HomeMy WebLinkAbout2884 ELLESMERE AVE - Building Permits_ �'- - _,
�' CITY OF COSTA MESA . ^
� BIIILDING DIVISION v �r �
� . � DEVELOPMENT SERVICES DEPARTMENT
� PERMIT PERMIT NUMBER
�'�
898-01286
(714) 754-5273 • Fau (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 2884 ELLESMEREAV
Suile:
Vicinity:
Parcel Nunmber: 13927311
Applicant: MALONE,SEAN
Address:
Owner: RIC
Address 2884
237
BUILDING PERMIT
Status: ISSUED
Applied: 07/16/1998
Issued: 07/16/1998
Zoning: R1 R1
� - i PFone: _ . �' .
�-,r��. � _ ZiP: � � � . --
�RDS;'RAYMOND E�TR, � - ` �;, ; � "
�ESMERE AVE. � ' .. ' � � � �- � ' �
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/ � � � � - � Phone �` _�r,�� -., _ � �A
MESA,CA � Zip 92626 � � �� - �
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S ROOFING�
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LATERAV � ���
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��v/ � ���/ License= 675241 - - - � " '�
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Arch / En �. i/
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' Address `� % � � � �� -� .
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.;� " _. License: ,
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�' � �' � � ' SCOPE OF PERMIT �
% , � '�
,�� /INSTALL 1 SKYLIGHT WITH NO STUCTURAL CUTS>•. �. � , `
, � ; ,. . � ' :C � � . . . .. �� .
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, � FEE SUMMARY � % ' �
PlanCheck: �,�.$0.00 _, y,,'�,,r-;-- .. ,r..:- CalcValuation: $seo.00
�' Permit , �. $32.00 — --- �' j'� - ` Claim Valuation: $aso.00
��l`SMIP Res '. $0.50 -� ` / '
SMIP,Com. ,$0.00 �/ �
��`� Other" -$Q00 ` --_ � � � �
Inspection:�� �;$0,00 . � � _ �- �
�, �i '� �
�`-.�� � '
�Total: $3 5�0, "' � � • ,�
.��c, � , .� � � �
.�, �.�, _ �
' �;� �� �� �� -PLANNING 8 ZONING. � �
� A
- ���\_- - . . ,
'� -
SETBACKS�..-�, . �, �, , � � , � � , ..
� � ��: : �- : ` _
MAIN STRUCTURE- Front �0; 0, _ Rear 0- 0�' �� -� � teR '�0- 0 " Right 0- 0 - �
� . .,
ACCESSORY Front �0=0 ��,� .Rear 0-0 � Lett 0-0 Rlght 0-0
PARKING Existinq: o \ � �- Reauiied: �0 , , , Pr000sed:. 0 - , '
NOTES: . � . , . .. �,.� ..,, � , ;,
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 period of 180 days.
INSPECTIONS: In ordei for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requiretl Inapectiona end final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARATION:
I hereDy a%rtn unAer penalry of perJury ane at the following decleretians:
❑ I heve anA wlll maintein e certificete at consant to sell-Insure tor workars' compensatlon, es provided for by sectlon 3700 of the lebar Code, for the pertormance of the
work for whlCh ihis permit is Issuetl.
I have end will mflinlain woAcers' compensetion insurence, es requiretl by section 3700 oi Ihe�Lebor Code, for Ne pertortnance of Na work for w�ich Nis partnit is issued.
My wo�°, �rs',�°mpensa Insurance cartierP n�tl policy nu�mtbe�r ere:
Cartier. �/�'1TL ��'� �/+�+,r —C/���(j�U PoliqNumber. �� 9�
(lhis section neetl not be comp/eted I7 the permit /s veWed et one hundred tlollars (5700) or /ess.)
❑ I cePity ihat in the partortnence o � 9w� this per��shall not emploP eny persPon in eny menner so as to bacome subject to the workers'
com en of Celifomle, d e ree tha ould become sub t to t e workers' com ensetion rovislons of Section 3700 of the Lebor Catle, I ahell forthwit�
Ap licant Signeture G ate: /"— �6 — 9/�
: AILURE TO SECURE WORKERS' COMPENSATION COVEMGE IS UNLAW L AND SHALL SUBIECr AN MIyAt�ENALTIES MID qVIL FlNES UP TO ONE HUNDRED
hKK15AND DOLLARE (5100,OW), IN ADDITION TO THE COST OF COAIPENSATION, �AMAGES AS PROVIDED f-0R IN SEC�IIXJ 3'l06 OETHE LABOR CODE, IMEREST, AND ATTORNEY'S FEES.
LICENSE� CON7RAC UECLARATION:
I hereby eNi l em Iice sed under provislons of Chapter 9(commenclnq wllh Section 7000) of Dlvlsio e Business antl Professions Cotle, antl my license is In full
torce e act uc, a � i�' Z S�/ Clas s C'— 3 9
ractor's Si�t� � . /'�l._ — Dat � — ['�— S �
CONSTRUCTION LENDING AGENCV: .
❑ I heraby aRlrtn that thera is e constructian lending agency tor Ihe peAormence of the work far which this permit is issuad. (Sec. 3097, Civil Cade).
Lenders Name: Lentler's Atltlress:
Signature:
OWNER-BUILDEH DECLARATIONS:
Date:
1 hereby eftirtn that under penelty o1 par�ury thet I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business end Protesslons
Code: Any ciry or county which raqulres e pertnit to construct, elter, improve, demolish, or repalr eny structure, prior to its Issuence, also raquires ihe epplicent for such permit
to fila e slgnetl statement that he or ahe Is Ilcensetl pursuent to the proNslons ol the Contractors License Law (Chapter 9(commencing with Section 7000) oi Divlsion 3 of t�e
Business antl Profeuions Code) or that he or sha is exemp� t�eretrom and Ihe basis lor the elleped e:emption. My violation of Section 7037.5 by any epplicant for e permit
sub�ects Me epplicent to e civil penalry ol not more than frve hundretl Gollars ($500).):
❑ I, as owner ot t�e property, or my employees wit� wapes as iheir sola compensation, WILL 00 7HE WORK, and ihe siructure is not intanded or oNeretl for sale (Sec.
7044, Business end Prolessions Code: The Contrectors License Lew tloes not apply to an owner ot property who bulltls or improves Ihereon, antl who does such work
himselt or herself or through his or �er own employees, provltletl that such Improvements ere not intentled or otteratl tor sale. It, however, t�e building or Improvement I5
sald within one year of completlon, the owner�bullder wlll heve the burden of proving that he or s�e did not build or improve tor purpose ot sele.).
❑ I, es owner o1 the properry, em E%CLUSIVELV CONTRACTNG WITH LICENSED COMRACTORS to canstruct ihe project (Sec. 7044, Business end Professions
Cotle: The contreclors License Lew does not epply ta en awner ot property who bulitls or Improves thereon, end who conirecis for such project with a coniractar(s)
licensa pursuent to Ihe Contrectors License Lews.).
❑ I am exempt untler sec. Business entl Professions Coda for this reason:
Signature: Date:
Owner ID veritietl by dnvefs license. ❑ Yes ❑ No Drivers License No.
Venficetlon of Ownership by (rype at dwument, i.e. - proparty tez 6ill or Aeed):
DIVISION OF INDUSTRIAL SAFEfY PERMR CERTIFICATON:
Expires:
❑ I hereby certtly that no ezcavetlon Ilve (5) or mare teat In tlepth Into whic� e person is required to tlescenQ wlll be made in connection with work euthorizad by this
permlt, entl thet no builtling structure, scaXolding, telsewark, or tlemolition or dismantling thereof, will be more then thirry-six (36) faet high. (Chap. 32, Grp 2, An 2, Sec.
341, 7tle B, Celifamla Adminlstretive Code). �
❑� As owner-bullder, I will not employ enyone to do work which would require e pertnit trom the Division ot Intlustnal Sefery, as noted ebove, unless such person hes e
pertnit lo tlo such work from the tlivision.
Signature: Date:
Division of Indusirial Safery Permit Number:
CERiIFlCATE OF COMPLIANCE AND Al7T}10ROJ1TON OF ENTTiY: I certily under penalty ot perjury that I have reatl ihis epplication end stete that �he information given is
cortecL I agree to wmply with ell stete lews and city ordinences relating to building construction, end authonze represantetives of Ihe Ciry ot Costa Mesa to enier upon the
flbove-dascnb� property for inspecGon Duryoses. I egree not to occupy or allow occupancy ot any building auNorizetl by this pertnit until fnel inspeIXion.
{O�E /. INSPELTWNT'PE
1818 Fixetl System Finel Fire Prevention
1288
200
Pool Spe Final
Finel Re-Roat
201 Final BIaWReteining Well
202 Final Fectory Fire Plece
203 Final Sign
204 Finel Demalition
2146d
'� � _ �6'
nI ate
�jE ��$ jQpfj INSPECiIONTYPE �jE ��,5
206 Finel Mechanicel
208 Final Plumbing
210 Final Electncal
212 Final Fire Preven�ion
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
._� a o t MFSq
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(774) 754-5273 • Fax (714) 754-4856
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
BUILDING PERMIT
�ob Address: 2884 ELLESMERE AV
Suite:
Vicinity: HOUSE 8 GARAGE
Parcel Number: 13927311
Appliwnt: MIGUEL ENRIQUEZ
Address: 1420 E. EDINGER AV
SANTA ANA, CA
SUITE711
Owner: RICHARDS, RAYMOND E TR
Address 2884 ELLESMERE AVE
COSTA MESA,CA
Contractor: BEST VALUE ROOFING
Address: 1420 E. EDINGER AV
SANTA ANA, CA
SUITE111
Zip: 92705
Arch :
Address:
Phone:
Zoning: R1 R1
Phone: 714-542-5222
Zip: 92705
Phone:
Zip: 92626
Phone: 714-542-5222
License: 715903
Eng:
Address:
�
PERMIT NUMBER �
699-01975
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 12/7717999
Issued: 72/17/1999
Phone:
Zip: - License: License:
SCOPE OF PERMIT
REROOF - T/O, INSTALL/FILL IN ON SPACE SHTG, 1 LAYER OF 30# FELT AND NEW MIRA VISTA LIGHT WIGHT
SHAKES ICBO# ER-5209.
Plan Check: $0.00
Permit: $265.25
SMIP Res: $1.55
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $266.80
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0- 0
PARKING Existinq: o
Rear 0- 0
Rear 0-0
Reauired: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0-0
Right 0- 0
$15,500.00
$15,500.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California stetutes 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 1 BO days, or if work is suspended or abandoned
toi a period o( 180 days.
INSPEC710NS: In order for the work authorized under this permit to be considered lagal, such work must comply with all applicable codes, and all
requlred Inapectlona end flnel epprovel must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
�
WORKERS' COMPENSATION DECLARATION: �'
I herehy aHirm untler penalry oi perjury one of ihe tollowing declarations:
❑ I have end will meintein e cenificate of consent to seN-Insure tor workers' compensetlon, es provided for by section 3700 of the Lebor Cotle, for Iha patlormance of the
work for which this permit is Issued. '
� 1 have antl will maintein workers' compensation insurance, as required by section 3700 0l Ihe labor Code, for the pertortnance of the work tor which this permit Is issued.
My workers' compensation Insurance cerrier and policy number are:
Carrier �ei D PolicyNumber. O�O���� I
(This sec(ion need at Ee camp/e(ed i! the permit is ve/ued af one hunOretl Gollers ($100) or /ess.J
❑ I certify that in the pedormence oi the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to Ihe workers'
compensetion lews of Calitornia, and egree thet if I should becroma subject to Ihe woAcers' compensation provisions of Sec�ion 3700 of ihe Labor Cotle, I shall forthwith
comply with Ihese provisions. .
. q
ApplicaniSigneWre: � Date: � IoZ � I7"G /
WPRNING: FAILUFE TO $ECURE WORKEflS' COMPE ATI ERAGE IS UNLAWFUL AND SHALL SUBIECTlW EMPLOYEfi TO CPIMINAL PENALTIES AND CIVIL FINES UP TO dJE HUNDRED
THWSAND DOLLARE (5100,000), IN ADDITION TO THE ODST OF COMPENSATION, DAMAGES aS PROVIDED FOR IN SEGTION 31O60F TNE IABOR CODE, IMEREST, AND ATiORNEV'S FEES.
LICENSED CONTRACTORS DECLARA710N:
I hereby attirtn that I am
torce antl eHect. Lic. k_
Coniracbr's Signature:
of Chapter 9(commencing with Section 7000) ot Division 3 of tha Business antl Professions Code, end my license is in full
Class # C— .�
�,, Date: l,� - li -G
CONSTRUCTION LENDING AGENCY:
❑ I here6y aHirm thet there is a construction lending agency for the peAormance ol ihe work tor which this permit is issued. (Sec. 3097, Civil Code).
Lender's Neme: Lender's Adtlress:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereDy attirtn Iha� under penalty ol perjury iha� I am EXEMPT FROM TME CON7RACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or counry which wquires a pertnit to wnstmct, elrer, improve, demolish, or repair eny structure, prior ro its issuance. elso requires the applicant for such permit
to file e signed statement that he or she is licensetl pursuant to tha provisions of tha Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of tha
Business and Professions Code) or that he or she is exempt theretrom antl Ihe 6asis for Ihe ellegetl eaemption. Any violation oi Section 7031.5 by any epplicanl for a permit
sub�ects the epplicant to e civil penalry of not more than five hundred dollars (3500).):
❑ I, a5 owner of lhe propehy, or my employeas with wages as iheir sole compensalion, WILL DO THE WORK, antl the structure I5 noi intended or otteretl lor sale (Sec.
7044, Business antl Professions CoOa: lTa Coniractors License Law tloes noi apply to an owner of property who builds or improves thereon, entl who does such work
himself or �ersell or through his or her own employees, provided lhel such improvements are not intended or oHered for sale. It, however, Ihe builtling or improvement is
sold within one year of completion, ihe owner�builder will have the burden ot proving Ihat he or she did not builtl or improve for purpose of sale.).
❑ I, as owner ot �ha property, am E%CIUSNELY LONTRACTING WITH LICENSED CONTRACTORS ro construct Ihe project (Sec. 7044, Business and Pw/essions
Code: The contractors License Law tloes not apply to an owner ot property who �uilds or impmves Ihereon, and who conirects for such project with a con(ractor(s)
license pursuant to Ihe Coniractors License laws.).
❑ I am exempt under sec. Business end Pro�e55ion5 Code br Ihis reason:
Signaiure: Date:
Owner ID verifiad by driver's liconse. ❑ Yes ❑ No Driver's License No.
Venfication of Ownership by (type of document, i.e. - property taz bill or daed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICA710N:
Ezpires:
❑ I hereby certity thet no excava6on five (5) or more teet in tlepth In�o which a person is requiretl to tlescend, will be matle in connectlon with work authonzed by �his
pertnit, and that no building sirucNre, scaflolding, falsework, or tlemolillon or tlismantling Ihereol, will be more than Ihirry-six (36) taet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Ttle 8, Calitomia Administrative Cotle).
❑ As owner-builtler, I will not employ anyone to do work which would require a permit from Ihe Division of Industnal Safary, as notatl above, unless suc� person has a
permi� to do such work tmm �he tlivision.
Signature: Date:
Division of Intlustrial Salety Pertnit Number:
CER7IFICATE OF COMPLIANCE AND AU7HORIZATON OF ENTRY: I certity under penalty of perjury �ha� I have read this application and state that ihe information given is
correct. I agree to comply with all sta�e laws and city ortlinances relating lo building constmction, and authorize representatives of tha Ciry ol Costa Mesa ro enter upon the
above-descrlbetl property for inspection purposes. I agree not to occupy or ellow occupancy of eny building authorized by Ihis permit umil tinal inspection.
CODE �, INSFECTIONTYPE
1616 Flaetl System Final Fire Prevention
7266 Pool Spa Finel
200 Final Re-Roof
201 Final Block/Reteining Wall
202
203
204
29a8�a6
Finel Factory Fire Place
Final Sign
Final Demolition
Owner(s) Date
� ia - l� -q �'
icant ate
AT �NTRIALS
�T.'� �
T�
COOE� INSPELTIONTYPE
206 Final Mechaniwl
208 Final Plumbing
210 Final ElecMcal
212 Final Fira Prevention
220 Final Planning Approval
222 Final Site
250 FinalBuilding/Occupancy
DRTE NTI RIRLS
i '
AODlicanl to flll In all spates ezce0t those wit�in heavY �orOer lines anG sign all ap0�opriate Geclaratians.
f.I7Y-P: COSTA CO ST•RUCTIO��N PCER IT
ProjectAddress _!� ��~'iG,�-'� �� _
Applicant's MailV'�p Ad essy� �� ���
Owner's Name +`• �• (�1=1J1T'��� Phon 7�
Address Si�M -F+
Arch/Eng. License No.
Address
Conlractor's Nam Phone
Addresslmailing) T�
City License No.
LICENSED CONTRACTOR DECLARATION
I hereby atfi�m [hal I am licensetl untler provision5 of Chart2/ 9(Commencing
witn section ]000) of Division 3 of tne Business antl Pro�esslon5 Cotle, antl
my Iicense is in full torce antl eftect.
License C1a55 Llcente No.
Date Si9ndhre
W00.KER5'COMPENSATION DECLARATION
�rt�y aflirm that I have a certiticate oi ConS¢nt lo self-insure or d C¢rtificate
JJorkers' Compansation Inmrance, or a certifietl COpy theteot (Section
.JO, Lab. C.)
Policy No. Company
eCertifiea copy is nereby tumished.
Ccrtifietl copy 6 tlle0 with Ihe ciry Builtling Division.
Dale Applicant
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(Thissection need not be completed if the permil is tor one huntlretl (E300) or
less).
1 c¢rtity that In the perto�mance Ot the wo�k tor w'Ch [hIs pe�m�t is ISSu¢tl, I
shall not employ any person in any ma so o be me subje to the
Workers' p on L. ws of Galifor . . (
Date � Signature
NOTICE: I,af r akin this tleclaration, you snoWtl becoma subject to the'
Workers' ComOensation provizions of the Labor CoCe, you must forthwith
compy wilh such provislons or Ihis permit shall be tleemetl rewketl.
CONSTRVCTION LENDING AGENCV
1 hereby afflrm that there is a construcfion lentling agency for tne performance
ot the work tor wnich this permit is issuetl (Sectlon 309] Clv. GJ
LPntler's Name
Lentler's Atltlress
OWNER BUIIDER DECLARATION
I hereby alflrm that I am exempt from the Contractor's License l.aw tor the
. followin9 rea5on (Sec[ion 7031.5 Businesz antl Protesslonal Cotle: Any city or
'�, munty whlGh reqWres a pe�mit [O const�uct, alter, improve, tl¢molish or repai�
Iany sVucture, prlor to its issuance, alw reqWres the applicant for such permit
to fil¢ a 5ignetl slaleTen[ lhat �e/she i5 Ilcens¢tl Pu�suant to Ihe prOvision5 of
the Contractor's License Law (Chapter 9(commencin9 with Sec[ion 7000) of
`vi5ion 3 0� the Bu5Ine55 antl Profe55ion5 CoOe) or tha[ be/she is exemp[
rretrom antl the basis for the alleqea exemPtlon. Any violation of SecHon
i31.5 by any applicant tor a Permil sub7actz tne appllcant to a civil
e alty of not more lhan tive huntlretl tlollars (E500).
I, as owner of the property or my employees witn wages as their sole
omoensation, will tlo the work, antl tne structure is not inlentletl or offeretl
for sale (Section 7044, Business and Professional Cotle: The Contractor'S
Li<ense Law tloes not apply to an owner of a property who builGs or improves
tM1e�eon, antl who tloes such wo�k himself/hers¢I( o� thrOuqh bls or h¢� own
employees, p/pvltlatl tna[ such Improvements ara not Int¢ntlotl or oftevetl fo�
sale. It, howe:kq th! bulltling or improvement I55oltl wlthin on0 year of com-
pletion, tne owner wlll have tha burtlen ot proving he/she tlitl not builtl or im-
prova torthe purpose of sale).
❑ I, as owner of the OrOPerty, am exclu5ively Coniratting with IiG¢nsetl con-
cra<tors to construct the project ISection 7044, Business antl Professlons Cotla:
The ConVacZor's License Law does not dpPly to an own¢r Ot Property who
builtls or improves thereon. antl w�o wntracts for sucn oroiects with a con-
tractor(s licenze yursuan[ io me Convactor•5 Ucense Law). I am aware that
proo( o� their WorkerY Compensation insuran<e shoultl be provitletl to me.
❑ 1 am axempt under Se<tion—�—�- B. 6 P. C. for this reason
Dale h���� V � a-T� Owner
I he�eby ce�tify tha[ I have rea
information is mrrecL I agree to
antl state laws rel m9 l iltlir
senta[Ives of th' o enter
i�5pectiOn pu .
Signature
Orivers' License or 55 �
a
that the above
�'�_
TVPE OFCONSTRUCTION LINEW U ADD �ALTERAT�ON LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
D CRIPTIO OFWOFK/U�EOF� DG.
U �. S w,
TYPEOFPERMIT GRADING FOUNDATION STRUCTURAL
❑ TENANT � ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION 5�. FT. ` f OCCUPANC
CONSTRVCTION TVPE �y�.J_ VALUATION $ �
ZONE GRADINGGU.VDS. ACRES
Remarks:
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishwasher
Drinking Fountains
Floor Dreins
Floor Sinks
Gas Service Outlets
Kitchen Sink
Lavamries
P—Trap
Roof Droins
Reinspection Fee � $15
Boiler
Duct- Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact Blt. ICBO �
Heating System & Ducting
❑6700,000 BTU �700,0006T
Reinspection Fee � S75
OB65-46, rev. 5/88 White - Builtling: Canary - Applicant; Plnk - Accounting; Goltlenrotl - Assessor
$AOWCfi �min.
Service Sin�T
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank .
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Issue Fee � $ 3
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑0.100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
$ 3
A.P. qW ' /
S Main Building:
E
T Front
8 Rear
A
C Fight
K Left
S
Ping. Ref. #
Planning Notes: 1
�
Building:
ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW
Construction Pole Sub. � 50 + KW
Cooking Unit
Dishwasher .
Dryers �Gas' �Electric
Fan ,
F.A,U.
Fixture5 .�.
Device Boxes "
Outle[s
Switches
Garba9e Disposal
Generator �0.5 KW �5-15 KW
Meter LJup to 100 amps
Meter ❑over 100 amps'
Sub Panel
Momrs 00.7 HP � 1 h: 8
Inc. Soiar �9-15 HP 016-15+
Microwave
Pole Light i '
Range
Sign
Stending Set[ions
Trash Compncmr
FEES
O
N
I
N
G
R
E
Q
M
T
S.
I Rainspection Fee !$15 � I luue Fee I �-3�'
DEVELOPMENTSERVICESREQUIREMENTS•^'� ('
ZoninB APP��ved By �T_Date� �
BuildinB APP�oved By Date
Application luued By Data�
SUMMARV O �FEES �
BUILDING PERMIT $ SMIP $ (")—
PLAN CHECK $ PERMIT
PLUMBING $ Sw ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTFICAL $ d GRADING $
PLANCHECK 50% $ MICROFILM $ _��
MECHANICAL $ TOTAL FEE $ Sa _
PLAN CHECK ZS% $
�. L,�;_,,=�-crn:i2�a� �e9-e :,.:;.
OH'�: �1:���.'_t%g? TitiE=- t`^:j<.
„
" CONSTRUCTION AND PLANNING POC SP.A ,_
, APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector
�1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location '
2. Soil PipE'-Undrgrnd. -� 53. Steel Reinforcement � ,--%1
:31�Elect�i�al Conduit Utility-Undrgmd. � 54. Forms � ���1
i
.4�-Electfical Conduit-Undrgrnd. ' 55. Electrical Bonding ^ '�';
" < < � r
�5.�Sieel�Reinforcement 56. Rough Plumbing & Pressure Test ,.�.��
�6:7 Eiectrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE � ��'
r i ,
� �..
'7.<I Footings � 58. Electrical ConduirUndrgrnd. "� �. j
,�
8� Fountla[ion , 59. Gas Pipe, O Undrgrnd., Test � �
� � Ir
9!)Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. `�
�
tO;�StructuralFloorSystem . ` 61. APPROVALTODECK. %
17. Property Sewer Line & House Connection 62. Backwash & Receptor-Final �
12?• Sew�c Cap 63. Heater & Vent-Final � '-'
.^� � '
13�. Roof�Drains , 64. Plumbing System - Final .- -
14. Rou�h Plumbing 65. Electrical-Final ��
15. Rough Electrical-Conduit 66. Solar SYstem-Final
1¢, Rough Electric Wiring 67. Fencing & Access Approval -
t-7: Rough Wiring Sign - 68. APPROVED FOR PLASTERtNG
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19, Rough,Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20: Rough Factory Fireplace APPROVALS Permit #
'�d? DuCts, in,Structure 70. Underground Hydro
,22: Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Telt , 72. Underground Flush
24. Roof Framing -'� 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical .
27.,�FFame and Flashing � 76. Dry Standpipe
28. Lathing & Siding , 77. FIXED SYSTEM FINAL •
� 29. Insulation � 7S. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Me�er-Final � 80. FOOD CERTIFICATE ISSUED
33. Final Electric ' j Notes:
34. Final Heating & Air Conditioning ._ (�
35. Final Gas Pipe-Test
,36. Hood or Ca�opy
�37. Final Factory Fireplace
�
-3$. Final Plumbing , '] 2'(�� fii�
:�
39. WaterService-Final�> f�' �
�40. Gas Service-Final � ,
41. Solar pomestic-Final. � .
42. Backflow Preventer�•� _ � � � , '
43. Beckflow Irrigatio,� � -.. ' ��
.y .
44. Landscape Iriigation Sy3tem � , . '
. .
45. Sound Attenuation , � � i -
46. Handicap�Regulatio'ns _
47. FINALSTRUCTI)RE&BUILDING ��
48. Special Requirements Completed
;49. Electric Release to Edison l� ' .
�
50. Gas Release to Southern California Gas Co �! � •'1
51. CERTIFICATE OF OCCUPANCY , - , 't' •
No, Date • i ' - � �
�
�cTnooxess: Z88q ELLESMERE'AV
OWNEfl'$ NAME: RICHARDS RAYMOND E
nooaess: Zg84 ELL�SMERE AVE
COSTA MESA,CA 92626
714) 549-3676
AflLMIENGINEEfl: NEG.NO.:
AOOHESS:
UNIT:
UNIT:
aeemmee:RAYMOND RICHARDS (714)549-3676
nooncss: 2 g g q ELLESMERE AV
C.M. CA 92626
LICENSEO CONTflPLTOfl OECLAflATION: I hereDy allirm ihal I am licensed unaer pmvisions of Chapter 9(commencing wilh Section
]000� ol �iv¢ian 3 ot �he Business and Prolessions GaOe, ana my license is In lull larce antl eilect.
CITY LIC.: STATE LIC.: ClASS:
Oate: Signamre:
wOBREBS' COMPENSRTION OECIAPAiION: I hereUy allirm that I have a cenificate ol consem m self-insure or a cenificate ol Warkers'
ComOensation Insurance. or a cetlilied capY ��ertof (Semion 3800. la�. C).
POLICY NO.: E%P. OPTE:
COMPANY:
� C¢Nlied copy is here6y �umis�ed. ❑ Cerlilietl copy is file0 wit� Ine city BuilCing Division.
Oa1e: ADPlicanl: '
E%EMPTIONFBOMWOPKEBS'COMPENSATIONOECIAflRTION: (T�i55ec1ionneeGnolbecomple�e0i11hepermi�i5�oronehun4reU�5100�or1e55�.
� I cenily inat in e petlormance ol Ihe work lor w�ic� I�is per 't is i55ueG all no�employ an�any manner 3o a5 io Gecome
O�ecl �` orkers' mDensatian Laws ol Calilomia.
/Oat Signature: � �--P
NOTICE: i after Iting t�is Geclaration. you ihoulG Oecome suUle�� �o t�e Workers' Campenution provisions afthe �abor
COde. yov musl fonhvntn comDly witn sucn provisions or ihis permil Shall De AeemeA revoke0. �
CONSTBOCTION LENUING AGENCY: I AertOy allirm t�at ��ere is a wnslmction IenEing agency for ihe petlarmance of the xrork lar
w�ic� �nis permiiis issuea (Senion 3097. Civ. L�. �
.+
lENOEH:
RDUflESS:
OwNEH BWLUEfl OEClABA7lON: I hereby allirm Ihat I am exem0� ��om tne Coniractors' State License law lor tne followinA reason
(Section 7031.5 Business and Pmfessional Code: Any city oi couniy which rtquires a permi� [o conSlmci, aller, impmve, tlemoiish, ar
repair any stmcture. Orior to its issuance, also reQuires Ine applicanl lor sucn permit to file a signe0 statement tAat hpJshe is licensetl
pursuam io ihe provisions ot the Contractors' Stare License Law (Chapier 9 �commencing wit� Sectian 70W) ol Division 3 oi t�e Business
antl Pro�essions Code� orthal ne/sne is exemo���erelmm anA �he Oasis lorine allege0 eKemption. Any violation oi Section 703f.5 by
any apP�ican� for a permi� Subletls I�e a001itanl Io a tivil Oenalry ol noi more lhan liv¢ huntlretl tlollars (5500�.
❑ i. as owner of ine propeny or my employees with wages as ineir sole comDensation, vnll eo tAe woM, antl the
simc�ure is nol in�en0etl or o�lereA lor sale (Sec�ian 7Ud4. Business anG PrO�essional CoOe: The Con[racrors' State License Law
does no� appty Io an owner o� a pmpeny who Oui105 or impmves �hereon, and who Aoes such work himsell/hersell or IhmugA
� his or Aer own employees, proviCed �ha� such improvemen�s are nol inlendetl or oflere0 for sale. If, how¢ver �he builAinA or
impmvemenl is SoIA within one yeai ol com0lelion, Ihe owner will �ave Ihe burtlen o� pmvinA he/she tlitl no� bui10 or impmve
lor �he purpose of sale�.
I, as owner o� the pmDe��Y. am excWsively comracting wil� licensetl comrac�ors �a cons�mc� the pmleci (Seciion 70A4, Business
❑ and Prafessions COAe', The Comratlors' Siate License Law Eoes not apply lo an owner o� propeny who builAs or imD�aves t�erean
antl who conirac�s fOr Suth projeCls wi�h a COnlrat�Oqs) license pur5uanl ta ihe Con�raclors' State LiCenSe Law�. I am awafe
that proo� o� tAeir Worker'S Compensa�ion insurance S�ouIG Ge pmviAea to me.
W I am erempi untler Senion: H P-� Q 4 4 B. 8 P. C.
m�misrexsqn: �pWNER—BUILDER Q ��
�� � l( �( � t�—p--`—�
Oate' r_��_,� �'�e�: -.
nereby ceNty that I am aware of ana uneerstana the r¢puirements ol Calilomia Healin an0 Safery fAde Sections 25505, 25533, ana
2559A antl Iha� I or any lulme builaing occupani willlwill not (circle one� nee0 to comply wi�h sai0 staie wdes and Ihe requirements lor a
Oermil �ar consimqion or modil¢a�ion �mm Ihe Pir Oua6iy ManaBemenl DiSUic�, fle5itleniial corelmction applica�ions are eeempi imm
Inese provisions.
Date: ADOlicanC
I h¢t¢Cy ceniry t0a� I �ave reatl Ihls applitalion and 51a1e lhai I�e a�ove inlOrmalion i5 taneCi. I agree lo tomply vri(h all Ciry antl coUnry
or0inances an0 state laws re t� i� d0inp wnsimnion a`M �ere0y authpr¢� rese at es of tIi ciry m enrer upan tne ahove-mentioneA
prap • �or insp cl n ur oses. ( I
L �F �
Date'. SiBnalure:
oriv � �icense or Socia� Securiiy
Pink—Revenue; GolCenmtl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: E 066671 PLAN CHECK NO: N
CONSTRUCTION TYPE: V—S PERMIT TYPE; ELE
JOB DESCRIPTION : ADD ELECTRICAL FI7CTURES
CLAIM VALUE: CALC—VALUE:
PERM NO: E 066671
GOVT; N SUPP: N
PURPOSE: ADD
SQ FT:
GAOUP OCC: R-3 /
COMMENTS: ADD ELECTRICAL FIXTURES
�r�**�x*�*�r�r�r�*�t�tat�rir��*��e�*�r*+r+�ir�r��r�r�rx+r�*�r**+r«�r*��ear+r�r*w*«x�*+t*+�x�r�r�**+r�**+r�r�**��r
Z O N 2 N GS ERTEB�AUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARRING RE(?: PROV: PARCEL; 13927311 ZNE; REF NO:
PLANNING NOTES>
>
ititwx*it�r+t�r+r�rir+t*i����r�rx�***x�x��e***it+r��r�t�r�it�rw�r*irit�t�r*x��tx�*�r+t+tftx��f��**�rx��rirrx�f��t*i�*x�x+t�ex�fr�r**
D E V E L O P M E N T S E R V I C E S R E Q[I I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: � Y�l DATE:
ir**x�ir�r****i���x��x�*******+t— *�TrTt�F�*S��Tr"M�F"iF�*�F*�*�r**i[�x��r*+tit� *�r�
1f1Eif7EiElEiflFlfKiF1E1E1E1E1FIFiE1E1EfEi!lE1f1E1FifiElFlFiEfF1F1f1E1E1EkiElFMffMitMiElEifiEfE!l1EfEfE1E1ElElfffikiFiEfEikltlElkfFlEfh iEiklEfElFlFikif
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLOMBING ELECTRIC MECHANIC EIRE SMIP/RES GAADING
PERMIT 4,50
502 SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 4.50 15.00 0.00 19.50 19,50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 19.50 OVEA/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
19,50
1f 1f if M iE 1E 1ElE 1E 1E iF 1E 1E iE it iE 1E 1FlF fE 1E if 1E iF if 1E 1f if IE it if 1E iE 1f iE 1E if!! 1Elf k M k!k �! ik iF 1f iE 1E iE 1f fE iF fflf 1flklf 7f ik iE fF iE iE 1! 1E it fE 7f 1f iF i! fE 1E iE it 1Elf
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
ELE 3 EIXTURES LIGHTING 1 ST 20
ELE 2 RECEPT/OGTLET 1 ST 20
ELE 1 RECEPT/SWITCH 1 ST 20
END OF FEES
EA. .75 2.25
EA, .75 1.50
EA. .75 ,75
Q2 OQ15g3Sd—OO1SE356 TO T 19.50
,DATE: OS/04/94 7IlIE: 14:03
�
� CONSTRUCTION AND PLANNING POO� tL SPA
� APPROVALS Permit # Date Inspector pppROVALS Pe�mit # Oate Inspector
i. Temporary Electrical Service or Po1e 52. Pool & Equipmenc �ocation
2. Soil Pipe-Undrgmd. 53. Steel Reinforcement �
� 3.�EI¢ctric0� Cond�Uft Utility•Undrgrnd. �- 54. Forms
J . Y
.>�. Ele.ctrical Condui,�Undrgrnd. 55. E�ectrical Bonding
'S, $t'eel Re�nforcemem 56. Rough Pfumbing & Pressure Test
6. ELectricB�UFEE3�Gmd. 57. APPROVALTOCOVER•GUN�.� '
� 7. �Footings 58. Electrical Conduit�Undrgrnd. - '
� .
�� 8."Poundat�on '` 59. Gas Rpe, � Undrgrnd., Test ', �_
- 9a.Nlater PiPe-Undrgrfid. 60. Backwash Lines, P�Trap, C] Undrgrnd. -
rz
id: Structural Floor Svsiem 67. APPROVALTO DECK
11. PropertV Sewer Line & House Connection 62. Backwash & Receptor�Final
72. Sewer CaP , 63. Heater & VenrFinal
73. Roof Orains .� 64, Plumbiny System � Final
14. Rough PlumbinQ � 65. Electrical-Final
/5. Rough �lec[riraJ-Conduit 66. Solar SVstem�Final
16. Rough E�ec2ric Wiring 67. Fencing & Access Approvai
- ��7�
17. Rough Wiring S�j,yn 68. APPROVEO FOR PLASTERING
18. Rough E�ectrical•T Bar Ceiling 69, POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. fZEQUIREMENT
. . � .,, -� .r : .. . �,�,. ..
20. Rough �eFtory Fi7epiace - - r -? � o - � �� APPROUALS-'� =Permit # � ' �
1" '< �. ' �
' . .. � . .-. ` -1 "'1 } r �S J , • � _
21. j?uois, i�'Structut�? �`.. .. •. p -+ 4�0. ^ dergraundiHydio r �
22.�Duca, Ventilating. � t GS k � ' w��1, Produc��iping t7` .�s ❑Oi1
23. Gas'r'ipe��iough &'Tesi ! � ' � - F � j2 Under round Flush , ��
-. �, ., r: � P `C `-" 9
24. Aoof Frsmin9• - � " ^ • -' ' `' - ' � 73."Undergmd=Smray�'jank O Gas �� OH' � '
^l '� 1
25. RooTShCathing _' , �, ` - , 74.��verheadHydro�; j
�
26. ���Bai� C¢i��ng (Strvctural� & ry�oraocoat -� �'� � 75.:j)ry Chemicat " � ^ `• � T,
R
27.�frameandFlashiRg- � j, �„ 76.`DryStandpipQ J'-, `� '�� r:�. ,-
,i..� _ � _� -
28. LathingA�Siding:�, �;�:,� ' ' •• •�, • 77.^FIXEDS,I`6TENJ,F'(NAL' � �
n.
�29. insulati0'h' '�` ��Y •. ' � �.. I �� .. 76.?�IRE PREV. FINA1 ` �. _ -;• ��
:30. Drywail Nailing . ` o� � '= t � HEALTH.OEPTtREQU1REMENT
�31. Plaster Brown�CoST.' . � ;r '.. � �''' : ,79.`�INAL INS�P.�FCTION'; � ' ..
32.+£lectrica�ow`er Meterpinal � J ^ v t - 80.?EOOD CERTIFICIITE�ISSUED �
33. �E�nal Electric; � � ,� � 'Notes: ;, � '
�/s�9 � ,. . -, -'
'34. Finaa•Heaf�ny;& Air;Conditioqing, - F I � � . ¢� ' '� ., , '
w �
35. F.inatGas-Pipe�Test . .- " " *'� � � � ' .. . ��». �'^' �=' ' ,
x�-+ I .� r p J r 'u - �
36. Hood or CanoPY ,.. � ,� s - r , � `t x _ �o • , � � .
- i -„
37. FinaPFactory Pireplace _ Y ^ • ' �, - - . _ ��
Si � �
v Is ?:
�38. Final�Plumbing , '� •... � � � �» . . " '
' _
,39. Water'Service-Final . � . _ •" ' '. .� . �''..
- r ! � . y - . • , �
_40. Gas Serv�ce�Final ' _ - . � - � �> » , , : ' . �� �
41. Solar OomestirFinal �• ? = � " • ; �`- �_ .
i: � ;c '�
42, Backflow Preventer � -' . : - I I c�'s� . , � �
43. Backflow Irrigation • " •-- �' ` '•� - . , �
A � y. •
� ••.Z�� A ' � .
44. LandscaPe IrrigatioRSYstem r.;n - � . r �7 r� -i = � rr �; i - ... - .
'45. Sound Attenuation • �' z � 'T' } � � ' ;" : - .-' '� '. �
- � 7 ^. �. , - .
� .;. -� .. .. - . . . - " - -• -
�46. Handieap Regulations ._ � � ' � � e .; S �?.� . -
a7. FwAI STRIiCTURE & BUILDING ' � �; "� -� `� `
48. FINAL PLANNING' � �� ' �"
F.. + _ ' ��
49. �Elecdic Release to Edison �� �. � �+� : 7�, � x .
'; �, -
50. Gas Release to SoutFiern California Gas Co � �" . � �� ••
- •-1 '` ' . .�. �
51. CER7IFICATE OF CCLSPANCY . ;•- �-� r� � �
No. Date .
r ..r 1
5_
, ; „ � � � ,
, .. , �`'_
�_ �l � , . , , ,-�- - --- ----. .._.._____.._..__---_--. ----------_,--._.__-- ; � , ; �' ;
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, � � _
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, � 40 � �18 . —•----�_ _____�— yo � ____ �z � ' �3 -'4 . ; ' , � i � �
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; , .
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: . r . �-�-��� FEE RECEi1�ED
�pN 21196
Ci�STA MESA BUILDING-SAFETY DEPARTMENT V"`"
P.O. BOX 31� COSTA MESA. CALIFORNIA FINANCE DEPT.
FOR APP[/CANT TO f/LL /N COMPLETELY APPLGCA71fONOSFOR EPERMIT
TYPE OR PRINT BUILDING
BUILDING � S L= S M E � C�
ADDRE55
COSTA MESA, CALIFORNIA FOR Off/CE USE ONIY
//p I R¢CEIPT NO. I /I �T��
OWNER L v
MAIL RECEI EO Y DAT NECEIVEO O lE IB U O
A�DRESS ��� C � I '���'"G� �_�
TEL. BUILDING �'�
CITY µ NO. � pDDRE55
nacHiTEc7 ua COSTA MESA, CA�IFORNIA
OR ENGINEER NO.
FIRE �
ADDRESS � ZONE TYPE � GROUP
STATE �/ APPROVED
CONTRACTOR L LIC. NO. �Q J gy DATE
/�S5 t�C ra� ZONING
ADDRE55 E l �G o
LEGAL I LOT I �502 I IONE ^ I NO. OF U8E OF NEW,��
o¢sceivrioH NO. BLOCK TRACT t'� P�-ANS BUILDING j `/•
APPROVEDI
A.P. NO�.y y BV '1 �Y.6�.� DATE
SIZE T �� (� NO.OF 9LOG5. ypRDS �V'�' �� " EVES �� —3— � �
OF LOT Now OH �oi REpUIRED L�� ALLOWE�
USE OF (CENTER LINE 6T.)
EXISTING BLDG. FRONT ST! FT. IN.
SETBACN LINE FNOM �
ceHieA of' sirs[ei SU REAR YARD R. SIDE S FT. IN.
w � �+ I
SI�E YARD ILEFT RIGHT I �% L SIDE �J �. IN.
DESCRIPTION OF WORK REAR // Fr. li�I"G,%/o N.
NEW I II ALTERATION I II ADDITION I i I , Vt�LP_Q�
REPAIR I IIMOVING� I IDEMOLISH I / —�(i
6UILDING NO.OF r��i leti, u�
SIZE I ROOMS STORIES
E%TERIOR W l� I ROOF WD� p ' F� � y„� (y ��
COVERING C COVERING L'� � y . F r
USE OF BUILDING AND�WORK TO BE PERF M�E+D �-y� //
R C" J E �%( L�f.P � il /IM / �
_ �
C E �---- , �„ -
� •? ,�i. __L �h'P;t�VtD ..�_��
I HEREBY KNOWL GE THAT 1 HAVE RENO THIS �PPLIGTION THE AMOUNT BMOWN IINDER VALU�TION 18 FOR TH6
ANO STAT THAT THE BOVE IS CORRECT AND GPEE TO COM�
PLY WITH LL CITY OR INANCE ND S T, PEGULATING PURPOSE OF EST�BLISHING q pERMIT FEE ONLY.
auaort+c rv5T ucn VALUATION
SIGNATURE � PERMIT FEE $ ��i
PERMITTEE L/� ` � G
$ / /7 " PLANGHECK S I/�
AUTHORIZED AGENT TOTAL FEE S ���
. ;• 2685�
, COSTA MESA BUILDINCrSAFEfY DEPARTMEM
P.O. BOX 13W GOSTA MESA, CALIFORNIA 9T62E
For Appl7can! lo Fill In Completaly
TYPE OR PRINT
B���o�Na � yy F,t S E�
ADDRE58
COSTA MESA, CALIFORNIA G:�
OWNER
zzz7 S� „0���6��2/ '
INO. OI �LDOt.
Y6T0I1CK L�X[ IROY
ceMren or YTn�R �� RUR rARo
� -810QYARDI LirT �S � I RfOHT � �
� DESCRIPTIOtd OF WORK
BUILDINO
SIZE
E7(TERIOR
WORK TO BH
1 XCRCGY IICKNOWL6D06 TMAT I NAV[ RQAO TIIO MPLIGTION
AND OT�TB TXAT TH6 11pOV6 1� CApq6CT AND A0R66 TO COY.
PLY WITN A4. CIT O MA U M1O �TAT[ • Ri0YL11TINO
OUILO�NO COYBLIY ON. r
BIGNATUR80P� � �G
PHRMITTHa
AUTHORISQD AO[M
IiPR -S'E1�PATDOO ,L40 ��.�n
LMSA � ��*'" V
APPLICATION FOR PERMR
BUILDING
For Offlce Use Only
11[C[IR HO. ��
���
�Y T� R C�[I�% � D/
y_F
ZONINf3
wo. o� uaa
ruw � euii
YARDB MPROV HD
MAIN BUILDINO
lOM C/L HTPQ[T)
IHT �'ripT.
•A /
YM. �C
-S =
,�3 %/
BHALL B6 L888 THAN
N.B.C.REGUIR6MENT1
YARDBAPPROVED
AGCE880RYBUILDINO
ecr. Mw�n e
wccesa.eu
DATB
— _._ . _ �
�
�
�j m
✓V d BO. P'T. ,'�
0
TM[ AYOIIHT OMOWN UNGtR VALl1AT10N 1! IOH TIQ j
■UHPO01 OP [�T11BL19NIN0 A PCPM�T P[8 ONLV. �y
VALIlAT10N F,,�/ �
PERMITPEH V ' p
s3,���°° ' S w
TOTALP88
;y
523
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applicant to Fill in Completely
ADORESS ���^� CL�ML�LC:. / I I �'
OWNER �. � : 1_i � ("� �1�/✓�
MAIL
ADDRESS S�"��
y� TEL.
CITV rIOTA /LI �G/i, NO. �l�I 3G
LENDER �'
BRANCM '�—
ADORESS
ARCHITECT TEL.
CONTRACTOR (/G/////Ci�
AODRESS
TEL.
CITV NO.
STATE CITV
LIQ NO. LI0. NO.
OF LOT (Y��� ��^ INOWONLO S I
USE OF
EXISTING B�DG.
SIZE OF `, NO. OF
NEW6LOG. II X 3% ROOMS � STORIES I
F BUILDING AND WORK TO BE PERFORMED
i
A.P. NO.
BUILDING
ADDRESS
FIRE
ZONE
PAID
+uc24-72�„S„OOt�zs� �A��48.41
�ATION FOR BUILDING PERMIT
BV DATE RECEIVED DATE ISSUI
s2_'� .x= li F$ "1 � -
NE _/NO.OF �
PLu'NSd
VAROSAPPROVED
MAIN BUILDING
DISTANCE BET
MAIN BLDGS.
VAR.#` yy
9
USE OF NEW '� G�N
BUIIDING�������
VAFDS APPROVED
ACCESSORV BUILDING
BET.
ACCE'
DATE
.�
VI hereby acknoW�etlga [hat I have reatl this application and stare ,�p.`
� that the above i�(ormation is correct and agree to comply with
� all laws regulaUng builtling consvuction, antl I shall not employ .�1
F„ any person in violation ot the workman's compensation laws ot V
m
N t�e tate o alifornia. �
z1 hereby certity ffiat I am properly licensetl as a conRactor untler SQ. FT, o
the State of Calitornia Business antl Professions Cotle, Divisicn 3, E AMOUNT SHOWN UNOER VALU FOR
Ghapter 9, antl that such licenses are in tull force antl effect, or I ll-IE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: m
am exempt from the provisions of the State of California Business ¢
VALVATION
antl Professions Code, Oivision 3, Chapter 9. �—� m
,/��y �/� � PERMIT FEE 5 �
Sienatura of ` J� / 1 •� \ / �h [��yr�� � m
Permittee JL.L ��'��"������� $�^p'jif% PLANCHECK$ '� E
vci�r o
` Au[horizetl Agehi TOTAL FEE $
� � AU3aE550FBVIlqN6: Z88Q ELLESMERE AV
` avriEasruyeivaawu: RICHARDS, RAYMOND E
woness zg$q ELLESMERE AVE
—� COSTA MESA,CA 92626
��' � 714) 599-3676
lRlO AOONES£
urcwrtecT ox exm+vn:
/JICX.ON FNG.'S 1DOXE55:
uc. ao.:
LONIHACTIXYSNAYE:
CON111ACTOP'S YNIPIG
10UHEA4 11C ND.:
IINT:
UNT:
urR:
110EN5ED CONTHACTOqS OECL�HAiION: I hareb/ ellim under paneAy W peejury �hm I em lieenwd urdm provieians M Cheqer 9
(mmme�np xi�� Secibn 1000) d Drviaion � d �he Bumresc enE VMme'vn Gade. ud mY �� e in lull Iwtt enE eiled.
cm uc. No.: uc. cuss: uc. No.: EXP :
o�e: c�,a:
OW NEN BUILOEN OECLANATION: I heraby elfirm uMu per�aly d perjury tAet 1 em e�emq livm IM Conlredae Lieeeua law la the
lolbwig reeaon l`�ion )p3f.5 Busmsa ard Prdeoions COEe: A�ry c1Y a oounry wM1id� eequirea e pa�mu to om+miet. elier. imqove.
hmolsh, or repei eiry ai�ue�ure, prior to iie ieauerce, ebo reQuieea ihe applieent for aueh parmn �o file e aip�red alelemant �het M or eha
tkeruee wrnum �o �ne a�s d u�e conveeon license I.ew jcheqa s(oommand�q wnn seaon �000) d Uvuia, a a ina
siness aM Prolanons COEe� a Ihei he a she o ezamq ihrehan end tha beaia l« iha eilepeE aaempion. My violelion d Sedion
l031.5 W eny epplirant lor e permn subjxls iM epplieenl to e dvil penelry d nM mae iMn iHe huMred dolleea �4500�)..
� I. as axrar d IM praperry «mY �O�W� �h wapes av Ihet ede compen5a�bn. wiil do IM xwk. eM tM avuclure e ml inleMeE
w oilered lar eele (Saclion IOM, Busimas enE Prdeeeiana Cade: TheComrenon Licensa Lew Eoee rwt epplyb en ovmer W propery
wlw buids or inpmvee tMrean. enE who doec auch wrk NmseM a Mreetl a Nrpph he a her own employeae, p�ovMeE Ihel euch
imorovemeM� era ml imeMad «dlerea Iv eeb. n. Mwevar.IM Euikiep a inqm'emaN w eatl xnnin me veer a oom0�ion. the
owrwr-W iNer will heve �he buNan d provinp M or ehe did nd buik a imprave Iw tM WrPose ot xle�. �
❑ �. m mma a �ne rwaro. �%�awrveF/ eonvmire wiln 4weme ea,Venon �o mnw�a me wd� (senun )ou. a,.iin,. ene
Prolavions Coda: Tha Comraeaa Licenae Lew doea ml epply b en ownard papa�y wlw buiNe wimpovxtharean eM who
conlrecH M wdi prqetls wiN a mn�redor�e) Ikensed W�a� to ihe Comred� Lioanea lew). "�
,�,�e.m ��eas«��a,bP7094 a.aa.c.,ro� �s w�:0 �E$— UZLD �
� R o
�o�. � q �
Mreby ceMAy ihel em ewere d eM uMe�elend tM requiremema ot Celiana Fbellh enE Selety Code $apiane 25505, 2553�, vM
25534. eM itut I a arry Mure bWMi'q am�peM will / wil rw� (arcb «w) � b comply wYh eek aata wEm anE ihe reQuiremenp Ior
epermnlwmnslrucibnwmadificetionhan�M�� e�y anepement0inrid.PniEenlblmmtiudioneppim'vuweumplmmthese
p,owioos.
o�a: aod�
WONKEX'S COYPENSAl10N DECLAN�TON: I hereby etfiem uMar penehy d peejury wr d the Idbwirp Eetle'mum:
� I heve end wii meinten e cenJicale d caneem �o eell�inaure br xroAeie' wmpenmtion, v povidad ta by Sedion 3100 d ihe labor
Gode. lar IM paAmnv�ce d Na xork la Mich Nie permil o iasued.
� I hm eM wil meiMein wwkan' mmpense�ion inaurenw. a� nyuirW by Setlim �]00 d IM Lebor Gade. M tM peAormenca d iM
work ta xfiid� thia pe�mn ia isued. My wakers canperw�ian inwrarke carrier erd poliry number are:
cd,;a:
Policy Number:
ili9 SeCf%p1I1GB41Wf W CCn10b(Bd /lMG��x 6/OI pM �IYMTOQOIIB/s �1W� p b88.f
❑ I cenAy Ne� in �he perlormenca W �M wak fa whch thia pem�n ie issued. I ehell nd emd%' eM' ia� in anY menner eo m �a
become ahjad io iM wohen' ronpenaeiion kwe d CelAomie. ertl epree tM1e� tl I ehouk Exame wbptl lo IM v.wken'
cwnpensation qwiaions d Seaun 310U d the lebor CoEe. I ahell toMv.ilh camqy wM �hoae qaviban.
oa�e� aod�:
Weminy: Fellun ro�xuro xroikwi roillplNlt1011 roYNIp! b UII/IWNI� GOdlbll MIb//Cf L/1 �Tp/0yM f0 CIIIMNI pIMNNlOd
clvll Hnu ,q b ms hlntlrW fhouserd tlollen (SfPq000A M atltl/tlon ro tln rosl ol rompxu�fbM1 demsp�s u proHtls! br In
Sxflrn 3106 a/ Me Labor Cods, /nNnaf, aM ettomeyi hu.
CONSTflUCiION LENUINO AOENCY: I�Iiereby eifirtn uMer pvidiy d perjury ihm Ihae b a caMrudian bMi�p epmry 1« Me
�no��. a ms won a, .n�w ma ro�� ��•�a (saaoo xs�. ca. c�.
LENOEN'S NI1ME:
LENDEN'S RODHE55:
I canilythel I licm reed Nie epplketion eM �e thet Ihe ebove iMwme�ion u conea. I eprea io compy Mith ell ary eM mumy adinenws
eM ele�e lexs raletiq to Wild�vq camWtlun ard hereby aulharse iaqauntelrves d Ne dly lo enlx upon �M ebv.e-memuned popery
�°`�°`P°'�°�v��°°"�RAYMOND RICHARDS
om,: S �
"� �5151d6.WP) Whilo-Build'vqbSefely;Grean-Fk;Cenery-ADd���:Pink-Revenue:CadEen�oE-Asaeswr
CZTY OF COSTA MESA — HUILllING PERMIT
PERMZT NO: E 086587 PLAN CHECK NO:
CONSTkUCTION TYPE: V—S PERMIT TYPE: ELE
JOH DESCRIPTION : INSTALL 240V CIRCUIT
CLAIM ��ALUE:
CALC—VALUE:
N
PERM NO: E 086587
GOVT: N SUPP: N
PURPOSE: ADD
SQ FT:
GROUP OCC: R-3 /
COMMENTS: X
ak �If iE �1F if iF iF iE iF iF �FlE jE if iE iE iE iE 1E if iE if �f ik 1E ik iE if if IE 3E �f ff �)E 1E 1E 1FlE ik iE it k iE dE 1E fE �f !E iE iE 3E iE aE iE if iE iE k ik iE ik if 1t iE aE 1E 9E iE iF �E jf 3E �E iF iE 3F iE iF iE
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 ZN 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; 13927311 ZNE: REF NO:
PLANNZNG NCSTES>
� ..
jE 1E 3E iE it if i! iE 1E iE 1E dE iE i! iE dk �)E iE iE �f if iE iE 1f iE iE if if iF iE �E 1E 1E.�E 1E iF 1E fE 1F iE if iE iE 1t if 1E iE if �F if iE if if if iE iE 3E 1E iE iE iE iE iE �E jF iE �E iE if iE iE 3k iE iE 1f iE iE �E jE
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 "' DATE:
BUILDING APPROVED BY : �� DATE:
APPLICATION ZSSUED BY: ^ � DATE:
iE�E*ifjE3E�E�liEiE�E3E'1E1kif�ElElfifiFiEik3F3F3FiiiF'iF'�F3Fif�if3FiF3F3F�Fiiif7F7FiF iFiF if7fiFjfiFjFifiEiEiEiEiE')F'lEikiE ifit�
LEGALIZATION;N F E E S U M M A R Y STRUCTURA EGMENT:N
PERMIT bLDG PMT PLUMBING ELECiRI�C� MECHANIC FIRE SMIP/RES GRADING
SOR SMIP/NON—RES
PLAN
ISSUE FEE 22,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 1.00 22.00 0,00 23.00 23.00 �.00
REVENUE DIVISION TOTALS--> COLLECTED: 23.00 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
23.00
ik 1E iE iE 1E iElE iE if if iE 1k if i! iE iE i! fk iE iE iE 1E 1E �f aE �E �F �E �)t iE iE ft 1E iE k iE 1E jF iE iE 3E fE 1F ifltlE 1k 1E ff iE iE 3E iF iE if iE it 1E dE if� 1E jE iE if �E �E iF iFlE iE iE jE �f iF 7E iE if ik 1f
I N D I V 2 D U A L F E E H R E A K D O�t^I N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 1 RECEPT/SWITCH 1 ST 20 EA. 1.00 1.00
END OF FEES
�iN�-//�ss //z��
81-15-1998/81:82 DM/f23.88
PERM I T:T086587
�� ,�
� CO�' ,TRUCTION ANO PLANNING '- '' ' POO� 6AA
`y'�' APFHOVALS Permit# Date Inspector- APPROVALS Permit# Date inspector
t.'"8mporary Electrical Service or pole ", 52. Pooi & Equipment Locatior� -
2. Soil Pipe�Undrqrnd. _ � 53. Steel Reinforcement - ��
3. Electrical Conduit U[ility-Undrgmd. � 54. Forms ' -' '
4. Electricai Conduit-Undrgrnd. � . 55. Electricai Bonding
,5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test � -�
6: Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE �
7. Footingz 58. Electricai ConduirUndrgrnd.
� 8. Poundation 59. Gas Pipe, O Undrgmd., Test '
�9. Water Pipe�Undrgrnd. " 60. 8ackwash Lines, P�Trap, CI Undrgrnd.
10. Structural Pioor Syztem 61. APPROVAL TO DECK ,
: 17. Property Sewer lint & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap - 63. Heater & Vent-Final
13. Roof Drains � �- 64. Plumbing System � Final
14. Rough Plum6ing ' �• 65. Electricai-Finai -
75. Rough Electriwl-Conduit • /�/��� 66. Solar System-Final -'
76. Rough Electric Wirin9 ��� �" ` 67. Fencing & Access Approvai .-
17. Rou9h Wiring Sign '68. APPROVED FOR P(.ASTERING
18. Rough Electrical�T 6ar Ceiling 69. POQL/SPA SYSTEMS FINAL
79. Rough Hea:ing & Air Conditioning _ : • PIRE DEPT. REQUIREMENT
20. Fough Factory Fireplace � " - ' ' � qPpRpVALS Permit # '
21. Ducts, in Structure � . - - - 70. Underground Hydro
22. Ducts, Ventilating ; � � �- 77. Product P�ping OGas C70i1
23. Gas Pipe•Fough & Test . ' � -� � 7z, Underground Flush �
24. Roof Framing , - . 73: Undergmd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing . - �-- 74, pverhead Hydro �
26. T�BarCeiling (Structurai) & Monocoat " 75�. Dry Chemicai _ , � �
. 27. Frame and Flashing'. � � ... 76. Dry Standpipe �
28. lathing & Siding "� � ; 77. FIXED SYSTEM FINAL
29. Insulation � � � 78. FIRE PREV. FINAL
30. Orywall Nailing � � � - HEALTH DEPT. REQUIREMENT
. 31. Rlaster Brown Coat � 79. FINAL INSPECTION
32. Elecxrical Power Meter�Final F 80. FDOD CERTIFICATE ISSUED
33. Final.Electrit�: . 1 Z Notes: ,
� 34. Fina� Heating & Air Conditioning , . . � . �
35. Final Gas Pipe=Test - � , , . - _ - -
36. Hood or Canopy . � . � � •
, 37. Final.Factory Fireplace. - � � � ; .
� 38. Final Piumbing , .-j
39. Water Service-Final �- ` - �
40. Gas Service-Final � , . . � . . . � .
47. Solar pomestic-Fina�' ' � .
42. Backfiow Preventer . � � -
- 43. Backflow Irrigation . . - ' � . � . . �
44. Land:cape Irrigation System � - . . ' � '
45. Sound Attenuation - ' ' � ` , �
. ,• �
46. Handicap Regulations � . � ,- "' r
4J. FINA�L STRUCTURE & BUILDING �� � ��� �{
� ' =�
48. fINAL PLANNiNG � � . �"'' �� �� �t
. � _. .
49. Electrie Release to Edison ���'' '.'. .t�
50. Gas Reiease to Southern California Gas Co '
51. CERTiFICATE OF OCCUPANCY - " '
No. Date