping Oot�onal —
Channel8lotk With 1-3/8�
Horixontal Top of all
Fences
For Fences 5' or Less
Ven. Bars 3/8"y5 at 4' �0" O.C. '
For Fences Higher Than 5'
Vert. Ban 3/8"Q at 32" O.C. �
Fill Celis Solid Wi[h Grout
Where Steel Oecurs
Reinforcing Steel Shall � �; �
Conform to Set.A-15-39 ' '
A.S.T..NI. i � �.
All Steel to be Lapped
24" or to Code
NATURALGRAOE
t WO 7/Il"¢ 14A115 �
CONTINUOVSTOP
6 BOTTOM
HOQIZSTEEL MUST BE TIED IN
PLAI'E AT TIME OF TRENCH
INSPECTION.
f
0
a x
� �
Y w
a =
a
>Z
> —
a
i �
w o
U F
z
w n
�
� � ��1
A � N
D^
F�—� W'IDTH
� SEE Cht[
� BELOW
D I 'e.
FOOTING REQUIREMENTS CHART �
GENERAL- NOTES
MORTAR; p�e part Plastic Cement, and
Three Pa�ts Sand
GROUT; One Port Cement Three ana
One Half Parts S`and
COPIN�: One Part Cemenl, Three
Parts Sond
CONCFETE: Weil M�xed 1:2-I/2:3-I/2
Max. of 7-I/2 Gol;cns ot
Water Pei Sack of Cement
GHOUT MAV BE POURED FROM THE 70P
OF TNE FENCE IN CELLS WHERE STEEL
OCCURS.
CELLSANDAREASOF HORIZON7ALPEIN�
FORCEMENT SHALL BE C�EAR, CLEAN &
FREE OF ALL MORTAR DEBRIS, ETC.
N (iF C4FTHTCOIH
i/J T�IE HEiGTH OF FENCE
�LOW BOTTOM OF FOGT�NG
WIOTH t4" . . . . 14�' . . . , 12-��.�.
THICKNESS 10��. . . . . . . . 10" . . . . . ,, 9,�'-" .
DEPTH OF EARTHTOOTH . . . 24" 20" . . �..'.�':r16'�. -.�.,
SPACING OF EARTHTOOTH. . 12' 14� . . . . . '. . -. 16� .
City of Costa Mesa, California .
Building Department �- ��� t�
�ati'YSED NOV.82
SCALE: I/2" = I'
� , .
12"
8 �. t. i:._ �:`..
1�2" �� •"�"1• �'
16' .
PARTY WALL AGREEMENT
�
THIS AGREEMENT, made and entered into this ��
�
� TZU ��, by and between C- lz-�� ��
hereinafter referred to as "LANDOWNER;' and �O�IS T��%�S
hereinafter referred to as "ADJACENT PROPERTY OWNER"
It is hereby agreed that a party wall will be constructed on the property line
between
252� c7ut��
Z S �� �-C� ��Ol�
rropenies�
day of
in ihe City of Costa Mesa, County of Orange, State of California, as per map recorded
in Book , Page of Miscellaneous Maps, in the office of the County Recorder
of said County. The party wall shall be permitted to encroach
IN WITNESS WHEREOF, the parties have entered into this Agreement the day.and
year first above written.
LANDOWNER
(Signat
C��-i Lon1f�
Name (Typed or Printed)
a52� ����� n��-c��
(Address)
S�aCl.r� � G-'�
S.; hsu- _ b<.k�- � 1� e-(-�-�
Y�"� r'-,.� '� Q.,.'JcK� a� i�� �"� T'�l
r�{/,�j iJ —`_ `M � (�
�/(�r'\ ' ��l^'Y ,� OV+�J �I, `- 1"-CYii. u1.
J
190Fa6 . Q �. : NC
ADJACENT PROPER O�
� �.
(Signature)
� �� �� �S A-o �iv� _.
Nam Typed or Printed) _
� �������1
(Address) (�
* Melissa J. Lippand
V Comm. A7022125
�� - ' NOTARY PUBLIC - CALIFORNII
' �(` ' �' ORANGE COUNTV
a • n� / Gpmm [xprtes June 28. 1998
Comm. #1022125 �-�- -
CAmm. E�pree June 28. 1988
PARTY WALL AGREEMENT
THIS AGREEMENT, made and entered into this 2��
�BT�uM� ��l t D, by and between L�� �N��
hereinafter referred to as "LANDOWNER;' and ��-�C \`�=��C(L
hereinafter referred to as "ADJACENT PROPERTY OWNER"
It is hereby agreed that a party wall will be constructed on the property line
between 2520
Z SZ�E p�tc�
in the City of Costa Mesa, County of Orange, State of California, as per map recorded
day of
in Book , Page of Miscellaneous Maps, in the office of the County Recorder
of said County. The party wall shall be permitted to encroach
IN WITNESS WHEREOF, the.parties have entered into this Agreement the day and
year first above written.
LANDOWNER
(��A�CT"-I"
CT� LoNf�
Name (Typed or Printed)
ADJACENT PROPERTY OWNER
_Z_�_�U�-� P �AC C� Z� 2. �
(Address) (Address)
S� t::� Jj- �•,�n {�rr:, c`
�'pyr� �{ QJc>►-
5�,. {o o-�� �.,ioSex=.bcC NOTARIZATION RE�UIRED
ie., ��'�C@ .re � J1��SLi ���a l.:P�� �
no�-� Py�;` �- �-��.,� a� ��9a �� c����� ��e.�
�. �;re, ,9�0.�:� �:� y/�{�
,
1 • J�\��
��.��� � _ �a�.�
Metissa J. Lippanc
Comm. p1022125
IOTARV PUBUC • CALIFORNI.
ORANGE COUN7V
Comm. Expirea June 28. t99B
�. ���`�n�
PARTY WALL AGREEMENT
THIS AGREEMENT, made and entered into this 2 5-
� �' 1 � � , by and between � �� ��N�
hereinafter referred to as "IANDOWNER;' and ����ar� i��R
hereinafter referred to as "ADJACENT PROPERTY OWNER"
It is hereby agreed that a party wall will be constructed on the property line
between
i��6ter
(Address of Ad,
day of
Z � l � ��v � L� �Cc{}t[ ' —
in the City of Costa Mesa, County of Orange, State of California, as per map recorded
in Book , Page of Miscellaneous Maps, in the office of the County Recorder
of said County. The party wall shall be permitted to encroach
IN WITNESS WFlEREOF, the parties have entered into this Agreement the day and
year first above written.
LANDOWNER
` ( gn tu�
�;z��� Lc�N/'7
Name (Typed or Printed)
ADJACENT PROPERTY OWNER
�
� i „ -Zd ���:�'�
(Signature)�—� �
,��� �-�
M+��ua�z �7zQ
Name (Typed or Printedj
2S Zv �cllt{� f�CfkC� 2�l � U�E 1=«tc�..
r (Ad_drfess() (Address)
5��2 J`� CW.N�Cn.I� rd" � _ _
�,,� �.� � �`. Meliss3 J. Lipp� a�4
,�__^�1�f��/ Comm. F1p��25 /;�
S'�p,f �'�-L7 `-"'� jv�`OS Cf ` tl'Z `� �`d : NOTApY AUBLfC • CpIIFORNIqW
1p�-�cs� ,-� �,�,� �'QQ(� NOTARIZATION RE�UIRED � � ORANGECpUNTY n
,�o�x� Camm. Expires June 2B. 1998 �
�'a.1 C,ro�-i-�,,-� •, �'h;�ht�el 2:�, • _
1906 46 �/\y��..y/`'��J
�� " '�V�\�.
DECLARATION OF ; ►UTHORITY , Bldg. Permit #
FOR AGENTS OF PROPERTY OWNER
TO APPLY FOR PERMITS
This Permit #
�-fJ� DVfLC pLhCC� PAtzC�Z. 14l - ill2 -4(� � f� t2 ZoZq BLIC tal'3E
' Street Address AP Number
t. I(we), ��� L� �� , declare that I am the Owner of Title
of the above referenced real property, and that I(we) hereby authorize:
�3�x� �-1-��« ��k s�6 tos7
Name Telephone No.
Z52L1 bvKe I�cAt�
Street Address
C Os�, Y�l
City
to obtain permits in my behalf, as ownedbuilder, for �WC1L �%1Al.L
at the above referenced property.
26Z
2. Should any person become an employee engaged in the improvement of the property, I(we) shall im-
mediateiy provide Worker's Compensation 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 per-
son, company or corporation.
4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any
claim resulting in damage or personal injury to myself or any other parties as a result of work authorized
by the permits from the City of Costa Mesa.
5. I declare under the penalty of perjury that the foregoing is true and correct.
�
Executed this � � � day of ��
C2o� �NE,
Primed Name
19�, at `�)S`T � ESA, California.
Zl��`If�
Da e
NOTE: This authorization does not grant authorization to perform the work as owner, it solely provides
for limited power of attorney to secure this permit in any behalf.
I .
� I • � �+l/�! � �`�
� I � ,
0779-46 (Rev. 2I91)
<- �� �3 �3�
�COSTA MESA BUILDING DEPARTMENT
P.O. BO% 31�
. COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
COSTA MESA, CALIFORNIA
MAIL 1555 Placentia
ADDRE55
c�Tv , ort Be ch
ARCHITECT SB�e
�OR F NEER
IADDRE55 Sgme
TEL.
NO.
LIC.
NO.
Const. Co cirr �ic. 1217
NO.
APPROVE�
2029 a�
�E�.� �or g6
pESCRIPTION NO.
A.P. NO.
SIZE �^ x �oo
OF LOT Ol/
BLOCK
;,,'. �t.:o�..� �.e._
a�ql��....
FI��;`,P:�E Gc?T.
C�l. �,r" ^r�n�rp at�(�i.
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
BUILDING
ADDRE55
COSTA MESA. CALIFORNIA
FIRE
ZONE
NO.OF BLDGS. O
NOW ON LOT
SETBRCtt LINE FROM c �]
cervreA oF srR[[r lO REAR YARD 4O
ISIDE YAR� RIGHT S �EFT S
DESCRIPTION OF WORK
NEW X A�TEFATION AODITION
REPAIq �MOVING DEMOLISH
SIZEDING �Sn� — ROOMS v STORIES 1
!
EXTERIOR WALL ROOF
COVERING RtVCCO COVERING WOOd shing
USE OF NEW
BUILDING Residence & att. garage
Flan 3—CR
CORRECTIONS
The Amount shown under valuaiion is for tice
STPTE TNsi THE nBOVE IS <ORRECT wN0 AGREE TO COMPLV WITH iLL r—r o- �-""^ •^ �^•!•
CITY ORDIN�NCES • $tATE LAW$ R GUI�TING BUILOING�CONSTRUC�
norv. VALUATION q
SIGNATURE OF PEFMiT FEE S JS.00
PERMITTEE 15 747�0� 17�SQ
� PLAN CHECK $
S
AUTHORIZED A NT TOTAL FEE S 52�5C
�eir
r