HomeMy WebLinkAbout2426 ELDEN AVE - Building Permits(714) 754-5273 • FaX (714) 754-4856 • www.Ci.COSfe-meSa.Ce.uS 77 FAIFI ORNE, GVSiA MESA, GA 92626
BUILDING PERMIT
JobAddress: 2426 ELDEN AV
Suite: E
Vicinity: UNIT E(NEW GARAGE & 2ND FL UNIT)
Parcel Number: 43929144
Applicant WINTER, WILLIAM JOSEPH
Address: 1905 FULLERTON AV #W
COSTA MESA, CA 92627
Owner: WINTER, WILLIAM JOSEPH
Address 1905 FULLERTON AV #W
COSTA MESA, CA 92627
Contrector: O W N E R-B U I LD E R
Address:
Zip:
Arch : ZACHARY SHAMS
Address: 2600 NEWPORT BL
STE 154
N.B. CA'
Zip: 92663
0
Zoning:
Phone: 949.548.4813
Zip: 92659-0903
Phone: 949.548.4813
Zip: 92659-0903
Phone:
License: 000000
Eng:
Address:
Phone: 645-7322
License: 5004
ISSUED BY:
Status: ISSUED
Applied: 12/23/2002
Issued: 02/21/2003
Phone:
License:
SCOPE OF PERMIT
CONSTRUCT A NEW 582 SF DETACHED 2-CAR GARAGE WITH TWO 300 SF CARPORTS ON EACH SIDE OF THE NEW GARAGE. A NEW 974
SF SECOND STORY UNIT WILL BE CONSTRUCTED ABOVE THE NEW GARAGE WITH A 95 SF BALCONY ON THE FRONT SIDE OF THE UNIT
AND A 90 SF DECK WILL BE
CREATED ON THE RIGHT SIDE ABOVE THE CARPORT. TWO DUPLEXES ARE EXISTING ON THE PROPERTY IN FRONT OF THIS NEW UNIT.
FIREPLACE ICBO #ER5335 REF: ZA-02-68
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$711.46
$1,094.55
$11.73
$0.00
$0.00
$0.00
$1,817.74
SETBACKS
MAIN STRUCTURE Front 10- 0
ACCESSORY Front 0-0
Rear 29- 6
FEE SUMMARY
PLANNING & ZONING
Left 10- 0
Rear 0- 0 Lefi 0- 0
Calc Valuation:
Claim Valuation:
Right 23- 6
Right 0- 0
3 t � 7.zszao
so.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permlt shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inspectiona and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (774) 7545626
2446C6 (N00)
WORKERS' COMPENSATION DECLARA710N: � -
I hereby ettirm under panalty of perjury one oi the following declarations �
❑ I heve antl will maintain a certifiwte of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the pertortnence ot �he
work for which this permit i5 iuuetl.
❑ I hava and will maintain workers' compensation insurance, as required by section 3700 of the Labor Coda, for the perfortnance of ihe work tor which this pertnit is issued.
My workers' compensation Insurance carner end policy number are:
Carnor: Policy Number:
(Thls section need not be.comp/eretl il rhe permit is velued et one huntlred dallers ($100) or less.) .
❑ 1 certity that in the peAormance of the work tor which Ihis permit is issued, I shall not employ eny person in eny manner so as to become subject to ihe workers'
compensetion laws of Califomia, end egree lhat if I shoulA bacome sub�ect to the workers' compensetion provisions of Seclion 3700 of the Lebor Code, I shall torthwith
comply with ihase pravisions.
Applicent Signature: Data:
WAqNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVEMGE IS UNLAW FUL AND SHALL SU&IECT Ml EMPLOYER TO CPIMINAL PENALTIES AND CIVIL FlNES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COA9PENSATION, DAhU1GES AS PfiOVIDED FOR IN SECTION 3]O60F THE LABOP CODE, IMEREST, ANO ATTORNE`fS FEES.
LICENSED CONTRACTORS DECLAFATION:
I heroby affirm Ihat I am licensed under provislons of Chepter 9(commencing with Section 7000) ot Dlvision 3 of iha Business end Professions Code, end my Ilcense is in tull
torca end eHect Lic. A Cless #
ContractoYs Signature: Date:
CONSTRUCTION LENDING AGENCV:
�❑ I hereby aftirm that ihere is a constmction lending agency tor ihe pedormance of Ihe work for which this permit is issued. (Sac. 3097, Civil Code).
Lender's Name: Lender's Aatlress:
Signature: Date:
OWNER-BUILDER DECLARATONS:
I heroby attirtn ihat untler penelry of perjury Ihat 1 am E%EMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or counry which requires a permit to construct, alter, improve, demolish, or repair any structure, pnor to its issuanca, also requires tha applicant for such pertnit
b tile a siqnetl statement ihet he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business antl Professions Code) or ihat he or she is exempt therefrom and the basis tor ihe alleged exemption. Any violation of Section 7031.5 by any epplicant for a pertnit
,,,s���,,,u!!!blects ihe epplicent to a civil penalry oi not more then five hundretl tloliars ($500).):
1� I, as owner of the propeny, or my employaes wlth wages as their sole compensa�ion, WILL DO THE WORK, and ihe simcture Is not intendad or otteretl tor sale (Sec.
'� 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of properiy who builds or improves thereon, and who tloes such work
himself or herself or �hrough his or her own employees, provitletl �hai such improvements are not intentletl or oflered tor sale. If, however, ihe builtling or improvement is
sold within one year of completion, ihe owner-builtler will have the burtlen ot proving ihat he or sha tlitl not build or impmve for purpose o( sale.). �
❑ I, as owner oi tha properry, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sac. 7044, Business and Professions
Cotle: The contractors License w does wt apply to an owner ol propeny who builtls or improves Iheraon, antl who coniracis lor suc� project with e contrador(s)
license pursuant to the Cont d rs Licgnse L�ws.)._
❑ I am ex t nd r
Signature:
Ownor ID ventied by driver5liC 58. ❑ Ves ❑ No
Business antl Professions Code for ihis reason:
Venfication ot Ownership by (rype of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PEfiMIT CERTIFICATION:
Driver's License No.
Expires:
❑ I �ereby certify ihat no ezcavation five (5) or more feet in depih into which e person is required to descend, will 6e made in connection with work authonzed by ihis
permit, and that no building simdure, scaflolding, talsework, or tlemolition or dismantiing ihereof, will be more ihan ihiny-six (36) teet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Ti�le 8, Calitornla Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit irom the Division of Indusiriel Sataty, es noted ebove, unless such person hes e
permit to do such work from the division.
Signature: Date:
Division ot Indusirial Satery Permi� Num6er:
CER7IFICA7E OF COMPLIANCbAA'D AUTHORIZA710N OF ENTRY: I certify under penalty of perlury that I have read this epplication antl state that ihe iniormation given is
corroc�. I agree to comply wl Y(ell s ate laws antl ciry rdinances.relating to builtling consiruction, and authorize representetives of Ihe City of Coste Mesa to en[er upon the
above-de cri �d prop y Fspe ti u oses r�ot to acupy or allow occupancy of eny building euthorized by Ihis permit until final inspection.
�%�� ���� a �-a �-a� 3
re Ot Legal Owner(s) Date
AnNOr Authorizad ApPlicenl Data
COUE N, INSPECTIONTYPE QgjE INTITIALS
1616 Fixed System Final Fire Prevention
1266 Pool Spa Finel
200 Final Re-Rooi
201 � Final Block/Retaining W all
202 Final Factory Fire Place � �
203 Final Sign
204 Final Demolition ' ' '
COOE11 INSPECTIONTYPE -
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval �
222 Final Site
250 Final Building/OccupenCy
I�ISI�Cii11F1�F9
��
(714) 754-5273 • Fan (714) 754-4856 • wv+w.ci.Costa-m85a.Ca.uS 77 FAlfi DRIVE, GOSTA MESA, GA 9LtiLe
Job Address: 2426 EIDEN AV
Suite No E
Vicinity:
Parcel Nunmber: 43929144
Applicant: WINTER, WILLIAM JOSEPH
Address: 1905 FULLERTON AV #W
COSTA MESA, CA 92627
Owner: WINTER, WILLIAM JOSEPH
Address 1905 FU�LERTON AV #W
COSTA MESA, CA 92627
Contractor: OW N ER-BU I LD ER
Address:
Arch / Eng :
Address:
ISSUE FEE
BackFlow irrigation
BackFlow Preventer
BathWb
Clarifer System
Connect Qce,Soda,etc)
Dental Units
PLUMBING PERMIT
Status: ISSUED
Applied: 0?l24/2003
Issued: 02/24/2003
ISSUED BY: C�'�
Phone: 949.548.4813
Zip: 92659-0903
Phone: 949.548.4813
Zip: 92659-0903
Phone:
Zip:
License: 000000
Phone:
Zip:
License:
SCOPE OF PERMIT
CONSTRUCT A NEW 582 SF DETACHED 2-CAR GARAGE WITH TN/0 300 SF CARPORTS ON EACH SIDE
OF THE NEW GARAGE. A NEW 974 SF SECOND STORY UNIT WILL BE CONSTRUCTED ABOVE THE NEW
GARAGE WITH A 95 SF BALCONY ON THE FRONT SIDE OF THE UNIT AND A 90 SF DECK WILL BE
CREATED ON THE RIGHT SIDE ABOVE THE CARPORT. TWO DUPLEXES ARE EXISTING ON THE
PROPERTY IN FRONT OF THIS NEW UNIT. FIREPLACE ICBO #ER5335
PLUMBING TO INCLUDE: 1 BATHTUB, 1 DISHWASHER, 1 SEWER PRIVATE LINE, 1 KITCHEN SINK,
1 SUMP PUMP, 1 WATER CLOSET AND 1 WATER HEATER. REF.: B02-02064 UNIT E
AMT
523.50
$0.00
$0.00
$9.80
50.00
50.00
50.00
FEESUMMARY
QTY AMT
Laundry Tub / Washer $0.00
0 Landscape Irngation 50.00
0 P-Trap 50.00
7 Pressure Regulator $0.00
0 Process Piping (per 10 ft) $0.00
0 Receptors $0.00
0 Septic Tank 50.00
QTY
0
0
0
0
0
0
0
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr BkFlow(1-4)
Vacuum Brkr BkFlow(5+)
Wash Basin
AMT
59.80
50.00
$0.00
$0.00
50.00
50.00
50.00
QTY
1
0
0
0
0
0
0
NOTICE: The work authorized by this permit shall comply vrith all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-27-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a penod of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. �
✓/
FOR INSPECTIONS CALL: (714) 7545626
244E48�8�W)
WORKERS'COMPENSAnON DECLARATON: .
I �ereby eHirm under penalry ol perjury one ot the following tleclaratlons: �
❑ I have and will maintain a cenificate of consent m sel4lnsure for workers' compensatlon, es provitled for by section 3700 of ihe Labor Code, lor Ne peAortnance of ihe
work for whic� t�is pertnit is issued.
❑ I have and wiil maintain workers' compensation insurance, es required by section 3700 of the Lebor Code, for the pertortnance of ihe work lor which Ihis partnil is Issued.
My workers' compensatlon Insurance carner antl policy numher ere:
Carrier: Policy Number.
(This section need not be completed,il the permif !s velue � ne hundred dollars ($100) or less.) ,
� I cenity that in the pedortnance of the wark for ich t ertnit is issueq I s .not employ any person in eny menner sa es to becoma subject to the workers'
' compensation laws ot ell mle; a d � if I s come s o the workars' wmpensatlon provisions o1 Sectlon 3700 oi �he Lebor Code, I ahall torthwith
comply wit� these pr q
Applicent SignaNre: Date: C/ � � �� ��
WARNING FAILURE TO SECURE WORKERS' COMPEN ION COVEMOE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HONDFED
TFKKISANDDOLLARE(E100,000),INADOITIONTOTHE TOFCAMPENSATION,DAMAGESASPROVIDEDF-0RINSECTIIXJ3]OBOFTHEIABORCADE,IMEREST,ANDATTORNEYSFEES.
LICENSED CONTRACTORS DECLARATION:
I here6y ettirm that I em licensed under provisions ot Chapter 9(commencing with Sectlon 7000) of Dlvlslon 3 ot the Business entl Pmtessions Catle, end my Ilcense is in tull
force end ettect. Lic. a Class a
Contrectars SignaWre: Date:
CONSTRUCTION LENDING AGENLY:
❑ I hereby aHirtn that there is a construction lending agency for t�e pertormance ol ihe work br which this permit is issued. (Sec. 3097, Civil Cotle).
Lentlor's Nama: Lender's Address:
SignaWre: Dete: �I
OWNER-BUILDER DECLARATIONS:
I hereby eRirm Iha� untler penalty ol perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Busineu antl Professlons
Code: Any ciry or counry which requires a pertnit to consirucL alter, improve, demolish, ar repair any swcture, prior to Its Issuance, elsa requires ihe epplicant tor such pertnit
m File e signad statement Ihet he or sha is licensed pursuent b tha provisions of the Comractors License Lew (Chapter 9(commencing wit� Sectlon 7000) ol DlWslon 3 ot the
Business end Professions Cotle) or thet he or she is exempt t�erefrom antl i�e basis for t�e alleged exemption. Any violatlon of Section 7031.5 by any applicant for a permit
subjects the applicant to e civil penelry of not more than tive huntlretl tlollars ($500).):
❑ I, es owner of the property, or my employees with weges es Ihelr sola compensation, WILL DO 7HE WORK, end tha strucwre Is not intended ar aHeretl tor sele (Sec.
70a4, Business antl Professions Cotle: The Contractors License Lew does not epply to an owner oi property who builds or improves ihereon, end who does such work
himselt or herself or through his ar her own employees, pmvidetl thet such improvemems ere not Intended or oHered lor sale. tl, however, ihe bulltling or Improvement is
sold within one year o� completion, the owner-builder will heve ihe burden oi proving thet he or she did not build or improve for puryose ol sele.). '
❑ I, es owner of the property, am EXCIt�SIVELV CONTRACTING WITH LICENSED CONTRACTORS to construd �he project (Sec. 7044, Business end Professions
Code: The coniractors License I:�w dqbs not epply to an owner oi property who bullds or Improves ihereon, entl who coniracis for such project with e contrector(s)
, license pureuapt to tha Contractors LufBqse,law;.). //�
lam
Owner ID ven7atl by tlrivers
Verilicetian oi Ownership Dy
antl Pmfessions Code br Ihis reason:
s ❑ No Driver5 LiCense
i.e. - property tex bill or deed):
Expires:
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereUy certiy ihat no excavetion five (5) or more teel In dep�h into which e person Is requlred to descend, will 6e matle In connection with work euihodzed by this
pertnit, end that no building siructure, scaHoltling, falsework, or tlemolition or tlismantling �hereof, will be more ihen Ihirty-siz (36) feet high. (Chep. 32, Gry 2, Ar12, Sec.
341, Ttle B, Califomla Aaminisirative Code).
❑ As ownar-builder, I will not empby enyone to do work which would require a permit Irom the Division of Indusiriel Selety, as noted flbove, unless such person has e
pertnit to tlo such work irom the division.
Signature: Data:
Division of Indusinal Safery Permit Number:
H/SARDOUS MATERIALS AND EMISSIONS CER7IFICA710N:
7 Will the applicant or present or fuNre building occupant need to tile end cenify e Business Plen for emergency response to releese or ihreataned releese ot e hazardous
material? ❑ Yes ❑ No
(Section 25505 of Ihe Califomia Healt� antl Safery Code requires, with some exceptions, thet e Business Plan be liled with the Cosia Mesa Fire DeparimeN by every
business which �as at any one time during a reported year a quan�iry of hazardous matenals equal to or 9reater than a weight of 500 pounds, or e volume of 55 gallons,
or 200 cubic feet ot compressetl gas at stantlard tempareture end pressure).
................................._........................_..................._._..._"'_"_"......................_..._....................._...................._..__..................................._........._....................... ....._........._..............__._........._.............
2 Does or will the applicant or present or future building occupant need to lile a registretion lartn lor acutely hazartlous metenels? 0 Yes ❑ No
(Sectlon 25533 of Ihe CeOtomia Health antl Safery Cotle, wlth some exceptions, requires registretlon with the Caste Mese Fire Department by eech Duslness which at any
one time has on hantl e quantiry of ecutely hazerdous meterlels equal to or greeter Ihen e weight ot 500 pountls, or e volume oi 55 gallons, ar 200 cubic feet of
compressetl gas at stantlertl tempereture and pressure).
..................................................................................................................................................................................._............................................................................................................................._....................................................................
3 Does or will the applicam or present or luWre 6uilding occupant need to prepare en RMPP (Risk Menegement and Prevention Program tor acutaly haeardous meterials�7
❑ ves ❑ No
(Section 25534 of the Califomia Health and Safery Code provides tha� �he Casta Mesa Fire Department may require Ihe pre0aratioq certiliwtlon and tiling with the Fire
Depertmant ot an RMPP by businesses which are required to register acutely hezartlous metenels with the Fire Depanment.
It an RMPP is presen�ty requtretl, nas Seciwn 2555n o� ine Oeiiromie neann ena saiery c:oae oeen miry com
.................._......................_...................................................................._._..................._..__......................__....................._"................
Does or will Ihe applicent or present or fuNra building occupent require far the work which is Ihe subject of
trom the South CoaSl Air Ouality Manegement Distda or from any olher eir pollutlon contwl tlistrict or egenq
(Section 65050.2 of �he Celilomie Govemment Cotle requires Ihei the requested infortnetion be furnished on
� ol lhe Iaciliry to CB conSlNCtetl untler (his permlt be wll0in 1000 �eBi irom Ine oUler bountlanes oI e SCnOoI
� faciliry must meet the requirement of Sections 25534 ana 42303 ol iha Calilornie Health entl Safery Cotle).
......................................................................................................................................................................................................................................
Irom the South Coasl Air Oualiry Manegement Disirict or other eir polWtion control tlistrict or egency is
have ell ot the Olsclosures Orescnbed by Cellfomia Healih and Sefefy Code Sectlon 42303 baen metle? [
Signature:
CERTIFlCATE OF
correcL I agreQ iQ
or
non-residentiel 6uilding pertnits).
�,ificate ol compliance from the approD�ate air pollution wntrol otliceq.
COMPLIANCE: I certity that untler penalry ot perjury the intorme�ion given aDove is correct. I egree to comply with all state laws entl ciry orGlnances
is Materials end Emissions.
Date:
COUE �. INSPECTIONTYPE
1616 Fixed System Final Fire Prevention
1266 Pool Spa Finel
200 Finel Re-Rooi
201 Final BIocWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
OF ENTTiV nder Denelry ol perjury that I have read this epplication entl state t�at the infortnation given is
inanc ating to buil0ing construction, and authorize representetives of the Ciry oi Costa Mesa to enter upon the
�iigt t cupy or allow occupency ol eny building authorize by ihis permilintil figal insp� n.
� � y �,�v
Date
�g �
COOEI INSPECTIONTYVE �
2oe Finai Mecnanicei
208 Final Plumbing
210 Final Electncal
212 Final Fire Prevention
220 - Final Planning Approvel
222 FinalSite
250 Final euilding/Occupency
�
3 y
(714) 7`s4-5273 • Fax (714) 754-4856 • wvnv.cl.costa-mesa.ca.us 77 FAIR DRIVE, GOS7A MESA, GA 92626
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant:
Address:
Owner:
Address
Contractor.
Address:
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 uniLs)
New Res (3+units)
Pool / Spa
Lighting Fizts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to t000a
Service over 1000a
MOlors to 1 hp
Motors to 10hp
Motors to SOhp
Motors to 100hp
Molors over 100hp
Communication tlrops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
2426 ELDEN AV
E
43929144
WINTER, WILLIAM JOSEPH
1909 FULLERTON AV #W
COSTA MESA, CA 92627
WINTER, WILLIAM JOSEPH
7905 FULLERTON AV #W
COSTA MESA, CA 92627
OWNER-BUILDER
ELECTRICAL PERMIT
Phone: 949.548.4813
Zip: 92659-0903
Phone: 949.548.4813
Zip: 92659-0903
Phone:
Zip:
License: 000000
SCOPE OF PERMIT
ELECTRICAL TO INCLUDE: 1 TEMPORARY POWER POLE. REF.: 602-02064
$23.50
50.00
50.00
$0.00
50.00
$0.00
50.00
$0.00
50.00
$0.00
$0.00
$0.00
50.00
50.00
50.00
50.00
so.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY
Temp Dist System / �ighting
Busway /100 ft
Standing Seclion
Misc Electrical Equipment
Transformers up to i kva/kw
................up to 10 kva/kw
.................up l0 50 kva/kw
.................up to 100 kva/kw
..................over 700 kva/kw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misa Conduit
Misc. Conductor
Cirws ( gen or ride)
Circus (mech nde or lights)
Christmas Tree Stand
Fireworks Stand
Olher Eleclrical Fee
Investigation Fee
Plan Check Fee
Reinspection fee
Status: ISSUED
Applied: 02/24/2003
Issued: 02/24/2003
ISSUED BY:
Quantily
50.00 0
30.00 0
50.00 0
50.00 0
$0.00 0
50.00 0
50.00 0
$0.00 0
50.00 0
50.00 0
so.00 0
50.00 0
50.00 0
50.00 0
$0.00 0
$0.00 0
30.00 0
50.00
50.00
50.00
$0.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Calitornia statutes and related
regulations. (Ord. No. 92-28, � 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 100 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 vnih all applicable codes, and all
requlred Inspeelions and final approval mus� be obtained. Failure to oblain inspections and final approval vrill result in the ezpiration of tfiis permit.
fOR INSPECTIONS CALL: (714j 7545626
2ane�ae Iaroo)
WORKEHS' COMPENSAnON DECLA(7AnON:
I heraby eftirm untler penalry of perjury one oi Ihe tollowing declaraiions:
❑ I have and will mainiain a certifwta ot consent to self-Insure for workers' compensetion, es proWded for by section 3700 of lhe Lebor Code, for Ihe performence ot the
work for which Ihis permil is issued.
❑ I have antl wlll maiMain workers' compensetion Insurence, as required by section 3700 of the Labor Cotle, for Ihe pertortnance of Ihe work for which Ihis pertnit Is issued.
My workars' compensatlon Insurance carner and policy number ere:
CaMor. Policy Number.
(This section need nat be comp/eted i/ the permit is vehied t one huntlred dollers ($100) or less.)
� I certity ihat in ihe pertormance ol ihe work,for whlch rtnit' ed, I shall not employ any person in any manner so es to become subject to ihe workers'
CompBn58fion laws oi C'f ni , a r lhei I Sh o b�ect to tha workers' compensaiion provisions of Sectlon 3700 of the Labor Cotla, I shall forthwllh
comply with these o '
Applicent SIBneWre: Date: � �� �� �fi �
WARNINQ: FAILURE T CURE WORKERS' COMP COVERAGE I UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED
hKK15M1D DOLURE (5100,OD0�, IN ADDIiION T0 COST OF COMPENSATIpN, pqMqGES 0.S PROVIDEO FOfi IN SECiIIXJ 37060F TNE U80R CODE, INTEREST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eftirtn that I em licensed untler DroNsions ol Chepter 9(wmmencing with Section 7000) ot Division 3 of tha Business entl Prolessions Code, end my license is in tull
force end ettec�. Lic. k Class a
Contractofs SlgneWre: Dete:
CONSTRUCTON LENDING AGENCY:
❑ I here6y eHirtn that there is a construc�ion lentling agency for Ihe pedormance of the work for whlch ihis permit is issuetl. (Sec. 3097, Civil Code).
Lender's Neme: Lender's Address:
Signeture: Date:
OWNER-BUILUER DECLARATIONS:
I hereby eHirm thet under penalcy ot perjury that I em EXEMP7 FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Prafesslons
Cotle: Any ciry or counry which requires a permit to construci, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the aDP���nt tor such pertnit
to file e signetl slatement thet he or sha Is Iicensetl pursuant to lhe provisions of the Contrectors License Law (Chepter 9(commencing wilh Section 7000) of Dlvision 3 0l t�e
Businuss entl Protessions Code) or t�et �e or she Is exempt Iherefrom and the basis for the allegeG axemption. Any violatian of Section 7031.5 Cy eny epplicent for e pertnit
subjecis ihe epplicent to e civil penalry of not more t�en flve hundred dollars ($500).):
❑ I, es owner ol ihe property, or my amployees wlih weges as iheir sole compensatlon, WILL DO 7HE WORK, and the structure is nol intendetl or oHered tor sale (Sec.
70a4, Business end Pmfessions Cotle: The Contractors License Law does not apply lo an owner of proDerty who builds or improves ihereon, and who does such work
hlmsaN or herself or ihrough his or her own employees, provided Ihat such Improvements ere not Intended or ottered for sele. If, howaver, Iha building or improvement Is
�old within one year of completion, iho owner-builder will have ihe burden oi proving Ihet he or she did not build or improve for purpose of sale.). �
❑ I, es owner of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construci Ihe project (Sec. 7044, Business and Professions
Code: The coniractors License oes not epply to owner ot pmperty who 6uiltl5 or impmves thereon, entl who conirects for such prolec� with a contrector(s)
, license pursuant to ihe Contre ors icanse Lews.). �j
� I am ea t tl r i
Signe�ure:
Owner ID rifi d by drivers
Verllicetion ot Ownership by
Business and Professions Cotle tor this reason:
'� ❑ Yes ❑ No Dnvefs Licensa
documeni, i.e. - praperry tax bill or tleed):
Date:
Expires:
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CER7IFICATON:
❑ I hereby ceriify ihat no excavation five (5) or more faat in depth into which e person Is requiretl to tlescend, will be mada in connec�lon with work authorized by ihis
permit, and Ihat no 6uilding sWcture, sceHolding, Ielsewolk, or demolition or dismamling ihereoi, will be mo�e Ihan ihirty-siz (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Celifornia Administrative Code).
❑ As owner-bulltler, I will not amploy anyona to tlo work which wouid require e permit trom the Division ol Industriel Sefety, as notetl ebave, unless such person hes e
permit to do such work from �he tlivision.
Signature: Date:
Division ol Indusinal SafeTy Pertnit Number:
IQQp�y INSPECTIONTYPE QdjF ��19LS �QQ�Q INSiELT10NTYPE .� �j� �� I
7616 Fixed System Final Fire Praventlon 206 Final Mechanical
1266 Pool Spe Finel
200 Final Re-Roof
201 Final BIocWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 FinalDemolition"'
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 � Final Planning Approval
222 Final Site
250 Final Building/Occupancy
e�
�
Job Address:
Suite No
Vicinity:
2426 ELDEN AV
E
Parcel Number: 43929144
Applicant
Address:
Owner:
Address:
Contractor.
Address:
MECHANICAL PERMIT
WINTER, WILLIAM JOSEPH
1905 FULLERTON AV #W
COSTA MESA, CA 92627
WINTER, WILLIAM JOSEPH
1905 FULLERTON AV #W
COSTA MESA, CA 92627
OWNER-BUILDER
Phone: 949.548.4813
Zip: 92659-0903
Phone: 949.548.4813
Zip: 92659-0903
Phone:
Zip:
License: 000000
ISSUED BY:
Status: ISSUED
Applied: 02/24I2003
Issued: 02/24/2003
SCOPE OF PERMIT
CONSTRUCT A NEW 582 SF DETACHED 2-CAR GARAGE WITH TWO 300 SF CARPORTS ON EACH
SIDE OF THE NEW GARAGE. A.NEW 974 SF SECOND STORY UNIT WILL 8E CONSTRUCTED
ABOVE THE NEW GARAGE WITH A 95 SF BALCONY ON THE FRONT SIDE OF THE UNIT AND A
90 SF DECK WILL BE CREATED ON THE RIGHT SIDE ABOVE THE CARPORT. TWO DUPLEXES
ARE EXISTING ON THE PROPERTY IN FRONT OF THIS NEW UNIT. FIREPLACE ICBO
#ER5335
MECHANICAL TO INCLUDE: 1 INST FAU < 100K BTU, 1 GAS PIPWG, AND 1 FACTORY
FIREPLACE. REF.: B02-02064 UNIT E
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >'100 k BTU
Repair / Alt CoolingMeat
Inst / Rep. Recess Wall Htr
Re(rig Sys <700 k BTU
Retrig Sys >100 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Boz
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Rebcate Appl Vent
Air Handlers � 10000cfm
523.50
574.80
50.00
50.00
so.00
50.00
50.00
56.15
810.65
S0.00
50.00
50.00
$0.00
$0.00
$0.00
50.00
50.00
Quantity
FEE SUMMARY
Repair / Alt Absorbtion Unit
Repair / Alt Refrigeration Unit
Ventillation System
Evaporative Cooler
Commercial I nci nerator
Domesfic Incinerator
Campressors / Absorption Svstems
Upto3hp/t00kBTU
3To15hp/500kBTU
75 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
1510 30 hp
30 to 50 hp
Quantity
$0.00
S0.00
50.00
50.00
50.00
50.00
$0.00 0
$0.00 0
50.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calilomia statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or it work is suspended or abandoned
for a period of 1 BO days.
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes;-and all
required Inspectlons and final approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of thi� rmit.
FOR INSPECTIONS CALL: (714) 7545626
:
204&681W00)
WORKERS' COMPENSATION DECLARA710N: .
I hereby ettirtn untler penalry oF perjury one of the following tleclera�ions: -
❑ I have�end wlll malntain a certilicata of consent to self-Insure lor workers' compensation, es provided for by secilon 3700 of iha Labor Code, br the peAormance of,lhe
work tor which ihis permit is IssueU.
❑ I have and wlll maintain workers' compensa�ion Insurance, as requlred by section 3700 of Ihe Labor Code, tor Iha pedortnance of the work tor which ihis pertnit Lq issued.
My workers' compensation Insurance carner antl policy number ere: �
Certier. Policy Number.
(Thls section need nat be �cEmp/eted il fhe permit is veluetl et one hundred tlallers ($f 00) or less.) .
�_ I cenify thet in the perfortnance oi the work
compensa�lon lews ot Celiforni and e
comply with Ihese prov' ns
Applicant Signeture: �
WARNING: FAILURE TO SEC RE WORNERS' ODMPE�
TiNH15AND DOLURE (5100.000). IN ADDRIIXJ TO THE.
shall not employ any person in eny manner so as to bacome subject to the workers'
eethe workers' compensetlon provislons of Seqion 3700 of Ihe Labor Cotle, I shall forthwith
` ,�Oete: E% �� "%CC' �_
%WEMGE IS UN W FUL M'� SHALL SUBJECi Ml EMPLOYER TO CRIMINAL PENALTIES AND CML FlNES UP TO IXJE HUN�RED
COMPENSqTION, DMMGES AS PROVIDED FOFi IN SECiION 3]OB OF T1E LABOR COUE, IMEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aflirtn Ihat I am licensed under provisions of Chepter 9(commencing with Section 7000) ot Division 3 of the Business and Protessions Code, enA my Ilcense is in tull
lorce end ettecl Llc. x Class M
Camrectofs Signatura: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby aflirm ihat there is a consimction lending egency for the peAormance of ihe work for which this permit is issued. (Sec. 3097, Civil Code).
�i Lenders Name: Lender's Atltlress:
�I Siqnature: Date:
OWNER-BUILDER DECLARA710NS:
I hereby eMirtn thel under penalry of perjury ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business end Professlons
CoOe: Any ciry or county which requires e pertnit to consiruct, elter, improve, demolish, or repair eny structure, pnor to its issuance, also reQuires the applicant for such permit
to file e signed stetement thet he ar she Is Iicensed pursuent to Ihe proNsians ol the Caniractors License Law (C�epter 9(commencing with Sedlan 7000) ol Dlvlsian 3 oi the
Business end Professions Gode) or Ihei he or she is exempt therefrom and the basis for the alleged exemption. Any violetion of Sectian 7031.5 by any epplicant for a pertnit
suhjacts ihe epplicent to e civil penalty of not more than tive �undred dollars ($500).):
� I, es owner ol Ihe property, or my employees wl�h weges as �heir sole compensation, WILL DO THE WORK, entl the structure is noi intenaed or oXered tor sele (Sec.
7044, Business an0 Professions Code: The Contractore License Law tloes noi apply to an owner of property who builds or improves ihereon, and who tloes such work
himsalt or herself or ihrough his or her own employees, provitled that suc� impmvemenis are not Intended or ofleretl for sale. It, however, ihe building or Improvement is
sold within one year of completion, tha owner-builder will have �he �urtlen of proving Ihat he or she did nof build or improve for purpose ol sale.). �
❑ I, as awner ot Ihe property, em E%CLU IVELV CONTRACTING WITH LICENSED CONTRACTORS to construct t�e project (Sec. 7044, Business end Profeuions
Code: The coNractors License Lew oe not epply to en owner ot pmpeny w�o builtls or Improves t�ereon, end who wniracts tor such project with a conlrector(s)
license pursuan� to �he Contrac�s Lic nse Lews.).
I em ez m t de s. usiness antl Professions Code for this reason:
Signa�ure:
Expires: /n � ��
VeriOcntion ai Ownership by (type of dau eni, i.e. - property taz bill or deea):
DIVISION OF INDUSTRIAL SAFE7V PERMIT CERTIFICATION:
❑ I hereby cenify that no excavation five (5) or more teet In dapth into which e Oerson is required to descend, will be mede in wnnection with work euthorizetl hy this
pertnil, and that no building siructure, scattoltling, talsework, or demolition or dismantling t�ereol, will be more than ihirty-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec.
341, Titla 8, Celifomia Administrative Code). ,
❑ Ps owner-�uilder, I will not employ enyone to tlo work whic� woultl require a pertnit from Ihe Division of Intlustnel Safety, as noted ebave, unless such person hes a
permi� to do such work trom the division.
Signeture: Date:
Division of Indusirial Sefery Permit Number:
COUE I. INSPECTONTYPE
1616 Fixed System Final Fire Prevemian
1266 Pool Spe Finel
200 Finel Re�Root
201 Final BIocWRetaining Well
202 Final Feciory Fire Place
203 Finel Sign
'204 Finel Demolition
Q�jg �� �QQ[( MSPECTIONTYPE
206 Final Mechanical
20B Finel Plumbing
210 Final ElecMcal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 FinalBuilding/OCtupenty
1111.
� ��
LIf
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
(714) 754-5273 • Fax (714) 754-0856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
2426 ELDEN AV
E
CR�'Y.�'iCL!
Applicant: WINTER, WILLIAM JOSEPH
Address: 1905 FULLERTON AV #W
Owner:
Address
Contractoc
Address:
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Outlets
Switches
Nan Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 1000a
Motars to thp
Motors to tOhp
Motors to 50hp
COSTA MESq, CA 92627
WINTER, WILLIAM JOSEPH
1905 FULLERTON AV #W
COSTA MESA, CA 92627
OWNER-BUILDER
ELECTRICAL PERMIT
Phone: 949.548.4813
Zip: 92659-0903
Phone: 949.548.4813
Zip: 92659-0903
'Phone:
Zip:
License: 000000
Stams: ISSUED
Applied: 02/24I2003
Issued: 02/24/2003
�
ISSUED BY:
SCOPE OF PERMIT
CONSTRUCT A NEW 582 SF DETACHED 2-CAR GARAGE WITH TWO 300 SF CARPORTS ON EACH SIDE
OF THE NEW GARAGE. A NEW 974� SF SECOND STORY UNIT WILL BE CONSTRUCTED ABOVE THE NEW
GARAGE WITH A 95 SF BALCONY ON THE FRONT SIDE OF THE UNIT AND A 90 SF DECK WILL BE
CREATED ON THE RIGHT SIDE ABOVE THE CARPORT. TWO DUPLEXES ARE EXISTING ON THE
PROPERTY IN FRONT OF THIS NEW UNIT. FIREPLACE ICBO #ER5335
ELECTRICAL; NEW RESIDENTIAL UNIT. REF.: B02-02064 UNIT E
�23.50
50.00
$0.00
$54.54
$0.00
$0.00
$0.00
$0.00
$090
$0.00
$0.00
$0.00
$0.00
$0.00
50.Ob
$O.Ob
50.00
Quantity
974
0
0
0
0
0
0
0
0
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 Valt Wiring System / Ckt
Misc. Canduit
Misc. Conductor
Circus ( gen or ritle)
Circus (mech dde or lights)
Christmas Tree Stand
Fireworks Stand
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 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 Calitornia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21•g2)
EXPIRATION: This permit shall autometically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for 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 codes, and all
required Inspections and final approval must be obtained. Failure to obiain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
244&d8 (BI00)
WORKERS'COMPENSAnON DECLARA710N: � .
I hareby attirm untlar penelty oF perjury one of the following declarations:��
❑ I have and will maintain a cenificate of consent to self-Insure tor workers' compensatlon, es providad for by section 3700 of iha Labor Code, for the pertortnence ot ihe
work tor which this permit is issued.
❑ I have and will maintain workere' compensation insurence, as required by sectlon 3700 of the La6or Code, for the pertortnance of the work for which this pertnit is luuetl.
My workers' compensation Insurance carriar and policy numDer are:
Carrier:
�(lh/is sectian neetl nof be comp/efed i! Ne
5A I certity ihat in the performance of Ih
��compensetion laws of C lito "a, n
comply with ihese pra ' .
Applicant Signeture:
WARNING: FAILURE TO SECUFE WORKERS' C
THOU3AND DOLLARE ($100,000), IN ADDITION 1
this
Policy Number:
s ($100) orless.)
shall not employ any person in any manner so as to bewme subject to the workers'
t0 the workers' compensation provisions of Sectlon 3700 of ihe Labor Coda, I shell forihwith
�y Date: � rl ' � Y - r}�.P7 �
IS UNLAW FUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO qJE HUNDRED
\TION, DAMAGES AS PROVIDED FOR IN SECTION 310fi OF THE LABOR COOE, IMEREST, ANO ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARA710N:
I hereby aMirm ihat I am licensed under provisions o� Chapter 9(commencing wi�h Sectlon 7000) of Division 3 of the Business end Professions Cotle, and my license Is in full
force and eflecL Lic. # Class A
CONracroYs SignaWre: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby attirm that there is a construction lending agency for the pedormance of �he work for which this permit is issued. (Sec. 3097, Civil Code).
Lender'S Neme: Lentler's Adtlress:
SigneNre: ' Date:
OWNER-BUILDER DECLARATIONS:
I hereby aHirtn that under penalry ot perjury ihat I am EXEMP7 FROM 7HE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7037.5, Buslness ana Protessions
Code: Any city or counry which requires a pertnit to construct, alter, impmve, tlemolish, or repair any stmcWre, prior to its issuance, elso requires the applicant for such permit
to file a signed statement that he or she Is Iicensed pursuent to ihe provisions ot the Contractors License Law (Chapter 9(rqmmencing with Section 7000) of Division 3 of Ihe
Business entl Professions Code) or thet he or she is ezempt tharefrom antl tha hasis for ihe elleged exemption. Any violatlon oi Seclion 7031.5 by any applicant for e pertnit
subjects the epplicant to e civil penalry of no� more ihan five hundred dollers ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensa�ion, WILL DO THE WORK, antl the strucWre Is no� interWed or oNered for sale (Sec.
7044, Business and Professions Code: Tha Coniractors License Law does not apply to an owner of property who builds or improves Ihereon, and who does such work
himself or herself or through his or her own employees, provitletl thai such improvements are not intendetl or oNered lor sale. If, however, iha buildinq or improvement is
sold within one year of completion, the owner-builder will have the burden ot proving iha� he or she did not builtl or improve lor purpose of sale.). �
❑ I, as owner oi the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions
Code: The contractors License L,e�i tl�es not epply to an owner of property who builds or Improves ihereon, antl who contracis tor such prolect wiih e conirector(s)
license pursuant to ihe Contrag(ors Lj6ense L�v+s.). ,
�1 I em ex u der e<
Signature:
Owner ID ventied by drivers
Verification at Ownership by
Business and Protessions Code for ihis reason:
T❑ Yes ❑ IJo Driver's License
document, I.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICA710N:
Expires:
❑ I hereby cenity that no excavation five (5) or more faet in depih into which e person is required to tlescend, will be mede in connec�ion with work authorizetl by ihis
pertnit, and ihat no building sirudure, scaHoltling, talsework, or demolition or tlismantling ihareof, will 6e more ihan ihirty-six (36) faet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Ttle B, California Adminisirative Cotla).
❑ As awner-builder, I will not employ enyone to tlo work which woultl require a permit irom ihe Division of Industriel Setety, es noted above, unless such person hes e
permit to do such work irom the tlivision.
Signature: Date:
Division ot Indusirial Safery Pertnit Number.
CERl1FlCATE OF COMPLIANCE ANdA ORVA710N OF E Y: I cenity under penalry oi perjury that I have read this epplication and state Ihat the informetion given is
cortect I agr e to c m ly iith Iate 1 i rtlinaq relating to Duiltling wnstruciion, and authorize representatives of the Ciry of Costa Mesa lo enter upon the
ebovo- ed o � ction e 6 0 o cupy or ellow occupancy of any building authonzed bylhis permit unti iinal i� e�n.
C% d �
/ Sia u L oal Owner(s1 Date �
COOE 1, INSPECTIONTYPE
7616 Fixed Sys�em Final Fire Prevention
1266 Pool Spe Final
200 Final Re-Roof
201 Final BIaWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
DRTE ,INT �j INSPECTIONTYPE
206 Final Mechanicel
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Builtling/Occupancy
Date
DpTE INTITIALS
'
vo �
0
Propert
Owner
CITY OF COSTA MESA
BUILDING DIVISION
ROOF COVERING CERTtFICATION
!.? a�'l _ n � v� i�/
Contractor \ ��f%1 Q
State Contractor License Number /,/%//1/P� %'�[I/L,t�� Classificafron �—
I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the
above address in conformance with Chapter 15, and Appendix 15 of the latest adopted edition of the Uniform
Building Code, and the installation instructions of the manufacturer.
� I further certify that I am the owner of the property. (Owner-Builder permittee ony).
❑ I further certify that I am:
❑ Owner of sole proprietorship company
❑ Full partner of the company
❑ Limited partner of the company
❑ Officer of the corporation
I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this
certifiCation, which shall be binding on all successors or assigns of the company or corporation.
I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building
Division for acceptance.
Receiyed by Building Division
By:
/iu //
�- ..
��MW690 White-Bu'ildipDrv;Csary-CmVxia:Pink-Owner
ComOany or Corporate Name
Address
/ F
.�-a3 -a�
SignaWre // � Date
�il ��/<1 m �l�li�'117�.R - O�uhl Pi�
Printed or Typed Name
March 14, 2005
CI'TY OF COSTA M£SA
a.o.scx,zao • „raiacar.�e • cAu=o�^:in �_.,.e�,zoc
�.�z.-,�,�,.,,....� ,.,a,m..a.r.�,..,...�.��....�...:..�,.��.,.,�•..
DEVELOPMENTSERVICESDEPARTMENT
BUILDING DIVlSION
NOTICE OF OUTSTANDING PERMIT
William Joseph Winter
1905 Fullerton Av., Apt. W
Costa Mesa CA 92627-2277
PERMIT NUMBER (S):
FOR:
PROJECT ADDRESS
602•02064
Garege
2426 Elden Av., Costa Mesa
This is to advise you that the above permit is still outstanding. Final approval cannot
be issued without an approved inspection by the Engineering Dept. and Pianning
Dept. Please contact the Planning Dept. at (714) 754-5245 and Engineering Dept. at
(714) 754-5671 two working days prior for an inspection.
if you have any questions, please contact the Building Division at 714-754-5273,
between 8:00 a.m. and 4:30 p.m., and a staff member will assist you. We appreciate
your working with us to resolve this matter.
Sincerely, `�
���y�'���%�
Mary Jane Weidenkeifer
Office Specialist II
_ j'�� l �
i���� � / ,� 1 ,�'���/� �
' ` �ti �
3uilCing Oivision (11sj 75d-5273 • Code EnlorcemeN (71iJ i5�S623 • Pfznning Oivisicn (71�) 75a-52�5
FA%(714) 754d856 • TDD (714) 754-523a • vrv.N,�i.cosla-mesa ca.us
Mar 24 04 11:48a Progressive Insulation � 714-539-0909
� �.,�,..r �..�-U� � P. 2
c ,.,. �.�o.��_�� .,�,� ,.., _ ...o,.� , . .r,� .
.. L✓b
INSULATIOPI CERTIF[CATE ��z � � te-X
c� y .�e �i427a /��q
�G ( ,..c
Numher an Strcet � �� ry -- �
���
ry. SubAivi5i0n Lo[ Number
Description oElnstrUaHon
1. ROOF ,/� o� � {�-
Matcrial dCY��i91✓� ��a�%�.✓_J_ Rrand�l`3amc- __��Gihti- �' 1—D i�
Thickncss (inches) �I�hermal Rcsistance (R-Valuc) . _ _ _
2. CEJ[.NG
Batt�or BlankerType ,Q _ Bra�d]Vanw� - �, [/11 ,
Thickness (inches) �i� �fhermai Resistance (R-Valur) � O
Loose F71�Type Bramt�
CoMtacmr's m9n insiallcd weight/h' Ib blinimum thickness �� inohes �
Manufacturer's instailed weighCper syvare (oot [o achieve�T7mrtrral��Kesistmcr. � Vaiee)�
3: EACERiC7R���W.1Lb
Frame Typc �
A. CSvity fnsul6tion
Matefial ,�j'•E=� •
Tfiickness(incfies) ���i
H . Exterior Foam Sheathing
Vlaterial
Ibickness.(inchrsl.
4. RAISED FLOOR
Mate: ial �iF��
Thickncss(inches) �%L �
5. S1.AB FLOOR/PERIMETER -
Materiaf
Thiekness (inches)
Perimcrcr l�vculaiion Depdi (incfiesj _
Brand tiame S' �
Tf}emmtRcsiscarrca(R-Valee}� f 3
Brand�Name
77iennal Resistance (R-Value)
Brsrr�Namr �/. {ti/
Thermal Rcsiscancc (K-Value) _�_g
Brar`d Yamr
Thennal Resistanm (R-Value)
6. �OUNDATlON44ALti
Material Hrand Name
Thiekness(inches) "IhertnatResistarrce(R�Vslue}� � � �
Deelaration - ..
f hereby ceniF thai rhe above inzulation was installed in the buildin� at ehe abnvc location in conformance witfi the cuRen�
Enog- �ccxyStomi�vda (nn residen[ia! huildings (Titic 24; Part 6, Cati(om�a Code of Regu}ations) as indicared on the �
Certificate ofCo�nplianu, where applica6le.
/` ``� �ylG�l� �/z3�y �o1O(�rA�SS/ve �,vs4/�zu..
Itcm dc Signamre. Dare (nscalling Sabcontcacmr(Co. Name) OR
General Con[raaoc (Co. Name) OR Ou•ner
Irem tts
Ite^.� qs
Si�+mimr, Detc -
Sfgnamre, Dace
Revised Vlarch 1,
Installirtg Suhconcracwr (Go. Nuwe) �
Genernl ('onccaccor (Co. �'ame) OR O4+�er
Irts[aHirtg Suhcontractor(Ci. IvatrtcJOR`
General Contractor (Ca. Name) OR Owner
Mar 24 04 11:48a Progressive Insulation 6
,
•
Progressive Insulation and Windows
9750 Topanga Canyon Blvd.
Chatsworth,CA 913ll
(818)709-09A8
Fax(818)7p9-IOSS
License \umber J18096-C21C17
��'ORK AREA
Radiant Barricr rJundrsdc Rf Uck
Exterior Ceiling
Garage Clgs Lnder Living.4rea
Exterior W'alls
"Iitle 24 Caulking
Customer : $j]� Wjnter
Job\umber: ]04384
714-539-0909
�
Insulation CeYti tcate
ITEp�I/�STALLED
Aluma-Foil Radiant IIaniers
R-30 Itigli Petformance Unfaced Bau Insulativn
R-19 l"nfaccd Hatt lnsulalion
R-I} Vnfaccd F3att Insulation
N'indows, Duoa, l3asa Plaies, Plumbing & Electrica! Penevations
.Iob Address 1-U[lll
2426 Elden Avenue
Casta Mesa,CA
Date Completed : � O
Progressive Insulation and �Vindon�s
Builder Signature:
I)LfC:
p.3
CITY OF COSTA MESA
CALIFORNIA 926284200 P.O. BOX 7200
DEVELOPMENT SERVICES DEPARTMENT
December 24, 1992
Rodney E. Brown
177 F Riverside Drive
Newpo�t Beach, CA 92663
0
RE: GRA58038� B58039� H5640
2426 ELDEN AVENUE, COSTA MESA
Dear Mr. Brown:
I have reviewed our records in response to your request for
extension dated December 18, 1992.
The permits were issued on July 6, 1992. According to Section
303(d) of the Uniform Building Code, they would expire by -
limitation on Januar,y 2, 1993. Due to the circumstances stated in
your letter, an extension is herewith granted until July 1, 1993.
Please keep in mind that a second extension is not possible.
However, if you obtain any inspection prior to the final
expiration, this inspection date will serve as a starting point for
a new 180 day period, during which your permits will be valid.
Z wish you success in the negotiations for a loan and thank you for
the opportunity to be of service.
Sincerely,
.
KLAUS STRASCHIL
Plan Check Engineer
�erzowri.tre>c�3
� 77 FAIq DRIVE '
Building Division (714) 754-5626 • CoEe EnforcemenVBusiness Litenu p10)75a-5234 • Planning Division (714) 754-5245
FAX (714) 556�7508
June 2, 1992
To:
CITY OF COSTA MESA
CALIFORNIA 9282&1200 P.O. BO% 1200
DEVELOPMENT SERVICES DEPARTMENT
Building Safety Division
Code Enfoxcement
Communications
Copley-Coiony of Costa Mesa
County 1ldministration Office
County Cl�rk/Bd. of Supervieore
County Registrar of Voters
County Tax 1lsaessor
Enqineeri�g Division (2)
Fire Admin.-Training Officer
Fire Prevpntion
File (2) ,
Newport-Kesa Un. School Dst. (2)
Pacific Bell
8oli.ce Appt. - Ping. i Research
Santa 11na Heiqhte Water Company
Sanitary District Engineer
Southern California Edieon Co.
Southern California Gns Co.
State Board of Equalitation
Street Division
U.S. Post Olfice - AIS
U.S. Post Office, 1ldams l�venue
Mesa Consolidated Water Dist.
The City of Costa Mesa wfshes to advise you that the followinq
addresses have been changed or added:
2426 Elden Ave.
IdEW ADDRESS
2426 Elden °A"
2426 Elden "8"
2426 Elden "C"
2426 Elden "D"
2426 Elden "E"
2426 Elden "F"
Your eooperation in this mattez is appreciated.
Sincerely,
�
RICHARD WELMERS
Planniag Tntern
�taa�nwna�n
cc: Rodnpy E. Brorm
177 �F" Rivezside Drive
Newport Beach, CA 92663
439-291-01
77 FAIR DRIVE
BuiWi'p Dirisicn (lts) 76a3826 • CoW EnlorwmsnVHiiitlY! Cf91M6e (111) 754523I . Planninp Division (771) 7546245
Building Division (714) 754-5826 • Catle Eniorcert�(�f�9�l�se (714) 754�5234 • Plenning Division (714) 754-5245
� FAX (714) 55E7508
2426 ELDEN AVENUE
00126i -
City of Costa Mesa
PARK FEES
Fee Payment Receipt
Project Address�� nL�i�"'� ��� ���
A.P. Number 'rl-'� —ZQI � — �r
Building Permit Number
Owner's Name
Mailing Addr2ss
Total number of dwelling units in project �
Total number of existing dwelling units to be �
demolished or removed as a part of project -
Net number of units subject [o fees �
Type of Unit'
Single Family
Multiple Farnily
Net
Number of Units
�
Fee"
X $5,748.82 =
X $3,940.34 =
Planning Division Approval Date S � �/Z
Applicants' Signature ��,��
� f � �
•cny om��ao�e egze Ciry Rosqy{ipn 9t-53
01)A30 rev. ]�91 W���e-Flanniig; Canary-Plannirg; Pink-Finance; GWCenroO�Applicanl
By
I F�es
VW J
Amount
�' �I �� 1 • %
C �� �
�
'
co�sGamcs �
Cost$ Mesa Bnilding Department APPLICATION FOR PERMIT
..<<f--.. P.O.Box3n ���� BUILDING 7
1 ��V1 � V�a��
Show Iocation and distancea from
property Iine and between buildinpa
�
�
, . � ,
�
�� �.
. " ' f. '`
, " . �,., , .
�
' • '� \
� c_.
'� - �784�
COSTA MESA BUILDING DEPARTMENT
P.O.80X 31]
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN
BUILDING ✓/ //�/ C�// �. � /
COSTA MESA. CALIFORNIA
IOWNER
CIT�
ARCHITE;
OR E'
ADORE55
tEGhL L�T
�ESCRIPTION �.fp�
A.P. NQ ( t
5,=E � 6
OP lOT
USE OF
EXISTING BLDG.
SETB�CK LINE FHOM
NEW
REPAIR
BUILDING �
SIZE
IEXTERIOR W,
COVERING
USE OF NEW
BUILDING
LIC.
NO.
TEL.
.�
NO.OF 9LDG5.
now orv �01
{��'�� ���i�����
�'�
APP�A�I'ON�FO'R PERMIT
�,� BUILDING
FOR OFFICE USE ONLY
PECEIGT NO. R T NC
� �.
RECEIV� 6Y D=T�FEC-1� ;OE S�F
� 3
BUILDING
ADORE55
' COSTA MESA. CALIFORNIA
FIRE 2
PLANS
APPROV
BY Q'Jl{ f v DATE / 6 ��
a
CORRECTIONS
� � REAR VARD / Q J '
IGHT 0•O`,LEFT /
RI TION OF WORK BY
.
ALTERATION I A�DITION �
� ROOMS STORIES
CITY OF TA ME.`'iA
M 1 Y .
SUBJECT TO B G. DEPT. REG.
I MEREBV >CNNOWLEOGE TNPT I NTVE RELO THIS FPPLIC>TION iNp �
STATE TXtT TXE ABOVE I$ CORPECT <NO LGREE TO COMPLY WITN PLL
CITY OROINPNCE9 ANO STATE LAWS REGVLRTING BUIL�ING CONSTRUC�
T�o�. VqLUATION
SIGNATURE OF
PERMITTEE .�
► $% �' �°3 `
PERMIT FEE S �
r
PLAN CHECK S l ., �
r" (f'7:� �ers
TOTAL FEE 5 �� /
.�
�
�
7P0.1ECi RDOHE55: 'z 4'Z �7 gLD EN AV uNir:
OWNEfl'SNFME: RODN$Y E, BROWN �� F� F
noonEss: 177 '�F" RIVERSIDE DR
NEWPCJRT BEACH
CA 92663
RPCNIENGINEEP: � 7 1 4� 6 9 2— j 8 1 Z qEG.NO.:
nooeess: RODNEY E. BROWN NO
177 RIVERSIDE DR F
PFpminEE: NEWPpRT HEACH CA 92663
nooRcss: RODNEY BROWN (714)692-3812
177 RIVERSZDE DR F
NEWPORT BEACH CA 92663
LICENSED LONiBRLTON oECIAMTION: I nere�y atlirm Rut I am licensea un0er D�avisions ol Clwpter 9(commencinp witn Section
7000� ol Orvision 3 0l ��e Busineu ana Prohssions Cotle. and my license is in lull brce antl effacl.
CITY LIC.: ST�TE UL.: �55: /
/7 �
Oat - � �1 � Sig a107 � �
WOflREBS' COMPENSATION OECLqpp710N: I hereEy allirm �hal I have a ceri cate of consent m sell�insure or a cenilicare oi Warkers'
Campensation Insurance, or a cenified coDY Ihereof (Section 3800, Lab. C).
POLICY NO.: E%P. OATE:
COMPRNV:
❑ CenitieA coDY �s �ere�y Iumispe0. ❑ Cenifie0 copy is filed with tAe city Building Division.
Dale', Applicani:
EIfEMPTION FBOM WOPNE85' COMPENSA710N OECUNpTION: (T�is section neetl not be camplete0 if I�e permi� is lor one hun0ie0 (5100� or less).
I cetlily �ha� in ihe pedormance of ihe work for which ��is permi� is issued I shall no� emDloy any person in any manner as l0 0¢Come
suDle�� �o I�e Workers' Compensa�ion Laws ol Califomia.
Date: 7 ✓�� � �� Signat e' < <
NOTICE: It. afler maMing Ihis tleclaration. you shoul0 became su�leW9 �he WorkeR' CamOensation prOvisions ol ��e LaOor
CoOe. you muSl lort�vnl� comply wi�� Suc� �rovisions ar this permi� shall OC deemeA revoke0.
CONSTBUCTION LENOING RGENLy: I here�y a�lirm t�a1 there is a conslmciion lentling agenty �or the petlormance ot I�e work lor
whith ��is permii i5 i5su¢G �SetliOn 3097, Civ. C).
tEN�EP:
RO�flE35:
OWNEB BW�UEfl DECUBRTION: I �e20y atlirm Ihai I am e�¢mp� �mm Ole COnlratiors' State Lirenu Law for tne followin0 �eason
(SeCiion 7031.5 BUvn¢55 anG PmieSsional Cotle: Any tiry oi couniy whiCh reQuires a permi� to rnnSlmCi, alier, impmve, tlemol¢�, or
repair any stmciwe. D�ior to its aguance. alw repuires t�e ap0iicant lor suc� permit to file a 5igne0 slatement ttui �e/sAe is Iicense0
pursuant io Ihe O�ouisions oi I�e Contracmri Slaie License Law (ChaD�er 9(commencing with Section 7000) of Oivision 3 0l t�e Business
an0 Pio�essions Cotle� or Ihat helsM1e is e�empl l�ereimm antl �he ba5is for lhe alleged eeemplion. Any violation ol Seclion 7031.5 by
any applicant for a permil suUietis the apP�icanl lo a tivil penalry of nol more t�an five hunOreO Oollars (5500).
I. as awner ol ihe pmperly or my emplayees with wages as Iheir �le compensatian, will Oo the wark, anu �ne
❑ strutmre is no1 in�enGed or oiferetl for sale (Secuon 7044. Business and Professional Code: T�e Coniraciors' State License Law
Ooes not apply �o an owner ol a DmDeny who Euilds or impmves I�ereon, anA who tices such work himsell/herself or t�rough
�is ar her own emDloyees, pmviGed Ihat suc� impmvemenis are not intentled ar offeretl for Sale. II, however the �uilding or
imD�ovement is sa10 wit�in one year ol com0le�ion, the owner will have ihe 6ur0en ol provinp he/s�e Aid not builtl ar impmve
tor ihe Durpose ol sale�.
� I, as owner ol Ihe pwpeny, am exclusively coniracting with licensed coniractors to consimcl lhe pmject (Section 70a4, Business
and Pm�essions COUe: Thq Coniraclors' Sla�e License Law does noi apDty to an owner o� pmperty who builtls or impmves �herean
antl wha conVaclsior suc� pmlecis with a conVacia�s� license pursuant�o ihe Coniraclors' Sta�e License law),I am 2wa�e
Ihat proo� o� ��eir Worker'S Compensation insurance shoultl be pmvidea �o me.
� 1 am erem0� untler Section; B. b P. C.
�Or I�is r¢ason:
;
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 058039 PLAN CHECK NO; 01399-92 A
CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR
JOB DESCRIPTION ; NEW 'TRIPLEX' W/ATT GARAGES 6 LAUNDRY
CLAIM VALOE: CALC—VALUE: 307,925.90
acr
PERM NO: B 05803
GOVT: N SUPP: N
PURPOSE: NEW
SQ FT: 6,087
GROUP OCC: R-1 /M-1
COMMENTS: �
�+r�trt***�*�r**x*��***�+t�r�r*�***�*�**�*�x****+�**��r�*�r��r�t****+�***�+r��*******�**�**+�+�
Z O N I N GS ERTEB�AUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDI�IG ---------
FRNT: 10 FT 8 IN REAR: 16 FT 8 IN FRNT; FT IN REAR: FT IN
LEFT: 5 FT IN RGHT; 7 FT 6 IN LEFT: FT ZN RGHT; FT IN
PARKING REQ• 15 PROV: 15 PARCEL; 43929101 2NE: R2 R-91-17A
PLANNING Nt7TES> 3 UNITS OF A PROP 6 UNIT RES CONDO PROJ, FT BK IS�
> SEPARATION. P3CING ABOVE TOTAL FOR SITE, UN' S D E F F E
�r�t�r�r*�****�**�r�r���*x�r*�t*�x��r�e�t�t�e****+t�r�e***�r�r���r�*�**�r**+t*� **� 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 N T S/�
ZONING APPROVED BY W(� [� DATE: ��T' � 2
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: S, DATE: ��F3�
*ifiFiEiEiP3f*if�iliFiEiFiFlF1EiE1fiE�flfik iEi(�jE1flEiFifiF3faf ifiE
ififiEiFiEkiFiEiEifiEiEiEiE�EiFjF�FkiEiEiFiEaflFik�l41Fk3EifjEil�flE 1EiEiflElEiP1EiE1FkiEiEiFif41FiF1E1F1FifiFlFiF�FifiEiE3FiE3Eififif3fiP3EjFiEiFlEih
LEGALIZATION:N F E E S U M M A R Y STROCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 1,367.50 SMIP�1vON—RES �
PL,AN 222.22 "—"
ISSUE FEE
BUILDZNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE�
TUTALS----> 1398.29 0.00 222.22 1620.96 1620,96 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 398,24 OVER/SHORT: 00
HLDG PMT PLUMBING ELECTRIC MECHANIC FI P/TOT GRAI)ING PLAN—CHECK
1367,50 30.'14
1E iE aE It iE �E if iE 3E iFiE if iF 3f iE iE if k iF if k 1F iE iE �E if IF iE iE �E iE iF iF if if !f iE if iE iE iF iE iF iF 1E iE IE-1E if if iF �f ih 3f iE jF 1FiE iE 1E iE 1E 1E iE if iP if IE if iF iE 3f?F 3E iE ik iF 3E ih
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
oaie: owner: SFR 9767 APT—TYPE V—WOOD FRAME
I Do �ereUy ceNty Ihai I am aware ol an0 underslan0 ihe requiremems o( Califomia Heal�h an0 Safery Code Seclions E5505, 25533, an0 S FR 1 3 2 � RES —GARAGES TYPE V
25534 ana that I or any WW�e Euiip�ng occu0am wiil/will not (circle one) neetl to compq wi�h saiA state codes anU the reQuiremenis for a END �F FEES
Dermit b� conslmclion or moEilicdtion Iwm I�e Aii Ouality Managemenl DisiricL Residential construction applicatiMs are erempt imm
inese pmvisions.
Date: AD�licanl: �� � �� �// /��
I �ereDy cetlilyt�al Ihav¢teaGihiS aDVlication and stale that Ille aboveinlormationis co�rect. I aA�¢eto compty vnt� allcity ana county
orCinancesanOsla�elawsrelaling�Obaltlingconsbuctionantlherebyam�orrzerepreSenlaliveso�I�iscilytoemeruDonl a0ove-men�ionetl �
pmOar�Y �or inspeclion pwposes. p
Dale: � `���5 �� Signal� h � �
� �river's license o� Sociai Security
I6nt-46 Wmie—Bundmg: Greeq—CaEe Enlorcemem; Canary—Appl¢aN: Pmk—Revenue: GOIEenroE—Assessar
�: _:t t
•
,3� �z 2"8 6.00
r
I �i
� �,�
OWh.i/1� !��W
1
� i'�', ��=' 1!1— S ��a. �C�l� .�..--�._.
,....-.—__ ......L,1. _ [y ` "' -
CONSTRUCTION AND PLANNING POOL d SPA
APPROVALS Permit# Date Inspector AppROVAIS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment �ocation
2. $oil Pipe•Undrgrnd. ' 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical.Conduit.Undrgmd. 55. ElectriCai Bondiny
5. Steel Reinforcement 56. Rough Piumbing & Pressure Test
6. Electrital UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings � 58. Electrical Conduit�Undrgrnd. �
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe•Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgmd.
10. St�uctural Floor SYstem ' 61. APPROVALTO DECK
11. Properzy Sewer line & House'Connectio� 62. Backwash & fleceptorFinal '
12. Sewer Cap � 63. Heater & VenrFinal
13. Roof Drains . � 64. Plumbing System - Final
1�.�Rough Plumbing 65. Electricai�Final
l,�i.'� ROugh Electrical-Conduit 66. Solar System-Final
76: Rough E�ectric Wiring . 67. Fencing & Access ApPioval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
16. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. RPugh Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. RGu9h Factory Fi[eplace � � APPROVALS . Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Oucts. Ventilating 71. Product Piping O Gas ❑ pi!
23. Gas Pipe�Rough & Tesc �� 72. Underground Flush
24. Roof Framing - �73. Undergmd.StorageTank �Gas ❑Oil
25. Reof Sheathing ' , � 74, Overhead Hydro .
26. T•Bar Ceiling (Svuctural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe .
28. L3thing & Siding . - 77. FIXED SYSTEM FINAL
29. Insulation - 78. FIRE PREV. FINAL
30. DtYwall Nailing , HEALTH DEPT�RE�UIREMENT
37. Plaster Brown Coat '� ' 79. FINAL INSPECTION -
32. Electriral Power MeterFinal j I; �� 80. FOOD CERTIFICATE ISSUED
33. Final Electric ' � Notes: ' •
34. Final Heating & Air Conditioning . ' •
35. Final Gas Pipe�Test - .
�
36. NOod or CanopY � , '
37. Final Factory Firepiace ' � - .
38. Final Plumbing � ' . -
39. Water Service�Final ' .. . �
40. G8s Service�Final - . � '
. ,
41. Solar pomesticFinai - '"=" '�
� � •-: �
42, gackflow Preventer ' , � : � � �
� °: !
43. B�ckflow Irrigation 4• .� .
44. L9ndscape irri9ation System . . �
} ..
q5. Sound Attenuation . � � � +
46. Handicap Regulations � �
47. FINAL STRUCTURE & BUILDING ' � � " _ '
48. fINALPLANNING ' • `- " ' ` -
��
49. Electric Release to Edison �
50. Gas Release to Southern California Gas Co �-� � '
51. CERTIFICATE OF OCCUPANCY ,
No. Date
Pfl0.1ECTA�OflE55: z426 ELDEN .�v
owxen�snan+e: RODNEY E. HROWN
noosess: 177 "F" RIV�R5IDE AR
NEWPORT BEACH
CA 92663
AflCH/ENGINEEfl: ( 714 � 64 z-3812
nooxEss: RODNEY E. BROWN
177 RIVERSIDE DR
uxiT:
nec.xa.: NONE
UNIT: F
NEWPORT BEACH CA 92663
PE"miTTEE: RODNEY BROWN ( 714 ) 692-3812
noonEss: 177 RIVERSIDE DR F
NEWPORT BEACH CA 92663
ULENSEU CONTflACTOB OECIAPATION: I �ere0y allirm tha� I am licensetl unaer provisions al C�aDter 9(cammencinp wii� Seciion
70W� ol Division 3 0l i�e Business anG Proie sions qtle, ana license' �ull �orce an0 e��eci.
CITY LIC.: STRiF LIC: S� �
_��
�a�e Sipnaturp �
WOBNEBS' COMPENSATION DELIANATION: I he�eby aHirm t�ai I have a cetli�ica[e ot consent �0 SelNnsure or a ce�ilka�e ol WaM1ers'
Compensation Insurance. or a certifieU cooY �nereoi (Sec�ion 3800, Lab. C).
POLICY NO.: E%P. DFTE:
COMPRNY:
❑ Cenifiea ro0Y �s nereUy lumisnee. ❑ Cenilie0 copy is file0 witn the city Building Oivision.
Daie; ApDlicanp,
EKEMPTION FpOM WOHKEHS' LOMPENSATION OECIAflRTION: (ihis section neetl nat be comDleteO if Ihe permil is for one hunOreO (StW) or less�.
I cenify �ha� in I�e pedarmance o� Ihe waB �ar whicM1 Ihis permit is issuetl, I aIL I employ any person in any manner so as to 6ecome
Subletl lo Ihe Worker5' COmpensa�ion Laws ol Cah _/� /
Dale: 7 �`�s 7� SiQnaiur>� // —
NOTILE: II, aller making Ihis declara�ion, you Shoul hecome suCjeU 1he Wo�s' Compensation pmvisians of ��e Labor
Code. you must IonnwitA comply witn sucn pmvisians or tnis permit shall De Oeemetl revoketl.
CONSTflOLTION LENOING pGFNCY: I Aere6y affirm roa1 Ihere is a conslmction lentling aAency lor lhe DeAormance ot I�e work lar
which I�is permil is issuea �Sec�ion 3097, Civ. C�.
LEN�FH:
ROOPESS:
OWNEP BUILDEB DECLANpTION: 1 �ere�y allirm tha� � am exempt imm t�e Coniracmrs' Slate License Law for t�e idlowinA �eawn
(Sec�ion 7031.5 Bu5�ne55 an0 Pmlessional CoOe: Any �ity o� couniy w�ich �eQuires a permii to con5imct. alter, imprwe, Gpmoli5h, or
re0air any SVuctbre. pri0r (oif5i55Wrrce. a150 rCquireS t�e apWitant fm 5uch permit to tNe a sipnetl statement that he/57M h IiCenSeE
pursuan� lo ��e O�ovisions ot ��e Contraclors' State License Law (Chapter 9(commencing with Section 7000) af �ivision 3 0l the Business
an0 Prolessions Cotle) or Ihat he/she is exempl lherefrom antl ine basis lor ihe allege0 exemo��on. any violation ol Section 7037.5 by
any apD�itant br a permii SuUjet�s the applitanl Io a civil p¢nalry ol nol more lhan liv¢ �untlreG E011ars (ESfp�.
I, as awner ol tM pmDerty or my employees with waqes as iheir sole compensaqon, will Oo t�e woA, antl I�e
❑ simcture is noi inteneetl or ollereA lor Sale (Sectqn 7044. BusineA antl Professional Co�e: The fAntracIDri State License Ldw
Goes noi apON �o an owner ol a O�oDeny who OuilGs or improves I�ereon, and wAo Ooes such work himsell/�ers¢II w I�muO�
Ns or Aer own emDloyees. proviae0 inat sucn impmvemenis are no� intentled ar onerea for Sale. If. however ine euilding or
impmvemenl is soltl vn�nin one year of tomol@�ian, ihe axner will have ihe buraen ol Droving he/she ditl not euila or impmve
lor ihe purpose ol sale�.
n I, as owner o� Ihe pmDeny, am eKclusively con�rac�ing with licensea comractors m consimct I�e pmlec� (Seclion 7p44, Business
yy and Pmfessions CoEe: TAe Conlractors' Siate �icense Law aoes noi apply �o an owner o� properry who �utlds or impmves Ihereon
and w�o tantratis lor Suth pmleds wil� a conlraClor�S�licen5e purivan� Io �he COntratlOrs' S�ale L¢en5e LaW�.I am awafe
tlw� proot of I�eir Worker'S Compensalion in5urance shoultl �e pmWded ro me.
� I am eKempt unGer Section: 8. 6 P. C.
for Ihis reason:
oa�e: owner
I tlo �ereby cenily t�al l am aware ol an0 untleistan0 Ne requiremen�s ol Calitornia Health antl Safety Cotle Sections 25505, 25533, an0
25534 an01ha1 I or any IUWre huiltling occupanl willlwill no� �circle one) neetl to comply wiih saia state coaes antl Ihe repuiremen�s for a
peimil lor consimclion or moddication irom I�e Air Oyality Managemen� Oi5lrici. Besitlential conslmc�ion apDlica�ions ar¢ ekempl tmm
�nese o�ovisions.
Oale: Applican�:
I hereby cetlily I�at I have reatl ihis application antl staie thal I�e above inlorma�ion is correcl I aAree to wmply wiih all cily and counry
ordinances antl sla�elawsrelating�o building con9mc�ion antl here�y aulhorizerepresen�alives oflhis city�o enieruponlhe above�mentioned
pro0etly lar ins0ection purposes. %%
—9ete: / `[� ��— 5'9na�urQ� A / �
Oriver's License or Social Securiiy p:
i6<I-ab Wbne—BvilOinp: Green—Caae Enlo¢emem: Canary—AoolicanL Pink—Revenue: GolEenraE—Acsnx�nr
CZTY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: GRA 058038 PLAN CHECK NO; 01400-92 A
CONSTRUCTION TYPE: 5—N PERMIT TYPE: GRA
JOB DESCRIPTION ; NEW 'TRIPLEX' W/ATT GARAGES 6 LAUNDRY
CLAIM VALUE: CALC—VALUE;
PERM NO: GRA 05803
GOVT: N SUPP; N
PURPOSE: NEW
SQ FT:
GROUP OCC: R-1 /M—i
COMMENTS: *
�r�r*�rx*�rt�r�*x*�t*+r�*x�� ***r*�r*****+t�t**�r*�*�r*���*******��r*�**�**�t**�***�+�***� *�*��t
Z O N I N G R E Q U I R E M E N T S
S E T H 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
PARKING REQ• PROV; PARCEL: 43929101 2NE: REF NO;
PLANNING NnTES>
�
±t �lE If It if if iF if it i� 1E if iE �F 3f iE af aE If iF jE it if !E if �F iF �E iF it at k it ik iE 1E �k 1f If it i(� iF 1E iE #� if iF �E 1E iF iE aE1h iP iF �F iE iP iEif iE iF if ±F �F iF iF �F iF iE iF if if fP iE if i634 ik
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
ZONSNG APPROVED BY �/7LL DATE: '% '���
BUILDING APPROVED BY :_
APPLICATION ISSUED BY•
*�r**�r*��**�r�r*�*�r*x*�*��
�E �f IE if if if IFlE iE if 1E if if �E iE iE �)E IF 1E iE 3E �E aE jf
LEGALIZATION:N
BLDG PMT PLUMBING
PERMIT
PLAN
ISSUE FEE
, DAT$;
� DATE: �-6 � Z
iFiFlFiFiPil3FiFifX� �iFirl6ih
�F�likffiF IEkiEiE�l6iFiEjE�litlfkiflEiEiEif3F3f�Ek3FiFiE3fiFikaf3fV.�if�EiEiFiEifil�fifjEiFikiE-If
F E E S U M M A R Y STRUCTURAL SEGMENT:N
ELECTRIC MECHANIC FIRE SMIP/RES GRADING
96,00
SMIP/NON—RES
BUILDING—DIV—> YERMIT ISSUE PI,AN—CHECR
TOTALS----> 96.00 3.00 5.63
AEVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
5.63
3.00
TUTAL PAID DUE
104.63 104.63 .00
99 OVER/SHORT: 00
FIR�J SMIP/TOT GRADTNG PLAN—CifECK
99.00
1! iF aE ik if iE iF iF 1E if if if 1E iE �FlE iE 1't 1E iE 1t iE jf if if aF IE iE If IE K i(� if iE iE iE if 1E if if if 1E if jE 3f iE if iE iE iF iF �lf 3f iF 1FlE±E iFiE iE 1E IE iE-1F # if �lE ik ih iE if i(� ik if 1k iF iE If iF
I N D I V I D U A L F E E H R E A R D O W N
TYPE QTY D E S C R Z P T I O N ��j ��� ST
NO FEES WERE SELECTED FOR H�E�T �
� � �n� wcn �
(3.u..� �p OW' �"a'I
�x�e-«-a�� .a�.�.:G �/�/93 pkTE��-SIG. �'�-----
;i •.'U:�_ - ..
�N�f. " �
CONSTRUCTION AND PL'ANjVING POOL � SPA
APPROVAlS Permit# Date � Inspector qppROVALS Permit# Date Inspector
' 1. Temporary Electricai Service or Pole 52. Pool & Equipment Loca[ion
Z, $pil Pipe�Undrqrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. FOrms
4. Electrica4Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Ftlotings •, ' 58. Electrical Conduit�Undrgrnd.
8. Foundation ' S9. Gas Pipe, O Undrgrnd., Test
9. Water Pipe•Undrgmd. 60. Backwash Lines, P�7rap, � Undrgrnd.
10. St�uctural Floor System� . 61. APPROVALTO DECK
7 7. Property Sewer Line & House Connection - 62. Backwash & ReceptorFinal
72. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Piumbing System - Final
14. Rough Plumbing 65. Electrical-Finai
15. Rough Electrical-Conduit 66. Solar SYstem-Final
16. Rough Electric Wirin9 67. Fencing & Access ApP�oval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
16. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. fl0ugh Heating & Air Contlitioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure . 70. Underground Hydro
22. Ducts, Ventilating - 71, Product'Piping OGes OOd
23. Gas Pipe•Rough & Test 72. Underground Flush '
24. Roof Framing ' ' ' 73. Undergmd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing • ' � 74; Overhead Hydro
26. T�Bar Ceiling (Structuraq & Monocoat � 75. Dry Chemical
27. Frame and Flashing 76. Dry Sta�dpipe
28. l2ihing & Siding 77. FIXED SYSTEM FINAL � .
29. Insulation 78. FIRE PREV. FINAL
30. DrYwall Nailing HEALTH DEPT. FEQUIREMENT
31. Piaster Brown Coat. '�� ! 79. FINAL INSPECTION
,,
32. Elecvical Power MeterFlnal '.�� '1 80. FOOD CERTIFICATE ISSUED
33. Final Eleciric � _ Notes:
34. Final Heating & Air ConditiOning � �
i
35. Finai Gas Pipe�Test �
36. Hood or CanopY . � � . �
37. Final Factory Fireplace ' '
38. Final Plumbing ,
.. - -� _ _.._�,��i '`•
39. Water Service�Finai E
� �.:,�,_
40. Gas Service-Final � �y [ , ' '.
41. Solar pomestic-Final • � , i
42. Backflow Preventer � � ~ �
• '�i..
43. Backflow Irrigation .,... ,
f ""
44. L2ndscape Irripation System � : - _ ,,,,,�. _ : � �
q5. Sound Attenuation � -
t n' J.'
46. Handicap Regulations � ' `4., ,
47. FINAL STRUCTURE & BUILDING ' � �-� . '
48. FIiJAL PLANNING ' � " - � � � .
49. Electric Release to Edison ' '°"""` >
50. Gas Release to Southem California Gas Co ' - ' . � . � � �__ _, �-
51. CERTIFICATE OF OCCUPANCY
No. Date
'\
\`
PflOJECT A�OpESS: ��� 4 z 6 ELDEN AV I1NIT:
awxexseame: RODNEY E. BROWN A Q, e.
aoosess: ��� ��F" RIVERSIDE DR �
NEWPORT BEACH
CA 92663
(714)642-3812
AXCHIENGINEEP: RODNEY E. BROWN flEG.NO.: NO
aoosess: 177 RIVERSIAE DR ��' F
NEWPORT BEACH CA 92663
PEXMITTEE: RODNEY BROWN ( 714 ) 642-3812
aoneess: 17'7 RIVERSIDE DR F
NEWPORT BEACH CA 92663
LICENSEO CONTPACTOB OECIAflATION: I here�y a�hrm Iha� I am Iicen5e0 untler provision5 oi Chapier 9(commencing wiih Section
7000� ol pivision 7 0l IAe Business ana Pmtesslons CoOe, antl my license is in tull lorce and eflect.
CITY �LIC.:---�.�c�-� STATE LIL.: CLASS:
Date� �— ` � L SignatW _
WOBKEflS' COMPENSFTION OECLAflATION: I �ere�y a��irm �ha� I have a ceni�ica�e o� consen� lo self-insure or a certilica�e oI Workers'
Compensa�ian Insurance, dr a cetlilied coDY thereo� (Sectioq 3g00, lab. C).
70LICY ND.: Eyy. DA7E:
COMPANY:
�] Ceni�ietl coDY is �ereby Wmishea. ❑ Ceni�ieU copy is filed wi�h �he ciry Builtling Division.
�a�e'. ApplicanC
E%EMPTION FflOM WOAKEPS' COMPENSAiION OECaMTION: (This section neetl not be completed i��he permit is �or one hunOretl (51W) or less�.
I certily tha� in t�e petlormance o� t�e work lor whith ��is permtl is issu II not employ any person in any manner so as to become
suble�� �o Ihe Work/ers' C/ompensalion Laws of Califor � / y�n/ /^ /
�ate: 7�!, "7 7� SignaNre'—� i� / `
NO7ICE: II. after making ihis tleclaration, you s ultl become su�iect to ine Workers' Compensation pmvisions of Ine Labor
Code. you mu5i Iorlhwiih comply with suc� pmvisions or �his De�mi� s�all he deeme0 revoketl.
LONSTBUCTION LENOING AGENCY: I here0y afiirm that �pere is a cons�mction lentling agency �o� ��e Dehormance ol �Ae wark tor
� wnich �nis permii is issued (Sec�ion 3097. Civ. CI.
LEN�EX:
aoosess:
OwNEB BIIILOEfl DEClABR7lON: I nereUy aifirm ihat 1 am exempl fwm the Contractors' Stale License Law for ihe following reason
�Sec�ion 70.31.5 BuSinesS and Pm�essional Coae: Any ciry o� cowry w�ich requires a permi� to con5imc�, alier, impmve, Uemolish, or
repair any simclure, prior Ia its issuance. also repuires the applicant for such permit to file a signea statement ihat he/she is IicenseA
pur5uan11oihe pmvisions o�l�e ConVac�ors' Slale License Lew�COapler 9�cammencing with Sec�ion 7000)o�Division 3 ol��e Business
an0 Pmlessions CoOe) or Ihat he/she is e�emp� ��erelmm an0 ihe basis �or the allegetl exemplion. Any viola�ion oi Seclion 7031.5 by
any apDlicanl lor a permil sublects ��e appiicani to a civil p¢nalry at no� more �han live hunar¢d Joilars (5500�.
I, as owner ol I�e DroDerty or my employees with wages as their sole compen5aiion, witl ao �he work. antl Ihe
❑ stmcwre is not intenUetl or olleretl for sale (SecUon 7pda, Business and Pmtessional Cotle: The Contractors' Sta�e license Law
aoes not apply lo an owner o� a pmperly who builtl5 or impmves �hereon, and who tloes such work himselfl�ersell or �Amugh
his or her own emDloyees, O�ovitletl tha� such impr0uemen�s are no� inlen4e0 or offe�e0 lor sale. I�, howeve� Ihe builtling or
impmvemem is soltl wilhin one year ot camplelion. �he owner will have the 6ur0en ol pmving he/she AiJ not builtl or imOmve
br Ne purpose ol sale�.
� I. as owner of Ihe pwpehy. am.eMclusivelp conirac�ing wiih licensed coniractors to consimc� �he pmle�� (Sec�ion 7044, Business
� antl Pmfessions CoOe', The Conlrac�ors' Slale License Law tloes nol appty to an owner o� pmDenY who bmltls or impmves Ihereon
antl who conlracis �or suc� pmlec�s wi�h a contractoqs)license pursuant�o Ihe Contracmrs' Sta�e License Law),I am aware
�hal prool o� I�eir Worker'S Compensation insurancn, shoWa be pmvidetl �o me.
� I am exem0� un0er Seclion: B. g P. C.
for Nis reason:
�ate'. Owner
I tlo hereby ceni�y ��al I am aware o� and untlerstana the requiremems ot Califomia Healt� antl $atety Code Sec�ions 25505, 25533, antl
25534 and I�al I or any INure building occupant will/will not Icircle one) neetl �o comply wi�� SaiU Sla�e codes antl ��e r¢Quiremenis for a
permit lor consimction or motlification imm t�e Air Ouality Management �istrict. ResiAential consimction apDlicalions are exempl irom
these pmvisions
Uale: ADPlicani:
I hereby ceitily that I have read I�is apPlicalion and state tha� ihe above informa�ion is correct I agree lo comply wit� all city antl coun�y
orainances an0 siale laws retating �o builtling cons�mction antl here�y aNhorize represen�atives ol lhis ciry �o enler uDon �he above�menlione0
pm0erly �or in5pecii/on purpose5. �/J
Oale: � � O � `— Signa� �s-ff�i ��
' Driver's license m Social Securiiy
AoolicanC Pink—pevenue; Goltlenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PzRM NO: B 05804
PERMIT NO: B 058040 PLAN CHECK NO: 01397-92 A GOVT; N SUPP: N
CONSTRUCTION TYPE: S—N PERMIT TYPE: STR PURPOSE: NEW
JOB DESCRIPTION : NEW 'TRIPLEX' W/ATT GARAGES 6 LAUNDRY SQ FT; 6,132
CLAIM VALUE: CALC—VALUE; 310,112.4U GROUP OCC: R-1 /
COMMENTS; *
****�*�*�*�r******�*****��****��r�rrt**�***x **�**�c **+�**�r*�t�r*****��u *** ��******�e****
Z O N I N GS ERTEHQAUCIxRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; 20 FT IN REAR; 10 FT 8 ZN FRNT; FT IN REAR: FT IN
LEFT: 29 FT IN RGHT; 5 FT IN LEFT; FT IN RGHT: FT IN
PARKING REp• 15 PROV; 15 PARCEL; 43929101 ZNE: R2 REF NO; DR-91-17A
PLANNING N(STES> 3 UNIT qNIT RES CONllO PROJECT, REAR STBK IS SEPAR,
> UNITS A B C. PKING ABOVE TOTAL F/ PROJ. P, F, E
*�t+��t*�*******x�x****� *************�c�r*���***�*�t*******+�*�*x****�*�*����
D E V E L O P N T S E R V I C E S R E Q U I R E M E N T 5 ,
ZOtJING APPROVED AY WD�L DATE; %��% Z
BUILDING APPROVED 8Y : _ ' DATE:
,
APPLICATION ISSUED BY• S� DATE: --�%�
�*�r��r** �*���***ir +��r*�*�***��-����*
iEiEiEjF�E�]F7EiE ifiFiFiEiEiEififfEiFiFiEiFlF�tjE�k�llfF)(�ifdfiEifikit�F ifiEikiE*�1FiFiEiflEikiE�lFiF�fIFiEiFif#itiEiflfdf�3EiFiFiE�FiF3E}ififaFiEiF�1ElEiEiF
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 1,378.00 31.01
SMIP/NON—RES
PLAN 223.93
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 1409.01 0,00 223.93
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMHING ELECTRSC MECAANIC
ii�s,ao
TOTAL PAID D"JE
1632.94 1632.94 ,00
- 1149,01 _�VER/SHORT: �00
�IRE— �MIP/TOT GRADING PLAN—CHECK
31.01
iE �E 3E * iF fF if 9F iE iE dEiEiE iE iE if iE �Ih �k iE ib iF fF iE if 3E iF 1f iF ik dE if iF aE if �E Y.� iE jf �7(� 3Eif� 1F �F #E iE 3k�lE # iE 3E iE �F iE IF3(� if 3E %� ib if 3E iF if iE iE jE iF if iE jf �E iF jE iE �E iElf 3t
I N D I V I D U A L F E E B R E A K D O W tJ
SFRE 51320 RES—CARAGESwT�YPEFV�� _G�� �t7��3 � 87A 76;00
END OF FEES c� ���^ �t �� r
p��, r��v_ sic._ �
��.�1� .�-�' ���
� � 93
� �
LL_� i�yr . ��A�'. �
�
CdNSTRUCTION AND PLANNWG POOL .. SPA
APPROVAIS Pesmit# Date -inspector AQpRpVAIS Permit# Oate Inspector
i
� i. Ttmporary Electrical Serviceor Pole 52. Pool & Equipment Location
2. Spii Pipe•Undrgrnd. � 53. Steel Peinforcement
f � -
3. Electrical Conduit Utility-Urrdrgrnd. 54. Forms
4. Electrical ConduifUndrgrnd. 55. Electrical Bonding
' 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFEfi Grnd. 57. APPf;OVAL TO COVER�GUNITE
_7. Footings' � 58. Electrical Conduit�Undrgrnd. �
8. Foundation ' � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgcnd. ; 60. Backwash Lines, P-Trap, O Undrgrnd.
�
70. Suuctural Fioor System ' _ 67. APPROVAL TO OECK
77. Property Sewer Line & HouseConnection 62. Backwash & Receptor•Final
�2. SQ°'�e� CaP ' 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14.' ROugh Plumbing 65. Elecirical-Fina4
15. flough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
}7': Ao�gh Wiring Sign 68. APPROVED FOR PLASTERING
18: Rough Electrica6T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rpuqh Factory Firepiace � " APPROVALS Permit #
21. Ducts, in Structure , 70. Underground Hydro .
22. DUcts. Ventilating - � 71, product Piping �Gas ❑Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Praming • ' 73. Undergmd�. Storage Tank O Gas ❑ Oil �
25. R�of Sheathing - 74. Overhead Hydro
26. T-Bar Ceiling (Structurai} & Monocoat ' 75. Dry Chemical
27. Frame and Flashing � �'� 76. Dry Standpipe
28. Laihing & Siding • 77. fIXED SYSTEM FINAL
29. Insulation � � . 78. FIRE PREV. FINAL
30. Drywall Nailing � : HEAI.TH DEPT. REQUIREMENT
31. Plaster Brown Coat . ` ;' � i'� 79. �FiNAt INSPECTtON �
32. Electrical Power Meter�Final "� �� � 80. FO00 CERTIFICATE ISSUED � I
33. Final Electric - � � Notes: '
34. Final Neating & Air Conditlon'mg, . �,
35. final Gas Pipe-Test �� �
36. Hood or Canopy � !
37. Final Factory Fireplace • � � •
38.; Final Plumbing � � � ',
39. Water Service�Final ' i � � � �'. .
40. Gas Service�Final -
41. Solar pomesticFinal � �
42. Backflow Preventer` ' " . -
{ �
43. Batkflow Irrigation � � � � +„_
44. LandscaDe Irrigation System �
i � --
45. Sound Atte�uation +
46. Hendicap Regulations . , � ' � �
47. FINAL STRUCTURE & BUhLDING �/� j�. .
48. FINAI PLANNING , i ' �
49. Electric Release to Edison �---- ,
50. Gas Release to Southern California Gas Co - � _ �� . %; ' ' ,_ _
51. CERTIFICATE OF OCCUPANCY
No. Date
CITY OF COSTA MESA
BUILDING DIVISION
OWNER-BUILDER VERIFICATION
A City or county, which is required to give notice pursuant to Section 19830, shall attach to such
notice, and, as a condition precedent to issuing a building permit, require the completion and require the
return of, an owner-builder veri(ication.
Attention Property Owner:
An 'owner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity
to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued
until this verification is received.
1. I personally plan to provide th major labor and materials for construction of the pro-
pased property improvement.,�1 Yes ❑ No
2. I(have/have not)� signed an application for a building permit for the
proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction:
Name _
Address Ciry
Phone ( ) Contractor's Lic. No..
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name _
Address City
Phone ( ) Contractor's Lic. No..
5. I will provide some of the work but I have contracted (hired) the following persons to pro-
vide the work indicated:
Name Adtlress Phone Type ot Work
I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State
of Califarnia Health and Safety Cotle and have completed the above information to the best of my per-
sonal knowledge, in compliance with this State law. C
Signed '���� �� Date: � ` /�
Name: �'�NEy � �O/N✓v
(Printed or TYP�)
C.D.�. p or SS. #/�
754-5273
CERTIPICATE OF COMPLIANCE
PAYMENT OF SCHOOL FACILITY FEES
NEWPORT-MESA IJNIPI�D SCAOOL DISTRICT
Developer/Applicant:
�
� � -� ,�/ ,/�
Address: � % � /� �/A/F,rP_('/ilJf //�� �/!/, f'S .
Telephone Number: (, 1--�2 � ���
Tract/Parcel and Lot
Location of Project:
Number of Square Feet
Residential Space
Number of Square Feet
Commercial and
Industrial Space
o� ��
Number(s): �j�,OGT ��,�y7
.,� s� � � �. ��.. � C�, � ,
o f � �//�/L�" p`/ ��q
'— L%"71 7 x $1.50 Total' �j}",�V
oe �dZ.63
Commercial/Industrial Project is
Mini-storage
Movie Theater
Racquet/Health
Warehouses
Heavy Industrial
Regional Shops
Light Industrial
x $0.25 Total
(Check One)
Motel
Bank
Neighborhood Shops
R & D
Hotel
Medical Office
Office Park
Preschool
Auto Repair
Hospital
Large Office
Office Bldg.
Restaurant
Past Food
The provisions of Government Code Section 53080 are not applicable.
This certifies L-hat the above-named Developer/Applicant has paid school
facility fees in compliance with Government Code Sections 53080 and
65995.
Checics are to be made payable to N�p.or.t-Mesa Unified School District.
� � �
� � �� ��.
tsusiness rtanager
Newport-Mesa Unified School District
The above representation as to square footage is true. Developer/
Applicant agrees that if it is later determined that such representa-
tions are not true then this certificate shall automatically terminate
and the appropriate City/County shall be notified.
Date: ��� ��� �,�z� �/",�`�
Developer/Applicant
�o ��,�y � ��d �,,�