HomeMy WebLinkAbout2900 ELLESMERE AVE - Building Permits'` '� • --
CITY OF COSTA MESA
"'F BUILDING DIVISION
i�� 77 FAIR DRIVE. COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
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° ` FOR INSPECTIONS CALL: (714) 754-5626
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PERMIT NUMBER: P09-00088
PERMIT TYPE PLUM
APN: 13927213
STATU S: ISS U ED
DATE ISSUED: 07/14/2009
ISSUED BY:
JOB ADDRESS: 2900 ELLESMERE AV CM Suite/Unit:
vicinity:
SCOPE OF WORK: CHANG�-OUT OF A WATER HEATER AT AN EXISTING SFD.
NO OTHER WORK AUTHORIZED WITH THIS PERMIT.
OWNER:
PHONE:
APPLICANT:
PHONE:
LLOYD, RON H AND HEATHER l
CORTEZ, EZE�UIEL
714-771 •7481
Address: 2900 ELLESMERE AVE
City/State2ip: COSTA MESA, CA
Address:
City/State/zZip:
CONTRACTOR: AMERICAN RESIDENTIAL SVS DBA RESCUE ROOTER License No. 765155
Atldress: 965 RIDGE LqKE BL SUITE 201 � PHONE: 7'14-771-7481
Ciry/State: MEMPHIS, TN ZipCode: 38120 . CELL: 510•729-6000
ARCHITECT:
ENGINEER:
License No.
License No.
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE:
PERMIT FEE:
TOTAL FEES:
$0.00
$35.80
$35.80
PHONE:
PHONE:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 780 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must wmply 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.
GOU t. INSPECTIONTYPE DniE INRPALS COOE� INSPEL➢ONME UA ,T INTRIRLS
1616 Fized System Final Fire Prevention 206 Final Mechanical /
1266 Pool Spa Final 208 Final Plumbing !%-� �[i) p} /S� \
200 Final Re-Roof 210 Final Electncal �
201 Fina181ocWRetaining Wall 272 Final Fire Prevention
202 Final Factory Pire Place 220 Final Planning Approval
203 Final Sign 222 Final Sile
204 Final Demalitian 250 Final Building/OCcupanty
WORKERS' COMPENSATION DECLARATION:
I hereby aHirm untler penalty o( perjury one of Ihe following declarations
❑ I have antl will maintain a certifcate o( conseN to sel(-Insure (or workers'
compensa�ion, as provided for by section 3700 of the Labor Code, for the
�,�p rtormance of Ihe work for which ihis permi� is issued.
I have antl will maintain vrorkers' compensaiion insurance, as required by
tion 3700 0( the Labor Code, for the pertormance of the wnrk for which this
permit is issued. My workers compensation Insurance carrier antl policy
number are: 9 �, },�t
Carrier: ' l_l %vY� � � (��✓�"�
(This sec(i.vi neetl nol0e mmde(etl J�Ne pemN it vCaNetl aCl 'one huMied do9ars (C5�100) a less )
Policy Number: � �� — (g � � — ) �a d�� — � ��J
❑ I certify that in the peAormance of [he work for which this permit is
issuetl, I shall not employ any person in any manner so as to become subject
to Ihe vuorkers' wmpensation laws o( Califomia, and agree that if I should
become suhject to the workers' compensation provisions of Section 3700 of
Ihe Labo e, I shal} fohhwj��.co�p ly with �hese provisions.
�1 ��',�C �-�' 1 %- %�% �� � ,
App nt's5ignaWre, �Dat�
`_ _
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
(5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions o( Chapter 9(commencing
with Sec�ion 7000) of Division 3 of the Business and Professions Code, and
my license is in /(ull force antl eflecL 7 l
Lic.-#� -�� v � -Class # � "- J
7--/%-DI"
Co racmr'sSrpnawr Dal�—
\ , �
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a constructbn lending agency tor the
peAortnance ol the xork fa vfiich this permit is issued. (Sec. 3097, Civil Cotle�.
Lender's Name:
Lender's Address:
SignaWre �ale
OWNER-BUILDER DECLARATIONS:
I hereby aKrm Ihat under penalry of perjury that I am EXEMP7 FROM THE
CONTRACTORS LICENSE LAW (or the (olloWing feasOn (Sec. 7031.5,
Business and Professions Code: Any ciry or county which requires a permit m
consWct, alter, improve, demolish, or repair any swcture, pnor to its
issuance, also requires the applicaN for such permit to file a signed statement
that he or she is licensed pursuanf to the provisions o( the Contraclors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Protessions Code) or that he or she is exempt therefrom and
the basis for lhe alleged exemption. Any violalion of Section 7031.5 by any
applicaN (or a permit subjecis lhe applicant fo a civil penalry of not more than
fve huntlretl dollars ($500).):
❑ I, as ovmer of the property, or my employees vnth wages as their sole
compensation, WILL DO THE WORK, and the stmcture is not imended or
offered for sale (Sec. 7044, Business and Professions Code: The Contracrors
License Law does not apply to an ovmer of property who builds or improves
thereon, and who does such vrork himself or herself or through his or her ovm
employees, provided that such impmvements are not intended or oRered !or
sale. If, however, the builtling or improvemenl is sold within one year of
completion, the owner-builder will have Ihe burden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as ovmer of the property, am EXCLUSIVELY CON7RACTING WITH
LICENSED CONTRACTORS to construcl the prqect (Sec. 7044. Business and
Pmlessions Cotle: The contrac�ors License Law dces not apply to an owner of
property who builds or improves Ihereon, and who cont2cts fw such project vdth
a con(raciw(s) license pursuant to the Coniractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for �his reason:
905]-4fi(JIO'!)
. !
Owner ID verified by driver's license. ❑ Yes ❑ No
L
Driver's License No. Expires:
Verification of Ovmership by (type oi tlocument, i.e. - property tax bill or deed�:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby ceridy Ihat no excava�ion Me (5) or more teel in Oep�h into which a
person is required to descentl, will 6e made in connection with v.ork authonzed
by this pertnit, and that no building sWcture, scaffdding, falsework, or tlemolition
or dismantling Ihereo(, vrill be more than thirty-su (36) (eet high. (Chap. 3.2, Grp
2. M 2, Sea 347, Title 8, Califomia Administrative Code).
❑ As owner-builder, I will not employ anyone [o tlo vrork which would
require a permit trom the Division of Industrial Safery, as no[etl above, unless
such person has a permit to tlo such vrork (rom the division.
npphcanfs Signawre Daie
Division of Industrial Safety Permi� Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or presenl or fuWre builtling ocwpant need to file and
certify a Business Plan tor emergency response to release or threatened
release of a hazardous material? ❑ Ves ❑ No
(Section 25505 0( the California Health and Safety Cotle requires, with some
exceptions, Ihat a Business Plan be filed vnth [he Costa Mesa Fire
Department by every business which has at any one time dunng a reported
yea� a quantity of hazardous materials equal to or greater Ihan a weight of
500 pounds, or a volume o( 55 gallons, or 200 cubic feet of compressetl gas
at s�andard temperaWre and pressure).
2. Does or will the applicant or present or future builtling occupant need to file
a regisiration form for acu�ety hazartlous ma[e�ials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health and Satety Code, with some
exceptions, requires registration wilh the Costa Mesa Fire Depanment by
each business which at any one time has on hand a quantity ol acutely
hazardous matenals equal to or greater Ihan a weight of 500 pounds. or a
volume o( 55 gallons, or 200 cubic feet of compressetl gas at stantlard
temperaWre and pressure�.
3. Does or will the appliwnt or present or fWure builtling occupaN need to
prepare an RMPP (Risk Management antl PreveMion Program for acutely
hazardous materials)? ❑ Yes ❑ No �
(Section 25534 of the Califomia Healt� and Safery CoOe providas tha[ the
Costa Mesa Fire Depariment may require the preparation, certifcation and
fling with Ihe Fire Department of an RMPP by businesses which are required
ro register acutely hazardous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 of the Califomia
Health and Sa(ety Code been fully tomplied with? ❑ Yes ❑ No
5. Does or will Ihe applicant or present or fu[ure builaing otcupanl require for
Ihe work which is lhe subject of this application a permit (or such wnsWction
or moaification from the South Coast Air �ualiry Management DisMct or from
any other air polNtion control tlisMct or agency? ❑ Yes ❑ No
(Sec�ion 658502 of Ihe California Govemmen� Code requires tha� Ihe requested
infortnaiion 6e fumished on applications far non-residential building pertnits).
6. Will any part of lhe faciliry to be constructetl under this permit be within
1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If "yes", the faciliry must meet the requirement of Sections 25534 and 42303
o( the Califomia Health and Sa(ety Cotle).
7. It a permit trom the South Coast Air Qualiry Management District or other
air pollution control disMct or agency is required br the work which is the
subject of this appliwtion, have all of the disclosures prescribed by California
Health and Safery Code Section 42303 been made? ❑ Yes ❑ No
8. (It'yes", attach certificate ot compliance from the appropriate air pollution
contml oKcer). •
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
information given above is correcl. I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
SignaWre Dale
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalry of perjury that I have read this application and 5tate lhat
the information given is correcL I agree to comply vnth all state laws and city
orainances relating �o buil0inq construction, and authorize representatives of
Ihe City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any buildinq
authorized by this permit until final inspection.
�Si naNre of Legal Ovm (s) Daie
--z� �il �,6.�- �- � �i-o 9
�An64 /Au1M1Or¢¢0'rlpplrtdN LOale -� �
�
• � CITY OF COSTA MESA
BI/ILDING DIVISION
F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • vnwv.ci.wsta-mesa.ca.us
� FOR INSPECTIONS CALL: (714) 754-5626
�"`� PERMIT NUMBER. 608-00129
PERMIT TYPE B_ROOF2
APN: 13927213
STATUS: ISSUED
DATE ISSUED: 04/21/2008
ISSUED BY: RMD
JOB ADDRESS: 2900 ELLESMERE AV CM Suite/Uni.t: ,
Vicinity: HOUSE AND GARAGE ; . : � ' � � . � �
Squares: 3000 ' Valuation: $11,500.00
SCOPE OF WORK: TEAR OFF;(E)�ROOF�MATERIALS, INSTALL 1 LAYER OF 15# FELT ON A 5:12 PITCHED ROOF AND REROOF
WITH 40 YEAR COMP SHINGLES ON AN ATTACHED HOUSE AND GAR4GE. REPAIR AND REPLACE SHEATHING AS
NEEDED. . ' , � ' �. - �. "
OWNER: BLANK, CHRISTOPHER L
PHONE: . , � � �
APPLICANT: GALITSKI,'GUY � ��� i ,
PHONE: 714-965-2387, .. � ,
CONTRACTOR: G G ROOFING CO INC
Address: 197g2 pOTOMACUnit:
City/State/Zip: HUNTINGTON BEACH, CA
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
TOTALFEE$
. r' .
$0.00
$209.25
$0.00
$209.25
Address: 2900 ELLESMERE AVE, " � '
City/State/Zip: COSTA MESA, CA -� . - ,
Address: 19792 POTOMAC �- � A�� � -
City/State/Zip: HUNTINGTON BEACH, CA - �
' License No. 364151
PHONE: 714-965-2387 .
92646 CELL:
License No.
License No.
PHONE;
PHONE:
Unit:
Unit:
NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under Cali(omia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92) -
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval musl be obtained. Failure to obtain inspeclions and final approval will result in the expiratlon of this permit.
c o i. ixsrecnow.rve o� IN7IIIpLS cooe� ixsvecnoNrrre o� ixrm��
1818 Fizetl System Final Fire Prevention 206 Final Mechanical
7288 Pool SOb Final . 208 Final Plumbing
200 Final Re�Roof �`0 � 210 Final Electrical
201 Final Block/Retaining Wall 272 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning AOProval
203 Final Sign 222 Final Site
20a Final Demolition 250 Final BuilOing/Occupan�y
WORKERS' COMPENSATION DECLARATIOI.
I hereGy affirm under penalty of perjury one of Ihe tollowing declaralions:
❑ I have and will maintain a ceAificate of consent to self-Insure for workers'
compensation, as provided for by section 3700 of the Labor Cotle, for �the
peAortnance of the work for which this permil is issued.
❑ I have and will maiNain v.orkers' compensation insurance, as required by
sectbn 3700 of the Labor Code, /or [he peRormance of the work'for which this
permit is issued. My workers' compensation Insurance carrier and policy
number are: n
Carrier: • S� ��C �; J U "V
(ilvs seppn nee0 nol6e mmp'e1etl91�epemui is vaNetl a>! o�ne huM—retlOollars (5100) a less )
Policy Number: ��– �� �i l 7 �"' �–o
❑ I certify that in the peAormance of the vrork for which Ihis pertnil is
issued, I shall not employ any person in any manner so as lo become subject
to the workers' compensation laws of Cali(omia, antl agree that if I shoultl
becoma subject to the workers' compensation provisions of Section 3700 0(
Ihe Labor Cotle, I shall forthwith wmply vnth these provisions.
�j- z /-O�
PW�� s Si Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm Ihat I am licensed under provisions of Chapter 9(commencing
wilh Section 7000) of Division 3 of the Business and Professions Code, antl
my license i5 in full torce and eRecl. �7
Lic. # ���o �i � 5 i Class # � �`
4 ='L�/ -
C � orsSignalure �ate
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirtn that [here is a conSWcfqn lending agency fa lhe
pedormance of Ihe aork ta which tttis pertnil is issued. (Sec. 3097, Civil Cotle).
lender's Name:
Lender's Address:
SignaWre Date
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty o( perjury that I am EXEMP7 FROM THE
CONTRACTORS LICENSE lAW for the following reason (Sec. 7031.5,
Business and Protessions Cotle: Any city or county which requires a permit to
construcl, aller, improve, demolish, or repair any structure, prior lo its
issuance, also requires the applicant for such pertnit to file a signed statement
thal he or she is licensed pursuant to lhe provisions of the Contractors
License Law (Chapter 9(wmmencing with Seclion 7000) of Division 3 of the
Business and Professions Code) or ihat he or she is ezempt therefrom and
lhe Dasis for the alleged exemption. Any violation oF Section 7031.5 by any
applicant for a permit subjecis the applicant to a civil penalry of not more than
Lve hundred dollars ($500).):
❑ I, as ovmer of [he property, or my employees wi[h wages as their sole
compensation, WILL DO THE WORK, and lhe swcture is not intended or
oflered for sale (Sec. 7044, Business and Professions Code: The Con�ractors
License Law does not apply to an ovmer of property who builds or improves
thereon, and who does such vrork himself or herself or ihrough his or her ovm
employees, provitled that such improvements are not intended or offered for
sale. If, hov.ever, lhe building or improvement is sold vrithin one year ot
completion, the owner-builder will have Ihe burden of proving that he or she
did not build or improve for purpose of sale.). �
❑ I, as ovmer of the property, am EXCLUSIVELY CONTRAC7ING WI7H
LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and
Professbns Code:�The contractas License Law dces not appty to an ovmer of
property who builtls or improves Ihereon, and who contracis for such projecl with
a contracta(s) license pursuant to the Contractors License Lavrs.).
❑ I am exempt under sec.
Business and Professions Code for Ihis reason:
SlgnaWre
305]-46(�/0]�
Ovmer ID venfied by tlri ici ❑ Yes ❑ No � `
Driver's License No. Expires� �
Verification of Ovmership by (rype of document, i.e. - properly tax bill or deed):
DIVISION OF INDUSTRIAL SAfETY PERMIT CER7IFICATION: '
❑ I hereby ceAify that no excavation five (5) or more feet in depth into which a
person is required to descend, will be made in connection with work authonzed
by ihis permil, and that no building stmcture, sc�fdding, falsework, or demolitbn
or tlismantling lhereof, will be more than Ihirty-sirz (36) feet high. (Chap. 32, Grp
2. M 2. Sec. 347, Ttle 8, Califomia AtlminisiraWe Code).
❑ As ovmeabuilder, I will not employ anyone lo do work whiCh woultl
require a permit from the Division of Industnal Safety, as noted above, unless
such person has a permit to do such vrork (rom ihe division.
Applicanfs SignaWre
Division of Industrial Safery Permit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future builtling occupant need lo fle and
certify a Business Plan for emergency response to release or th�eatened
release ot a hazardous material? ❑ Yes ❑ No
(Seclion 25505 of the Califomia Health antl Safety Cotle requires, with some
exceptions, Ihat a Business Plan be filed with the Cosla Mesa Fire
Department by every business which has at any one time during a reported
year a quantity of hazaitlous materials equal to or greater than a weight o(
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas
at standartl temperature and pressure).
2. Does or will [he applicant or present or fuNre Cuilding occupanl need to file
a registralion fortn (or acutely hazartlous materials? ❑ Yes ❑ No
(Section 25533 of the California Heal[h and Safely Cotle, with some
exceptions, requires registrelion with Ihe Costa Mesa Fire Depariment by
each business which at any one time has on hand a quantity of acutety
hazardous ma[erials equal to or greater lhan a weight of 500 pounds, or a
volume o( 55 gallons, or 200 cubic feet of compressed gas at standartl
temperature and pressure).
3. Does or will the applicant or present or fu[ure Duilding occupant need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazartlous materials)? ❑ Yes ❑ No
(Section 25534 of the California Health antl Safery Code provides lhat the
Costa Mesa Fire Departmenl may require the preparation, certifica[ion and
fling with [he Fire DepaAment of an RMPP by businesses which are required
to register acutely hazardous materials wilh the Fire Departmenl.
4. If an RMPP is presently required, has Section 25534 0( the California
Health and Safery Code been fully complietl with? ❑ Yes ❑ No
5. Does or will the appliwnt or present or fuNre building occupant require for
Ihe work which is ihe subject of Ihis application a permit (or such consWclion
or modification from ihe South Coast Air Quality Manaqement District or from
any oNer air pollution control disMcl or agency? � Ye5 ❑ No
(Sectbn 658502 of ihe Califomia Govemment Code requires Ihat NB requestetl
informalion be fumished on applications for non-residential building permits).
6. Will any part of the facility to be constructed under Ihis pertnit be within
1000 (eet trom the outer boundaries of a school? ❑ Yes ❑ No
Qf'yes", the faciliry musl meet [ha requiremen[ o( Sections 25534 and 42303
of Ihe California Health and Sa(ety Cotle).
7. If a permit from the South Coast Air �ualiry Management DisMcl or other
air polWtion control district or agency is required for the vrork which is the
subjecl of this application, have all of the disclosures prescribetl by Califomia
Health antl Safety Code Section 42303 been made? � Yes ❑ No
8. Qf yes", attach certificate of compliance from.the appropriate air polWtion
wntrol oKcer). � . . � . '
CERTIFICATE OF COMPLIANCE: I certify thal under, penalty o( perjury the
information given above is correct. I agree to comply wit� all state laws and
city ordinances regarding Hazardous Materials and Emissions. ,�
SignaWre ,Dale
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury Ihat I have read this application and slate that
Ihe intortnalioqgiven is correcL I agree to comply wi[h all slate laws and city
ordinances relating to buildinq construction, and authonze representatives of
the City of Cosla Mesa to�enter upon lhe above-tlescriDetl property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authonzed by this permil until fnal inspection.
SignaWreollegalOwn (c Dyte
�7�-z/-�-
onie0 APOlican� DalO �
CITY OF COSTA MESA
BUILDING DIVISION
ROOF COVERING CERTIFICATION
Property Address Z �C 0.'� L. L� S✓� ��(2 C_.
Owner �� \.�- l3L/�-N�
Contractor �� �� ( x- �
State Contractor License Number ��� ��( Classification C 3�
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 oi the manufacturer.
❑ I further certify that I am the owner oi the property. (Owner-Builder permittee only).
.0'llurther 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 oNicer 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.
Received by Building Division
By:
�j 21 �
Innia Dat
Og9p.a6 MW 6/00 W hpo- Builtling Drv.. CanarY � Ga�lrxta. PinM � Owna
C� � 2�� � c�: �
Company or Corporete Name
l�-c �42 � a�o v�'1� t- (�
Adtlress
�-il w i l t����� ��-�-c C(�--
Printed or Typad Name
�':r d EE- RECE1ilED
. i ,
11 :�'i' e �rt/ oz. .�_60
COSTA MESA BUILDING-SAFETY DEPARTMENT FINAfVCE DEPT.
P.O. BOX 317 COSTA MESA. CALIPORNIA CITY Of COSTA MESA
FOR APPC/CANT TO f/LL /N COMPLf ELY APPLICATION FOR PERMIT
TMPE - P� BUILDING
BUILDING Ell ere Avenue
ADDRESS t V
COSTA MESA, CALIFORNIA FOR OFFICG USE ONLJ
oWNERKen rof Development �.'O jp(,+ � ftECE1PT NO. I��e�ni�ro.
• 5�/rs'
ADDRE55 1555 Placantia RECEIVE_ D,$Y I O,�TE^EC=�V�DO I OATE ISSUED
(�-'� :L A 9
CITV Nevrport Beach TNo:6: 22 BUILDING
ADDRESS
ARCHITECT ���� COSTA MESA. CALIFORNIA
OR ENGINEER - NO.
A�DRE55 ' FIRE
ZONE TYPE GROUP
CONTRAGTO K�W� KOl�. �,�rNp 6119 BYPROVED DATE
cen a
nooRess � rrrfff ZONING
LEGAL I LOT K7 I���9 I�NE �/ I NO.OF I USE OF NEW
OE6CRIPTION NO. BLOCK T A T
� PlANS �� BUILDING
APPROVED /
A.P. N�. BY DATE —(� G
SIZE 75XZOO I NO.OF BLDG3, 0 YARDS E S
OF LOT rvow oH�oi REqUIRED ALLOWED
USE OF None (CENTEN LINE ST.1
EXISTING BLOG. FRONT U FT. IN.
SETBACK LINE FROM 11 � .
cen'rea oF siAeeT � t REAR YARD ZY� R. SIDE SFT. IN.
SIDE YAR� I LEFT J t�� I RIGHT � L. SIDE �FT. IN.
DESCRIPTION OF WORK � �+
REAR J FT. IN.
NEW I� II ALTERATION I II ADDITION I
REPAIR I IIMOVING I IIDEMOLISH I
S ZIE DING 1HOO S1 ROOMS��i / STORIES 1 �
EXTERIOR WALLCCO ICOVERrvN�G�LL Shingles
COVERING a���l
USE OF BUILDING AND WORK TO BE PERFORMED
Sin le-Fa i "
and Attached Garage
a s' C-�
1 HENEBY ACKNO IEDGE THqT I HTVE REAO TXIS APPLICATION
THE AMOUNT SHOWN UNOER VALLIqT10N IS FOR THE
AND STATE TH E A90V 5 CORfiECT pNO pGREE TO COM-
PlY WITH AL T OFDINA 5 A1 O ST TE LAWS REGULNTING PURPOSE OF ESTABLISNING A PERMIT FEE ONLY.
euuoWc c cnoH. C VALUATION
SIGNATURE OF � PERMIT FEE $ 3��'�
PERMITTEE , $ /���t_— ��'
`� PLAN CHECK $
AUTHORIZED AGENT TOTAL FEE E J/•�
r � 28647
� COSTA MESA BUILDINGSAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92628
For AppUmnt fo F71! In CampleMly
TYPE OR PRINT
COSTA MEBA, CALIFORNIA
BHTBACK LlN[ rPOM
1 X[R6GY
DESCRIPTION OF WORK
WALL
OP
AUTHORIZ[D AO[NT
�
� HO.OP
NI�V6 RIAD TII� A►'LIGTOH
CORRLCl AND AG11[[ M COY.
!1(1D �TA��OYyyy���� NO
i/ � _/��//
Yu� %J i / i /
HAY 29 � 07451* *+**18.00
/1rPLICATION FOR PERMR
BUILDIN<i
For ONIc� Us� Only
ZONINC�
uss or nnv s'i� �
Z .uuo�xo ipnn
4- �J
BMALL 68 Ll88 TNAN
YARDSAPPROVED I YARD9APPROVBD
MAINBUILDIN6 AGC6880RYBUILDIN6
tOM GL fTR[LTl �O [�. _
n�(N
VM• A� I DAT6
�
7 DATi 7 � L7 - �6
HOLD FOR SPECI L REQUIREMENT� °'
w
$2�� �oc� � C7d e (�,,��i , fzhc�. �
3�' �. �. �` ` � ' �
TX[ AMOYM �NOWN UNO6N VIILUATION IB POR TH[ �
►YR'OE[ O! f�YI�lL16MIN0 A PGNMIT I6R ONLY.
VALUATION � _ ]
PBflM1T FE6 �
Oa/"V — - w
0
TOTIXL PEfi /
enopessorem�ara: Zg00 ELLESMERE AV
OWNEIX9k.WEIFIMOWN:BLANK, CHRISTOPHER L
, ADOP�BLANK, RAJIA K
2900 ELLESMERE AVE
�vv�. wuwa wowess:
COSTA MESA,CA 92626
urcxnEaoa�anua+: RON LACKER
�PCX.ONFHO.'S�OOMESS: 133z N. MILLER ST
ANA
cor+m�cTarsru�: pROMONTORY POOLS
cwm�croxs�wiwo 1332 MILLER ST
"0°"� ANA
92806
110EN5ED COffrPACTONS DECLAfl0TI0N: I hereby Mim under pero�
(cammmidiq �mh SacYon )000) d Oivbion a W the Buaines� eM Pmtes
cm uc. r+o.: � uc. cuss: C- 5 3 ��
uxT:
uc.ea: z0949
urn:
CA 92806
(714)993-0557
CA � � 404194
uxr: 2 0 4
9�' thet I am IicemeE uMx prmrobu at CMqm 9
H; erd mY � e in IWI beu end Ml�a.
0 4 L��t P :
� bWt�[N BUILUEN DECLAHRTION: 1 Mroby effirtn uMm d �uy �Ral I em eyfiq fmm IM Coniretlon Licenee Lew la tlie
�pYG��q �eean (Swion>W 1.5 &nnma end Rafeu'vr.i :/�M a muYY wh(di nCu"vaa e D�O lo aavtruc�. els. impme.
Aemdah, u eepv mry ebuewre, pior b en'vwanro. ebo rm epplira�v Ip eueh psrmu io fib e epned uatement tliet M ar eAe
is licenaed punuenl lo IM pwifbna d IM Lontretl ioqia w ICheqer B(canmerviiq x�lh Setlun )000) d Div'vion ] d the
Buxrbas eM RMevixu COEe� a ihm he u ehe o e emp Ihereham enA tM Eeau In tM elbpeE aaempon. My videlion d Sed'an
'!W t.5 by eiry eppfunl Iv e prma wbp6� IM epplce�u lo e avd ynieAy d nol mae Ihen (rva'w�d�ed dooen �ssoop.
� I.mowrcrWiMqWanY«myemWWeeewinwnpecniheiedeaomV��ion.willEo�M1exwk.erdiMsvucwnem�imeMad
«MereE la eele (Seciion JOaa, Buvrcn erd PMeeeioneCode: TM Contredon Limnaa lawdoea nol epply loen owrer d propany
who Euide « mpwes �Mreon. aM Wa Eoea auM r.ork IimseM « henM a Wwph h'v a hw own empbyer. povided ihm such
impowmema ere nd iNaded a WaW Im aeb. tl. M1oxwer. ihe bWdirq a in V�xa u eold r.n16n ar Ymr d mmP�ion. Na
owner-0udCm wYl heve tM WrEm d pv.•iiq M a ehe EN nd butl a impow la �M puryme W aWl.
❑ �. a, orm.r d �ne o�aroro..m uduzvelr cmvea�w �.nn Fca�a.a convecwn �o mm.ua Y,s w9� (seuion �ou. eusi�se eiw
Pt010mme COb]: TM �.pVretloA IKVIM LBw dOe! eM 9VV�Y b M Ovnw d G�Y Wlp NItkB Of NIPwM IMIGM 8M Mfi0
CqIVOCIf �q 9X}I M�I�� M1��10 GVIIIfM01�t) �KlMld p11RUW 10I1q COI1�fBOIXt �ICeM! �9'M�.
� I am aRemq unEer Senion: B. 8 P.C., br ihie reeaon:
Dme: �+�:
I do haraby cMiry Ihet I em ewue W vM uMentenE �ha requiremenu d Cellana IbeAh erd Se1My COCs Sedions 25505. 2553�, aM
2553a. eed ihei I or anY �ure buiki�q ooeupenl will / wJl rot (�b me) neeE to eanply wih vaid mme mdm erd ihe rxryiremenu br
a permu la waviciiona moCifiraiion hwniMAi�Ty . anapemeM D'atrie. Reeidxiliel mn9rutlion eppfrAiomaeassanq from �heae
a�s.
ome: Aod���
WOHKEN'S COMPENS�TION DECLANATION: I Mreby elfimi �Mm pereXy M pe�jury one d �M fdbwiiq dstle�mnm:
� I �eve entl xil meimein e cenAce�e d mnwnl ta eeM-inaure ror v.orkere' compemalion, m pw+ded lor by Sacun ]]00 d ihe leEor
Gade, la iM pMamerca ol ihe wak lor wMch ihn parmn I� iaued.
p i n�.�e �;� �m.�.�n oomo�� ���.... �a�+�ed M s«a� s�ao a ine �no, cme. ia m. w„a� d m.
X work Ia wliid� ihie permn ie inued. My warken compeneelim inwrence rariier enA pdicy numbm are�.
c�a�: STLTF �rTUn EXPIRES
aa:v��me,,: y��9511-:L6 04/O1/97
This aecfion need nd ba complefed / tM perme is la one hunEred Eallen /S�i OJ w bse.J
❑ I cenM �hn in �he pMortnenw d iM wwk Iw whch �hie pe�mii in ie Jod jhNl mt em0loy eny peivon in e� memwr eo m to
beeome sud� �v �M MOMeri eom0��ion bwe d Celibmi0.- Of�s Ihel d�aM1wl4'Exome wblw m tM xveken'
pen �mn D (((}}}s�/s d Sedion �]OU M Ihe labor Code. I I, � h mm} r IAo 'pwieb/ne.
el :c��'�� V AVPf �: �J� i!.!Z
minp: Fsllun ro�xun woden' compmutlon eov�rpe nM 1, m0 �Nll l�cl en �mplay�r to ctlM�ul p�naltl�a eM
clvll flriea up ro ans hunlretl tMuuM tloll�n (SIOO,PpO Mf n ro M� cwf ��o�.�..uon e.m.oe, ., o.oMeee ro. m
' SxHon 3](I6 0l tln LMor Cole, InNrast, mtl ertomey' I.
CONSTRUCPON LENDING AQENCY: I MnEy �rm uMer penaM1y d porjury Ilw IMre u e cmv�uqion kMifq apercy la tha
peAamawe d iM wark 1« xAiM Ihc perm� u eaued (&eaion �09), C'v. C�.
LENOEF'SNAME: �
LENDEP'S ADDNESS: ' ' �
I cenify tAm I heve read ihia eppliceiian eM pme iAet IM eEove inlametbn n conea. I ep�ee to canply wilh all cily eM munN adineMea
end ete�e lews relelnB lo WiMinp canaVuaion andMieEy ninlwrize nprasemetivm W i�ia aryto emar upon ihe ebove�men�ioneE propery
LYLE�ORRISON
Dme: � � C I
WMe-BuiMiq d Salqf: GreerFb: Cvwy-AVVw^�: Pink-Re.ewe: CioldeiwE-/uwnr
�CITY OF COSTA MESA - BUILDING PERMIT
PERM NO: B 077388
PERMIT NO: B 077388 PLAN CHECK NO: 01587-96 L GOVT: N SUPP: N
CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION : CONSTRUCT GUNITE SPA & REPLASTER POOL SQ FT: 15,000
CLAIM VALUE: 15,000.00 CALC-VALUE: 15,000.00 GROUP OCC: R-3 /
COMMENTS: CONSTRUCT GUNITE SPA 6 REPALSTER EXISTING POOL
****atit�t*at�-�-�t�*x�**+tit�-*�-+t�-�t***at*x�*it�r****it**�*�r*�t*�-�-*+ti�+�*�*****+�i�*****�-+ti�**it�*�t*+�x�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT ZN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 13927213 ZNE: R1 REF NO:
PLANNING NOTES> INSTALLATION OF A NEW SPA AT GROUND LEVEL AND ASSOCIATED EQU
> IPMENT.
fE iElE 1E 3E IE 1E IE iE if 1E fE iE 1! 1E iE 1E IE iE iF 1E 1f 1ElE 1f 1E IE iE 1F iE if if 1f iE iElE IF iE 1k IE fk �F iE IE IE fE 1E fE iE iE fE fE 1E iElf if 1E if!! iE if iElE iE fF fE fE iE jE 3klE if f(� 1E �ElE fE �E �)E
D E V E L O P M E N T S E R V I C E S R E Q 0 I R E M E N T S
ZONING APPROVED BY �� 1� DATE: 1�
BUILDING APPROVED BY : � DATE: I 6
APPLICATION ISSUED BY; DATE:
3E�EiE1EiElEiElEfEiEjElElElE�EiElE3EiEiEiEiE fE !E jEiEikiflElEIEiE1F1E�E 3EiEdE if fEiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
r� J � � r
BLDG PMT PLUMBING ELECTRIC MECHANIC'l FIRE SMIP/RES GRADING
PERMIT 224.75 •� �? SMIP/NON-RES
�. �
PLAN 146.09 . �� � 2,84
ISSUE FEE • .i '
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECR � "TOTAL PAID DUE
TOTALS----> 228.09 0.00 � L46.09 374.18 374.18 ,00
�
REVENUE DIVISION TOTALS--> COLLECTED: 228,09 OC�ER/5HORT: ,00
BLDG PMT PLUMBING ELECTRZC MECHANIC •i FIRE'/SMIP/TOT GRADING PLAN-CHECK
224.75 � f,: / � 3.34
iE iE 1E iE iF �E iE if !f 1E k aE 1E if if 1E iE iE iE �E iE aE aE �E 1E IE fE iE iE 1E 1E if 1E iE iE �E fE �E fE iE �E 1E iE�iE 1E if if if iE if"IF,iE iE 3E �E 3E 1k if iE iE iF if if iE 3E iE iE iE iE 3E IE iE �E iE �E iF iE iE �)E
I N D I V I D U A L F E'E H R.'E'A K D O W N
TYPE QTY D E S C R I P T I O. N�. � '. UNIT COST TOTAL COST
SFR 1500 ALTER BY VALUE RESIDENTIAL �`NOZONE 1,00 1,500.00
SFC 13500 SPA - 1.00 13,500.00
END OF FFTES` '
"r '
I
� � -
• . . .f '.
� POO L �A
CONSTRUCTION AN� PLANNING ! "-)
:� APPROVALS Permit # � � Date Inspector pppROVALS Permit # Date InspeEtor
�,t. Temporary Electrical Service or Pofe 52. Pool & Equipment Location . �
'2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement Q� f� � �
3. Elecuical Conduit Utility-Undrgrnd. 54. Forms
4. Eletvical Conduit-Undrgmd. 55. Electrical Bonding ' �
5. Steel Reintorcement 56. Rough Plumbing & Preswre Test
6. Electricai UFER Grnd. 57. APPROVAL TO COVER-GUNITE d/L
7. Footings 58. Electrical Conduit�Undrgrnd. .
8. Foundation 59. Gas Pipe, �7 Undrgmd., Test -
9. VJatet Pipe-Undrgrnd. 60. Backwash �ines, P�Trap, Cl Undrgrod.
70. Structuraf Floor Svsrem 61. APPROVAL TQ DECK
11. Property Sewer Line & House Conrtection - &2. Backwash & Recepior-Finai
12. Sewer Cap 63. Heater & Vent-Final �
13. Roof Drains 64. Plumbing SYstem � Final
14. Rough Piumbing 65. Electrical-Final '
15. Rough EfecvicaLCond�it 66. Solar SYstem�Fl�ai �/�
16. Rough Electric Wiring � 67. Fencing & Access ApP�oval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING -
18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 3�-<�-R'� �,¢�¢--
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
27. Dutts, in Structure 70, Underground Hydro
22. Ducts,Ventitating 77. ProductPiping'�Gas ❑Ol
23. Gas P�Pe-Rou9h & Test . 72. Underground Fiush
24. Roof Praming 73. Undergmd. Storage Tank C] Gas ❑ Oil
25. Roof Sheathing 74. Overhead NYdro
26. T-Bar Ceiling (Structurall & Monocoa[ 75. Dry Chemical
27. Frame and Flashing ' 76. Dry Sta�dpiPe
28. Lathing & Siding . - 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Dryevall Nailing HEALTH DEPT. REQUIflEMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electtical Power Meter�Final 80. FdOD CERTIFICATE ISSUED
33. Final Electric � Notes: g' /3/�b �^GpC�¢� //�i,v,• �/�
34. Final Heating & Air CondiTioning �j.��� �G�� J
35. Finat Gas Pipe�Test �" � �., �
36. Hood or Canopy ��' � �L( LT�� �,.� �` --�p� _
37. Final Factory Fireplace � ,� ��s� �f�c1�,�„� �_ __
7"
38. Final Plumbing {
39. Water Service�Final 3-�1���=J✓ ��S ��T�"�' Fl�S
C
40. Gas Service-Final �v _/_ L/„�_ �� �_ G�` ��,y
T G�..... c�t� i��-
41. Solar pomestic•Final /' „ ,F}--
(O "vv
42. Backflow Preventer
43. Backffo�v irriqation
44. landscape Irrigation System -
45. Sound Attenuation
46. Handicap Reguiations
47. FINAL STRUCTURE & BUILDWG -1 � �
48. FINAI PLANNING �- ••,
49. Electtie Release to Edison
I
50. Gas Release to Southern California Gas Co
57. CER7IFICATE OF OCCUPANCY ,
No. Date
0
I ,
Y
�I�
�oax�ssaam�w+c: 2g00 ELLESMERE AV
�rv"Eas"u�i`p'°"": BLANK, CHRISTOPHER L
�oowesx BLANK, RAJIA K
` 2900 ELLESMERE AVE
�vr�. �uimo �ooxFss:
COSTA MESA,CA 92626
""`""�cT°"F"°p'�"' RON LACKER
n
IJICN.OP ENO.'4 AOONESS: S 3 3 Z N. M I L L ER S T
ANA
cafm�crarax� pROMONTORY POOLS
ca+rn�croxs�uiwo 1332 MILLER ST
,�noxeu: ANA
92806
UNT:
uur».: 20949
IINT:
CA 92806
(714)993-0557
CA ��� 404194
uxT: z 0 4
LICENSEU COMRACTOXS DECLANATION: I heroby y�irm untler pneXy W,pQury I. I em IkmuE unEer proNebns oI CMptx 9
(wenmantlnp wilh Setlbn'/aW) d D'M�on 9 d iha BualMee enE Pmtaeion oda, my Ikanw b In hll laee aM a�
cm w.: . ue. euss: C_ 5 3 �0' j 19 A:
. 2 c�a: e+ v�--.—_
BUILOEfl DECURATION: I hxaby dfimi u� p�y N � � y� exemq � iM Cantiaaon lioeme law Ia IM
Idbw'vq reewn (�� )0�1.5 Busiwa� ud Vrdmmoro Cod �'ry � coumY �� ine e pertnt m mmbucl, eXm, impo+a.
�lemd'oh, u ropei eny st�ucturo, prar b ea uaeMe, eyo M irent Iw suc� pem�e lo fib e ep�wd sleiement Nm M a sM
� limsed pum�ent io tM po.iwns d Ne Canlredar� '� �Chaqv B(�mendiq Mith Setlion ]000) d Di+eqn 3 d Ihs
Iuvnsa W Pratmaom WOeI a tlut te a ehe o x thaeivn eM iM base la Ne NbO� uemqian. Any violetion d Swon
)031.5 by eiry epplicaM I« a parmil wdjxfe tM eppli[ety Io e tlW perolly d nal mae Ihen livs huMred ddW �550011.
� I. es ow�ar d Ihe popenY a my emWry«e v.th w� Ay ihai ede campen�alion. will Eo �he xork. eM the ai'uaure e not iniendeE
or oltarad la ceb (Senian l0aa, BueinmeeM PmlMabna Code: TM Comraztan Licenee lew Eoee mt epplyto an owner W propa�ry
who buiEs or imD�� �hereon, entl x}ro doee such vmrli NmsaH ar hereetl or IhrouBh h6 ar her own empbyeae, proviCeE ��e� euch
CITY OF COSTA MESA – BUILDING PERMIT
PERM NO: E 077390
PERMIT NO: E' 077390 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V–N PERMIT TYPE: ELE PURPOSE: OTH
,TOB DESCRIPTION : CONSTRUCT GUNITE SPA S REPLASTER POOL SQ FT:
CLAIM VALUE; CALC–VALUE: GROUP OCC: R-3 /
COMMENTS: REF: B-77388
*it*i�i�*****�i�*it+r�t*f�*�r**ftft**it+�i�+�***�r*�r****�t*****at�t*+t+�********i�+�+t*�-it+��t***x�**�t**i�**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BOILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
I,EFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 13927213 ZNE: REF NO:
PLANNING NOTES>
i
1E IE fE 1E IE fE 1E 1E if if 1E 1E 1f !E iE iElE iE iE fE iE fE iE iElE iE if 1! iE iE 1F if if 1E 1E if iElElE if �E iF 1E 1E 1E �FlE iE 7E 1E IE iE �E fE iE �E 1E 1E 9E �)E fE iE 9E �E 1E �f !E iE if 1E 1F 1k 1E jE 3E iE i6 iE iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
improvemanla era id intanEed w dlareA lor aeb. M, M1owevaq �he bwNinO or impravemenus edd wilhm ana yeer d mmqa�ron, tM1e Z ON I NG AP P RO V ED B Y ' D AT E:
ownar-buiMer will heve Iha buken d qwieq ha or fM Ek � builE a im0� �w �he Wm�e d Wa�.
� 1. es Owinr d IM pWe�7. em e�duetteN eonlraqiq xnh licensed mnlextwa m eanxruu Ne Mq� (Setlun )Oae. &nirme vd ,
aw„�,.c�:rnecau�a�.�e���.a,,.�a�w�o,.,b,aa�n�wrow�w«�w�.«ma.,�,.�ewa BUILDING APPROVED BY : DATE:
conirena lor euN pmjen+ wnA e caHrequ(a) lice� Wrsuant to IM Conlretlan Licenee law). • ' /� _-� ��
❑ �„�,,.,mw���s«��: e.aPc..�a�,�,�: Af'f'LTt;ATTi?N I5�'UEC� PY: � /"/i'Y�.---- DATE; �
o�e: o.,��,: ��`�.`�E�������##���F�r�#����#�i��#�#i�X�#��:�:�k#**��. • *�**x�*�rx�r���t*u�*tr*�x+�+�x��*� *�*�r�r *
ieona,a�.wy�i�,e.�.eawwe�w�euro�m,��awac�e�uwam,�es.ro�ycaeesea�.zsws.nsaa..m LEGALIZATION:N F E E S U M M A R Y STRUCTURAL S GMENT:N
i2555C. eM Nm I a emy Mua dakvq maqaru..ri4 / WI rw� (dreb are) roeE b camDN xih mid mta mda xN �M �W�vemmb br
epamulammwcUanamodifmunhanlMAr�y ��om�u.A«id«u��xNeo�wa�„�+��mixt�m�s MZT aL�� ��� pLtJFtE1INt3 }�''L$2�1i�6 (��'f'H�NTl �'Tli$ SMIP/RES GRADING
a�.
� De�a: ADd�:
W OHKEN'S COYPENSATION DECL�H�TION: I Mropy yfi� uMar paneliy d pxjury aw M the bllowi'p detlerelions:
� I heve aM wl meimen e cmtliuie d wuent io eaMiruwa br vrorken' wmperaetion. m pwidad la by Seuion �IODW IM leCor
COEe, lw Iln pMwmarce d Ne v.oM la Mich Nn peimX e osueE.
�I Mro eM wil mein�ei� wwMeie' mnpenfe�on inay�yKe. a tequired by &etivn J]00 d IM Lebor Code. lu tM pa�lormence d IM
wwk lor xhiM ihia permil ia inued. My warMert cpnpe�ymion inaurenca rertbr eM pdiq number ere:
Cemec STATF F�TNTI EXPIRES
Pdiry Number: �Q (1 ri d— Q F, 0 4/ 01 / 9 7
mis seaim neee � ee canc�.d ] rns o�e u ro. one nune�ee doue�s (S�wl w �es., l/
❑ I cMN WI in ihe G�am ce a iM work 1« �ficA �he D�u u mueE. I.e1W «nV�' �Y � ry�e� eo m lo
nx wbjM to IM rliere canpenaation 4we d Celtlarrve, aM ies ! I abjee id�p�'
//1 eemiu mvu � d Seaion a)ao d �M labor Code. I shaA
/ ve: Ji� Md'ran: .
InD� FeNun ro secun roM1'ri rompau�tlon c�Mps_la ( ntl Msll utlj�cf wnployer fo crlMm/ peneMu �rrtl
INI firca � ro om h�nSrW llwuunJ tlalkn (SfOqpppA N tltlltbn N� cwf ol rn tbM1 damspu � povMeC br In
Sxtlon 9I(16 0/ Ns l�or Cob, In1auL +�tl �ttomry �� ,
CONSTPUCTION LENDING AOENCY: I hmaby effrtn uMm parely d perMrv �� �� u e mn�ueion bnCiip eperKy fa iM1e
panonnance d �ne .wn� m, wnim in: o.�� a b.�ed (seaun aos1. cN. c).
LENDEP'S NAME:
LENDEP'S ��ONES9:
I cenily �hei I heve reed �hia epplicetion uW ste�e ihm Ry ¢yove inlormetion e corted. I epiee �o oompty wilh ell ury eM counry pdirencee
azM 51919 kWf fNel'vp �O WiNip ConYNpxn GM M�OEy eNhWRe e9peaen181ivBp d Ih6 Gly b m�a1 upm �he 6b0.<�menliJl�pd pp�Mly
Iw iropatlqn q�rpmes.
/ LE MOR N
i i �� Z� '.
, t-.1 ome:
�Ti s'v e a o�nenno ��bo rmo
Sdwy:Oree�_Fb: Canary-Appirani: Fnk-Hevervn: Ookenro�Maesmr
PER SO$
PLAN
ISSUE FEE 15.00
BUILDING–DIV–> PERMIT ISSUE PLAN–CHECK
TOTALS----> 27.50 15.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
42,50
SMIP/NON–RES
TOTAL PAID DUE
42.50 42.50 .00
42.50 OVER/SHORT; ,00
FIRE SMIP/TOT GRADING PLAN–CHECK
iE iE 1E iE 1F iE if 1E iE if iE iE 1E aE iE fE fE iE 1E 1E 1E If iF if ik 1E iE 1E iE if iE iE fE fF 1E 1f !E fE fE iE 1E IE fE IE 1E IE iE fE fE iE fE fE fE 3E 1f ik 1E i! 1E if iE iE if IE if IE fE �E if iF aE IE 1E 3F 1E 1E iE IE iE
Z 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 2 O N UNIT COST TOTAL COST
ELE 2 FIXTORES, LIGHTING 1 ST 20 EA. .75 1.50
ELE 1 SUB–PANEL 1]..00 11.00
ELE 2 MOTOR/POWR APPARATUS 1,1 – 10.0 HP 7.50 15.00
END OF FEES
�
'
�
. CONSTRUCTION AND PLANNING �-.
- qPPROVALS Permit #
1. TemOorary Eiectrical Service or Pole
2. Soil Pipe-Undrgrnd. ;
3. Electrical Conduit Utility-UndrgrruJ.
4. Electrical Conduit�Undrgrnd.
5. Steel Reinforcement
6. Eiectrical UFER Grnd,
7. Footings
8. Foundation '
9. Water Pipe-Undrgrnd.
10. Structural Fioor SYstem
17. ProPerty Sewer Line & House Connection
12. Sewer Cap
13. Roof Drains '
74. Rough Plumbing
75. Rough ElectricabConduit
16. Rough Etectric Wiring
17. Rough Wiring Sign
78. Rough Electrical�7 Bar Ceiling . �
19. Rough Heating & Air Conditioning
20. Rough Eactory Fireplace
21. Ducts, in Structure
22. Ducts, Ventilating
23. Gas P�Pe-Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T•9ar Ceiting (Structurall & Monocoat
27. Prame and Plashing -
Z8. �athing & Siding
29. Insulation
30. Drywall Nailing
31. Plaster Brown Co2t
32. Electrical Power Meter-Finai
33. Finai E�ectric
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Finat Plumbing
39. Water Service•Final
40. Gas Service-Final
41. Solar pometticFinal
42. Backflow Preventer
43. BaCkflow Irrigation
44. Landscape irripation SYstem
45. Sound Attenuatipn
46. Handicap Regulations �
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
4g, Etectric Release to Edison
50. Gas Release to Southern Califomia Gas Cc
51. CERTIFICATE OF OCCUPANCY
!o. ___. - Date __. _
Date
��
POOL ,PA " �
Inspector AppROVALS Permit #� � � Date
� -
52. Pool & Equipment Location �
53. Steel Reinforcement ,
54. Forms �
55. Electricai Bonding '
56. Rough Piumbing & Pressure Test
57. APPROVAI TO COVER�GUNITE
58. Electrica� Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P�Trap, � Undrgrnd.
61. APPROVAL TO DECK -
62. Backwash & Recepior-Final :
63. Heater & Vent•Final
64. Plumbing System - Final ' -
65. Electrical�Finai � 1/
66. Solar Svstem�Final `
6�. Fencing & Access Approvai
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSF�NAt,
FIRE OEPT. REQUIREMEIVT
APPROVALS Permit #
70. Underground Hydro
71. Product Piping OGns ❑Oil
72. Underground Flush
73. Undergrnd. Storage Tank L� Gas � Oil
- 74. Overhead Hydro
' 75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL -
78. F�RE PREV. FINAL
HEALTH DEPT, REQUIREMENT
� 79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
��� Notes: -
f �
0
_� . �
Inspector
0
� .. ..
EMPLOYEE:
PERMIT NUMBER: � 7-/ 39Q
FEES:
TIM
SPECIFIC AS
BUILDING PERMIT LOG
av
TYPE OF PERMIT:
SQUARE FOOTAGE:
0
p�DPES50FBNLUNO: z9OO ELLESMERE AV
°"wERs"r�EiF'wo"": BLANK, CHRIST�HER L ,. ,.
- : ' �ooness HLANK, RAJiA '•
2900 ELLESMER AVE
COSTA MESA,CA 92626
UNT:
��-G
CNRECTORFNtlNEEP: RON LACK ER °B�NOa 2 0 9 4 9
' cx.oner+a.•swoness: 1332 N, MILLER ST °NT'
ANA CA 92806
coxm�cTarsw�xe pROMONTORY POOLS ( 714 ) 993-0557
'�. c«im�cTonswuuxc 1 3 3 2 M I LL ER S T
�op� ANA CA uGr�o.: 404194
92806 uM: 2pq
LICENSED COHfRRCTOPS UECLAN�TION: I henby Nim uMer para�y d D �uY �� I em liunaed un�pyrv�ian� of Cheqar 9
(ewnmeraip xilh Seelion ]000) d Gvhion � a11M Buviwq aed PMaseion de, ard my lieems' ' rfufl l e eM eHe�_
c u no.: / uacuss: C-53 uc "� 91 � tP:
oae: � comreaa: / ,iG/
EF BUIIDER DEClAR4TON: I M�y alfirtn uMm parely ' � am om q 1 tM Comrmas lioenae lew la Me
Idbwvp reeam (5eeion ]W 1.5 Bueiwas eM Prdauione COAe: Y r a munty xfiiM �ae e pe�mil to oorubucl. Ma, imparo.
Cemdvh, a repei eny aVucluro, pria w na oweM.e. ebo reQui 1 epplimnl iw wch ' to fib a eip�nd aWemenl Uut he a eM
i Iicenaed Wn�� io tM qwivms d iM Canlretlas Lice e �Cheqm 9(oommendrp xV� Sadion )000) W DHiion 3 d �Ir
luai�ea eM RWeaiom Codel w Ihel he v ehe u u ' arM �M baia la Ne eIMYb aaemqion. /�m vclmion d Setlion
)W 1.5 W eny epplirant lor e permn wbjetle IM epplicen lo e dvil penelry d rwl mae ihen Irvs hunEreE tldlen �5500��.
❑ I. m ownar W �M popenY a my empbYees xih wepee n iMi eob mmpenution. will do IM xwk. e�M �hs sVutlun u�wl imeMad
a Meeed br eala (SMion 1D14. B�ni�ee eM PrdeffbnsCaCs: Tlie Coniredae Lieenfs Lew Ewa iat eW�Y loen owrwr d popMy
who WiEa a inD��ae �Mreon. eM Ma doe* euch wark limwll or henell rc thraqh he u har oxn empbyvas, povideA ihal wch
impovemenro are iw imeMeE a dlae0la eW. X, however, tM Wikiiq a inpmamem ie eold wnAin me year d oompbtion, iM
wmr-0�iker will heve iM Curdan d poviip M w ehe did M WiIE a impovs lor �M WNae d We�.
� I. m owrer d tM MOGeM. em mdueiveN conireaM wn� IicaneaE convaaas to conmrutl iM pM� (&xfion )OM. Bue"vime eM
Pro/msiam Gode: The Comrepm licenae lew doee mi epply to en o�mer d prapeny x1ro Wilde or impovee IMrson eM who
mnvecp lor wM prqeda wnh a mmredor(e) licemed punueM to ihe Con�repors licenea Lewl.
❑ I em uampt urMx Section: B. 8 V.C., la ihn reemn:
o�a: o�.�,.,:
I do Mreby ceXity IMt I em ewere d ud uMereieM iM royuirmmeme d Gdlomu Heellh end Sdaty Code Saqiona 25503, 2553�, eM
255�a, eM thet I or eny Mure W ikiip oavpent will / wll nd (tlicb aw) neeA to wmpN w�h miC peb mEee enE iM rtyuiromend br
aparmXfaconsVud'qnormodifira�ionhomlheA'v�6u Ciyl�erepement0iqr'uf.Raeidaniieloare�ivaoneppimtiomereuemptimmiheee
pfON5M119.
D+ie: Applioenl:
WOHKEH'S COMPEN311TION OECLAFA110N: I Mreby elfiim uMer penelty W pxjury me d Ns lolbwi�p Eetlueliom:
� I heve eM wil meintan e cMilicele d wneent io eeM�inwre M wakere' canperue�bn, n proviAsd lor by Serlan 3J00 W IM labar
COEe, iw IM pe�ormence of �ha wrk lor which ihie peimn ie ivueE.
I'7 i na�s �e we m�m.m wo�ka.• �w��vo� ��.�,.M., d�w��,ad M sea� a�ao a m. �.no, coes, ia me oe�ro,m� d me
f� wmk fa vfiich I�ie paim� ie iasued. My wake�e compenWion inwrence wrbr eM poliry numbar are:
c�a�: RTATF FfiNT1 EXPIRES
Polcy Number: � Q(1 S d— Q f. 0 4/ 01 / 9 7
�his senion need nw 6e compbleC d(he paimd is lor one hundroC EWkn /E1001 w lesa.)
� I cenily Ihm in Ihe pertortnence d ihe wak br whch ihie permN ie ieeusd, I dl omploy eny en enner w m �o
become aubip io tM orkers' cwnpenaetion lewe M CeIA«nie, enE •• t t'I eh �c e ubjea io t�e 'e'
pa9e+tio�fpmvie' M Sec�ion 3'!00 W Ihe Lebor Code, I Mdl io�h 1� wii I� w�iviaio .
e�<: � j' �vacmn: /
G �
Inp; Ftllun ro�xuro workni mmpmutlon cov�rp� b unb 1, nd ahll �W)wt • I110IOj'N IO CIIMM/ pM/ION OIC
C/YII XM� 1IP M OIII IIMCIW �MIIM/M dOIII// �S�OQCOO�r III GAJ n� m. ew� or comp. u.em�, a.m.o.. ., a.o.m.e ro. i�
SxHon J106 0l fh� Le6or Cotle, InM1rs,t, mtl ettomsy'� I�u. (/
CONSTqUCT10N LENUINO AOENCY: I hemby eHrm undar penely ol Po�N�Y Ihet IMro'n e mnelmdion ISMinO e0ency br ihe
perlormance W Ihe wark br which Ihw partnn is esueE (Secibn �091. CM. C).
LENDEH'SNAME: 1 ' �,;%
LEN�EN'S ADDPESS:
I catlity that I heva reeE I�ia epplbetion end atele ihel �he ebova iniwmelion ia corted.
end elete lawa rele�inp io building coneVudion eM hereby eNhoriza reprerontmme W
lainspeclion pu/poses. ,� _
wnaa-a��ie:�u
vmk-r�.���e: adea,roe-N�
okinencee
ad woveM
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: P 077391 PLAN CHECK NO: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU
JOB DESCRIPTION : CON5TRUCT GUNITE SPA & REPLASTER POOL
CLAIM VALUE: CALC—VALUE:
PERM NO: P 077391
GOVT: N SUPP: N
PURPOSE; OTA
SQ FT:
GROUP OCC: R-3 /
COMMENTS: REF: B-77388
*��**+��**���*********�**rt��**�*****����***xxx*�*x��****+�*�***��*�**��**********
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR• FT IN FRNT: FT IN REAR: FT IN
-�EFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 13927213 ZNE: REF NO:
PLANNING NOTES>
i
*�*����*��********�****�*����*�*����***********���*��*���**�***����+�**��**��***
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 .
BUILDING APPROVED HY :
APPLICATION ISSUED BY
DATE:
DATE ; (j�
DATE: G 7
+�*+��t**** **
LEGALIZATION:N F E E S•U�M A.R Yy,%�� STRUCTURAL EGMENT:N
� .. i�l � i/�L
BLDG PMT PLUMBING ELECTRSC MECHANIC� FIRE SMIP/RES GRADING
PERMIT 7.00
25R , . . � � SMIP/NON-RES
PLAN .. n� -,
ISSUE FEE 20.00 '
HUILDING-DIV-> PERMIT ISSUE PLAN;CHECK' �+% �TOTAL PAID DUE
TOTALS----> 7.00 20.00 ' 0.:00 .27.00 27.00 .00
,�� • - �
REVENUE DI��ISION TOTALS--> COLL�EC'fED: 27.00 OVER/SHORT: 00
HLDG PMT PLUMBING ELECTRIC MECHANIC .�FIRE �_SMIP/TOT GRADING PLAN-CHECK
2%.Q� � �
a L,
�i' ' • � �
fE aE �E 1F iE 1E fE dE �ElElE vE 3f -)f jE jP3E 1f iF iF If 1E 3E iE if �E fE fE �)E 3E 3E jF aE jE IE�161E iE 1E iE 1E iE i6'jF 1E jE iE 1f !E if�lfLiE
I N D I V I D U A L•, F E E �H R E�
TYPE QTY D E S C R I P T I O N � ��' C�
{.. �-. i
PLU 1 SWIMMING POOL ' ' y% �
END OF �FEES�j �
, n �y
r �\1
J.'L'/
{ �I�/
.�_
.�
1E �k if !f if 1E iE Ik iE if �E iElf 3E 1E iF ik iE 1f iklf 3E if If iE 1E 1E
A K D O W N
UNIT COST TOTAL COST
�' '—' .. � .i i_. .. ,
. � _
�. CONS�k'CTION AND PLANNING j POOL ,PA
'; „'1PPROVALS Permit# ' Date inspector ppPROVALS Permit# Date I�spector
.
i�. Temporery Electrical Service or Pole � 52. Pool & Equipment Location
2. $oil Pipe�Undrgrnd. 53. Steel Reinfo�cement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' '
�
4. Electricai Conduit-Undrgrnd. 55. Electrical Bonding -
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test �� g,,1 ��
6. E�ectrical UFER Gmd. 57. APPflOVAL TO COVER�GUNITE ,
7 �'Footings 58. Elearical Conduit-Undrgrnd. --�
�=oundation . 59. Gas Pipe, O Und�Brnd., iest .
!�
9. Water Pipe�Undrgrnd. � 60. Backwash Lines, P�Trap, C Undrgrnd. �
10{•Structural Floor Svstem - - - 67. APPROVAL TO DECK
7 t. Property Sewer Line & House Connection � 62. Backwash & Receptor-Finai
7�. Sewer Cap ' 63. Heater & Ven[-Final
73. Roof Drains 64. Plumbing System - Final .� �� � I��
14. Raugh Plumbing , 65. Electrical-Final ' ' � �
15. Rpugh Electrical-Conduit . 66. Solar SYstem�Final �
tb. ROugh Electric Wiring 67. Fencing & Access Rpprovaf
il. Raugh Wiring Sign 66. APPROVED FOR PLASTERING "
18. Ruugh Electricai-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAI
79. Rough Heating & Air Conditioning . FIRE DEPT. REQUIREMENT
20. Ruugh Factory fireplace APPROVALS Permit #
21. Ducts, in Si�ucture 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas G Oil
23. Gas Pipe-Rough & Test - 72. Underground Fiush
24. Roof Framing 73. Undergrnd. Storaye Tank O Gas ❑ Oi4
25. Roof Sheathing � . 74, pverhead Hydro .
26. T-Bar Celing (Structural) & Monocoat 75. Dry Chemicai
27. Frame and Flashing ;� 76. Dry Standpipe
28, f�thing & Siding . 77. FIXED SYSTEM FINAL
29. Insulation 78, FIRE RREV. FINAL
30. DtYwall Nailing HEAITH DEPT. REQUIREMENT
.37. Piasrer Brown Coat 79. FINAL INSPECTION
32. Electricaf Power MeterFinal 80. F000 CERTIFICATE ISSUED
33. Final Electric Notes: S""'_13 �'� �J�]-�Z?J U-
� C� ��mzii�trau,
34. Final Heating & Air Conditioning
�� �����.
35. Final Gas Pipe-Test
36. Hood or CanoPy � ��_a2��,/
Jv
37. Final Factory P�replace - _;- �6 .� g ' � / e��2-�'�=(�L( S_ _ _ _
b n
38. Final Plumbing � 3�) I'C, � � p � C+_� �_ S O_ 'y
J v
39. 4Vater Service-Final � � � . � f' �� � �� ! ' ` ;
L ��
40. Gas Service-Final
41. Solar pomeSticFinal - '
42. Backflow Preventer .
43. Backflow Irrigation �
44. Landscape Irriqation System � 7
q5, $ound Attenuation �
46. H2ndicap Regulations , �
47. FINAL STRUCTURE & BUILDING .
48. FINALP�ANNiNG
49. Eiactrie Release to Edison
50. Gas Release to Southern California Gas Co . '
51. CEATfFICATE OF OCCUPANCY
No. Date
. �- cj �
, ,
,, ` SOUTHWEST INSPECTION AND TESTING INC. `
' 10826 S. Norwalk #A '�
Santa Fe Springs, CH 90670 .
310-941-2990 714-526-8441 Fax-310-946-0026
--��------�-----------------------��-��--�a------
FIELD DATA ON TEST SPECIMENS
--- ASTM C31, C138, C143, C172, C173, C231, C1064 ---
CONCRETE: GROUT: MORTAR: SHOTCRETE: X CORES: 6UNITE:
ADDRESS: 2900 ELLESMERE AVE. COSTA MESA JOB #: DATE: 6/il/96
JOB NAME: BLANK RES. PERMIT #: B77368 ISSUED BY:
ARCHITECT: ENGINEER: R L LACHER
CONTRACTOR: PROMONTORY POOLS SUB CONTRACTOR: D.J GUNITE
----------------------------------------------------------------------------
LOCATION IN STRUCTURE: 5PA & POOL ALTERATION
----------------------------------------------------------------------------
CONCRETE SUPPLIER: ON SZTE PLANT: MIX #:
TYPE OF CEMENT: V ADMIXTURE: TICKET #:
SLUMP: WATER ADDED: AIR TEMP: 66
CONCRETE TEMP: MIXING TIME: TIME CAST: NOON
----------------------------------------------------------------------------
DATE CAST: 5/Z1/96 RECEIVED AT 1.A6: 5/30/96
--------------------------------------------------------- — --------------------
SPECIMENS MADE BY: PAT BRENNAN SPECIFIED PSI: 2000
--------------------------------- — -------------------------------------------
FIELD IDENTIFICATION � A � B � C � D � E ( F
---------------------- --- — --------------------------------------------------
LAB IDENTIFZCATION : 605187 . . . . .
----------------------�---------�---------�----- — --� ----- -�--------�--------
AGE DAYS : 14 . . . . .
DATE TESTED : 6/4 . . . . .
SIZE-IN. : 6X12 . . . . .
AREA-SQ.IN : 28.27 . . . . .
CRUSH �OAD-LBS : 79500 . . . :� � � � �� � �
COMP-STR.-PSI. : 2812 . . .
� H/ o . . . . : GirY 9� 6Q�TA M€SA
CORR FACTOR , � _ : qil��Aininn�\;;r;ryh�
CORR. STR. -PSI . • • ' ' AUG 05��
TIME TESTED . . . . . .
-------------------------------------------------------------------------------
REMARKS:
------------------------------------------------------------------------------
ASTM C39, C174, C192, C470, C617, C42
COMPLIES: DOES NOT COMPLY:
BREAK TYPE A: X B: C: D: E:
------------------------------------=------------------------------------------
THIS REPORT SHAIL NOT BE REPRODUCED, EXC�P-f-� LL-WITHOUT THE APROVAL OF SZTI
---- — ------------------------------ �----------- ---------------------------
SAMPLES CAST BY OTHERS:
RESP LL1' SUBMITTED
S THW�£r,T� ��NSPECTIpN AND TESTING
OSyA'R D. ANDRES
LAB. MANAGER
�,nop�ssa�BN�ou+o: 2g00 ELLESMERE AV
owNeasruxeiv�waxn:BLANK, CHRISTOPHER L
��+�SBLANK, RAJIA K
• 2900 ELLESMERE AVE
� COSTA MESA,CA 92626
APPL.M/JfII10 �UDRE54:
�NCHRECT OP ENdNEEX:
AXCN.OH FNO.'8 AOOPESS:
uc xo.:
UNi:
UNT:
cartn�crarsx�xeJENNINGS, JIM CUSTOM MASO (714)645-8512
camucroxs�uiu/o 170 E 17TH ST
moxessCOSTA MESA CA ueno.: 392707
92627 uNT: 206
LICENSED COMRRCTOXS DECLAflATION; 1 Mroby tllim uMx pxWy d pa�ury tlut I am IicenuE uMx powWr M Chaqa B
(commendnp wilh Bection ]000) d Divivion 3 d IM Budnew xM Prafaume CoEe, enE my linius n in lull brro end eXap.
c uc.No.pzq5q7 uc.euss:c z9 uc.No.: 9z�07 EXP: 06/96
me�. convea«:
W BUILDEP ECUNATION: I Mnby effirtn under panely d perjury tIW I em ue 1 hom Ihe Cont aan lioems law la tM
owinp reeaon (`�bn ]W 1.5 Bus'viw� eM Profppon� Cods: Any eCY a munry wfiid� nQuim e permil to aonetrucY. eller. improve,
+emdmh, n rapLL eny sleueYure, prior b bs ieuenoe, e6o reQu'vee �M epqi�snl lor weh pertnu Io fila e eqmd eWemeM ihtl M a ehe
liceneed pureuent lo Ihe O�imn W Ihe Conveporo Licame taw �Chepter B(cammendip wilh Seeion ]000) d Dveion 3 d Ihe
:miroa erd Prda»ia�v Codel a Ihet Iro n ehe e azemp therNmn ud �he bam la Uw atlepsd usmqian. MY videtion of Setlion
]031.5 by enY aVdicen� la e permn suEpcu IM epplicanl lo a dnl panalry W nd more ihen tNe hurdroE Edlen 1350011.
� I.avowinrW�MMOGaM«myemPbY�swil�wap»nlheeWaoomO��.v,�TdotMMwk.ardNeatrvnunurotintmded
w oMered Iw cele (Sec�ion ]014. Binirose eM PMeaaians Coda: Tha Contreqora limnae law tlros not eppyto en oxner ot DroPeM
�.no wue «:nwwm in�. e�a:no me..�,d�.� m�..e «nen<� «waqn na «nu ow� emWnra+. r� �nm.�cn
'mprovemmms ere ml inieMed a dtereE la eeb. M, hawmer, �he buiWiiq a inpwemenl ie eok wnhin oro yeer d mm0��b�. �he
owner-WiNer xill heve tM buNen d yv.•'uq M a eha Etl nal CUYA ar'unpeave la �M pvpoaa d vlel.
� I. es oxner d IM popeM. �%�tluaiwry mntemiq wnA limnaed eonUeelon to wnprud Ihe pml� (5etlion ]016. Buaiiwss end
PMeaaiau COEe: Tta Comrmm lienx Law dom m� epply b an o�mer d popeny who bnNs or imqwm 1lw�ean enE w1w
<011V0CIH�OfeYf�1 P�Q�9 Nt1�1B m111Rtlp�9��GlIIMd P11911BII��O1�1B CiOf11f9tlM �ILB19B�dW�.
� 1 em examp uMer Sec�ion: , B. 8 P.C.. Irc thu ieawn:
ova: &�„e�:
i eo n�w c�y uw i.m aw�a d�a wdeB�,d me �w��.m d cmeomr x.mn .oe Smm coee sw� usos, zssa�. �e
2553a, end �hei I a any INure buiki�q owpeni wiil / wil m� (deb an) need io eanply x1h veid dma eodm eed iha mpuiremama la
e paimX Ia mnlruciion a modAitalionhomlM A'r�arm�emmu Dmritl. Rmidmtiel mw�utlion appirelbm ere ezemq trom iM1ane
p(ON9IOM.
W OFKEF'S CONPEH9ATiON UECLANATION: I hereb� effum ueEx pauty d pe'jW ans al ila IdbrArp Eetlerelione:
� I hew end vril meinlen e<eMcve d mnami �o eeX�imum la v.vrkae'rompemaiion, m pewitleC la by Seabn �]00 d Ihe Lebor
Code. ln ihe paNamarce d Ne xaM In w1icA tiva pemiu b usued.
I hew erd x�tl meinten woMxe' mmpen+eton iroureroe. n�pu'vad by Ssaim 9]00 d Ne lebar CoEe. M ihe pertormerce d ihe
i� wak la whiM I�u permn u mued. MY walun' eanpemNbn'nmrenes weier eM pdiry num Wr ers:
c�.,: FARMERS INS E}CPIRES(l
Pdicy Number: Q 1� 0 1� J%
, m;, a«.�., �a.e,�w w�ob�.e r rn. u�+n ro, o,» w,w,ad dma,. rs,ao� w�.l
CITY OF COSTA MESA — HUILDING PERMIT �
ERM NO: B 077261
PERMIT NO: H 077261 PLAN CHECK NO: 01466-96 L GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: CON
JOB DESCRIPTION : REPALCE WOOD FENCE W/BLO WALL SQ FT: 82
CLAIM VALUE: 2,000.00 CALC—VALUE: 1,640.00 GROUP OCC: U-2 /
COMMENTS• WALL BETWEEN 2895,1901 PALAU PL, 2904 ELLEMERE 6 2900 ELLESMERE
*�*+��+�*x**�*�***���*���x��*���xx�**x�**�+t+��rx�*�*�**+�+�rt***+�*+tux�****+��r**�r***�+�***x***
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 ---------
RNT: FT IN REAR: FT IN FRNT: 22 FT IN REAR; FT IN
EFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
ARKING REQ: PROV: PARCEL: 13927213 ZNE: R1 REF NO•
LANNING NOTES> 74.5 LF OF 6' HIGH HLOCF( WALL REAR P/L —(PARTY WALL AGMT);
> 6 8 LF OF 6' HIGH BLOCK WALL ON LEFT PROP LINE (P.W, AGMT).
iE iE iE fE iE iF iF 1E iE iE iE iE iE 1E if i6 if iE iE iE if dE iE iF �E �IE iE iF ik iE iF if� i(� 1f� iF 1E 1E iE �141E iE ik if if 1E if 1E ih iE �E iE �E if if iF iF iF iE fE jE iE �E �t iklE-lF 1f iF iF,if f@ iF iE if iE 1F i(� if
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 ,
ONING APPROVED BY {*C t� DATE:
UILDING APPROVED BY : DATE: /9 �
PPLICATION ISSUED BY; DATE:
**�r*+c+�*�**�*+�*�t�t*�r**�c ***�r�*+t+t** ��
EGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
�
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
ERMIT 54.00 r .50
� SMIP/NON—RES
LAN 35.10 ,'
SSUE FEE -
UILDING—DIV—> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
OTALS----> , 54.50 0.00 •35.10 89.60 89,60 .00
EVENUE DIVISION TOTALS--> COLLECTED: 89.60 OV£R/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
54.00 .SO 35.10
� I cendy ihei in �ha pMamerce d iln wark la whch �his pe�mn e iswed, 1 dWl m� ampbi eny pemn in vry menn« ao ea io
n«o�re �d«a �o �n.,.aw.n� ��� v... a cewom...oe ao�. u,m i.rome n«�,a wd<e m �ne wone� ****+t*��**�**atat�tit*��**�at�+t�it****irieieitft*�*�***it�+tx**it****+t�ic�it*itat�*+tiEat*irit�it**�iric *
/� n,���w� o,o„,a�• a sea� a�oo oi me �� cma. i u�`i m/�{n-.mn �vM �n ma. p,o.;smti. I N D I V I D U A L 'F E E H R E A K D O W N
� nta: �` � APNicen�:��n`�.. •
w�v:F�u ro• �tiwo w-� ' n���o�p�wua��o�•si+c��iu^v�mi,aoewn l«i��Mw�oy« ctlMrv/p�Mltlwen0 TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
n.n n,�.. w ro�. nwe,.a ero�,.�d dwa�. (tioa000l, m.mino� ro m. �o,r r�omv.�w�m�, am.w ., vro��ew ro. ��
s«no�moso�met�eoicoe�.��t�q��d�rcomw��»+. SFR 82 RES—CONCRETE BLOCK WALL / FT, 20.00 1� 640.00
CONSTFUCLION LENDINO AGENCY: I hereEy elfirm under pcaM1y d pxNry IM1eI �Mn b a cvnA�udion bnCi'p epercy Iw �lie END OF FEES
perlormeMe W i�e xnM1 lor which ��e prm� u aaued (Seaion �09]. CN. CI.
LENDEH'S NW1E:
LENOEP'S ADDRE55:
1 cenity ihei I heve reed �his epplicmim vM etme �het IM ebove inlormetbn b carM. I epree �o comply wiih ell dy eM oounty ordinences
ene s�m<mws rNe�na �o Wikiro wnmumm ena ne,ebr ewae¢e rqxeannetiw d ihc mr to emer uowi ine eno�.e.meniioned Wovem
������P����P��D�'iCAREN JENNINGS
Dete: �
(5151-46 WP) WM1ne-Buildvq 8 Salety; OreerFb: Ceiary-Ap rant: Pink-Revenue: Gddeneod-Assessor
.'S ! 9" ���n. - -- — _
i.�__ ..� . • . '-�a. _��_
CONSTRUCTION AND PLANNING POOI ,PA
APPROVALS Permit # Date Inspector APPROVALS Permit # Date ' Inspector
1. 4emporery Electrical Service or.PDle 52. Pool & Equipment l.ocation
2. Soi{ p�pe-Und�grnd. ' 53. Steel Fieinforcement ' ��
3. Electrical COnduit UtilitY�Undrgrnd. 54. Forms -
-A�: Electrical Co�duit-Undrgrnd. 55. Electrical Bonding •� �
5. Steel Reinforceme�t- � Z-�(� �4-.�/ 56. Rough Plumbing & Pressure Test �
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
-"�. Fnotinqs �.2,-�f(p ��,�/�- 58. Electrical Conduit-Undrgrnd.
��8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structural Floor SYstem ,. 61. APPROVAL TO DECK '
- 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final �
12. Sewer Cap . 63. Heater & Vent-Final •
13. floof Drains � 64. Plumbing System � Final . '
- 74. Rough Piumbing ' 65. Electrical�Final • .
75. Rough Electrica6Conduit ' 66. Solar SYstem-Final
76. Rough Electric Wiring 67. Fencing & Access Approval �
17. Rough Wiring Sign 68. APPROVED FOR PLASTEPING '�
1$. Rough Hectrical•T Bar Ceiling 69. POOUSPA SYSTEh4S FINA�
79. Rough Heai�ng & Air Conditioning - FIRE DEPT. REQUIREMEMT
20. Rough Factory Fireplace APPROVALS _� Permit #
21. �ucte, in Stiucture ; � - 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas OOiI
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank 0 Gas ❑ Oil
' 25. Roof Sheathing _ . 74. Overhead Hydro
26. T�Bar Ceiling (Strucwrall & Monacoat 75. Dry Chemical
27. Frame and �lashing 76. Dry Standpipe
28. Lathing & S�ding � 77. FIXED SYSTEM FINAL
� 29. Insulation . � 78. FIRE PREV. FINAL
30. Drywall Nailing - HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat . 79. FINAL INSPECTION
32. Electrical PdWer Meter Finai 80. FOOD CERTIFICATE ISSUED
33. Final Electric . , Notes: -
34. Final Hea'ting & Air Conditioning - L.{�J�_G,� �� L � ���_/ ^ 6� [�
�� P U
35. Final Gas PiPe�Test �. , � ,
36. Hood.or Canopy � - �
37. Final Faciorv Fireplace � .
38. Final Plumoin9 � �� �
� 39. Water Service-Pinal' '
_ 40. Gas Service-Pinal ' . �
41. Solar pomeSticPinal �
42. 8ackflow Preventer � . �
4�. Backflow Irrigation '
44. Landscape Irripation.System � .
45. Sound Attenuation
46. Handicap Re9ulations ' '
47. FINALSTRUCTUf;E&BUILDING /��6
(O
48. FINALPLANNING .
49. Electric Release to Edison � -
� �
50. Gas Release to Southem Calitornia Gas Cn
51. CERTIFICATE OF OCCUPANCV
No. Date
�,
�.:
il
i'' � Q�/ PP�-�a,k. S�'1 AW p w
I� V R^0
��1�pa `P�� 1� ,� 9�� �Go/-�tllir✓ hlnr'i ojo��M�
�,''��� ~� �� X�9S PA�A„ Pi.
�.' N � �
j:�i7V . �
c
BE APPROVED BY THE
�
.
I 4„�1�
�1S fYll/tZ
il7%I!;!�.. v!/.c?ur.
1'D ���„�,`„�,
� 2�
B��ING SAFETy
,,,.,._ - - -
and it is unlawlW to make an changes or alteration�onnsyme wittpu� �
Permission lrom Ihe Division I Building and �at__o n,a� r�,� ���_ �
The stnmping of this plan an specifications RHALL NOT be held Ip pamf� I
or to be an apOroval oi Ihe Olatio
- �. nce an or Slate aw.
These 4 _ :; =.:;tl perrtiii sha;l � x ire ' ' � ,
�'� '�9 � �+ur is not cort nenced and maintained acfive per UBC §303
Id) within I8C pays cl iss�snce
SHALL
�
eae,ecr m s�ca, cer:��eo
.Cs�_e— .�-29_
JIM JENNiNGS MASONP,Y TE�114-645-8512 Rpr 16. , 17�27 No.009 P.O1
PAATY WALL A6REEN$NT
TH[S A6REEMENT, MRDE AND ENTERED INTO THIS /�O� DAY
OF�, 19,,.� oL, BY AND
�f
HEREINAFTER REFERR6D TO AS "LANA OWNER", AND
HEREINAPTER REFERRED TO AS "ADJACENT PROPERTY OWNER".
IT IS HEREBY AaREED THAT A PARTY WALL wILL BE coNSTRUCTED ON
THE PROPERTY LINE
�
n � ADDRESS OP ADJOININa PROPERTI
ZG(o�{ ��_ tt�.
IN THE CITY OF__l-�//'[�Q. , COONTY OF ORANGE, STATB OF
CALIFORNIA, A3 PER MnP RBCORD6D IN BOOK ,PAOE OF
MISCELLANEOU5 MAPS, IN THE OFFICE OP THE COUNTY RECOBDER OF SAID
COUNTY. THB PARTY WALL SHALL BE PERMITTBD TO ENCROACH 1/� �at1
� --
�,,q� Sil'��- v� ��r?�l� C�ac�- -_
IN WTTNESS WHEREOF, THE PARTIES HAVE ENTERED INTO THIS
A(3REEMENT THE DnY AND YHAR, FIRST ABOVE WRIT'TEN.
LAND OWNER
2�
IGNATURE •' ` • �
��J��- � • 7-�
NAME (TYPED OR PRINTBA)
��L3� �lg��1�
qpDRESS
ADJACENT PROPERTY OWNER.
GNATUAL ���
J `� F [�fcC�.
NAME (TYPED OR PRINTED)
%`7C5-� �(�_
ADDRESS
Witness:: �
• .. . Chris_toph,er.L. Blank .
w � �
State of California
ss.
County of Orange
On April 19, 1996, befare me, DELORES M. BECKERT, Notary Public,
personally appeared CHRISTOPHER L. BLANK, personaily known to me (or
proved to me on the basis of satisfactory evidence) to be the person whose name is
subscribed to the within instrument and acknowledged to me that he executed the
same in his individual capacity, and that by his signature on the instrument the
person executed the instrument.
WIT'NESS my hand and official seal. ,�..
(SEAL)
Notary Public
DELORES M �CKERf
� �• � COMM. f %9622 �
_ . �� � NoMry PuWie — CWitornia
ORANGE COUNiV
Canm. EMphef AUG 14. IG9C
SUBSCRIBING-WITNESS CERTIFICATE ("WITNESS JURAT")
State of CALIFORNIA
No.590B
County of ORANGE
On this the 19th day of April 19 96 , before me, the undersigned
Notary Public, personally appeared CHRISTOPHER L. BLANK
NAME OF SUBSCqIBING WfTNESS
x� personally known to me - OR -❑ proved to me on the oath/affirmation of
, who is personally known to me,
NAME OF PERSON (CFEOIBLE WITNESS) WHO IOENTIFIES SUBSCFIBING WITNES$
to be the person whose name is subscribed to
the within instrument as a witness thereto, who,
being by me duly sworn, deposes and says that
r,P (he/she) was present and saw
.� DELORES M BECKERT
COMM.#� �
� : i� ' Notory Pubpc — Califomla
ORANGE COUNIY
Comm.ScplreSAUG 14. 1096 y
Linda Wexler and Jay Wexler
NA61E OF ABSEM PRINCIPAL SIGNER �
the same person described in and whose name
is subscribed to the within and annexed
instrument as a party thereto, execute the
same, and that said affiant subscribed
,,+� (his/her) name to the within
instrument as a witness at the request of
Linda Wexler.�d �av Wexler
SIGNATUpE OF NOTARY
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER (PRINCIPAL)
� INDIVIDUAL
❑ CORPORATE OFFICER
TITLE($)
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL
❑ ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
� OTHER: Witness
ABSENT SIGNER (PRINCIPAL) IS REPRESENTING:
NAME OF PEFSON($) OR EMITY�1E5)
DESCRIPTION OF ATTACHED DOCUMENT
Party Wall Agreement
TITLE OR TYPE OF DOCUMENT
one (1) oa�e
NUMBER OF PAGES
4/�16/96
DATE OF DOCUMENT
SIGNER(S) OTHER THAN NAMED ABOVE
01993 NATIONAL NOTARY ASSOCIATION • B236 Remmet Ave., P.O. Box 7184 • Canoga Park, CA 91309-7184
JIM JEMNINGS MRSONP,Y TEL� „ 4-645-8512 Apr 16.9 17�2i No.009 P.O1
,r-
r'
PAATY WALL AORE$11SNT
THIS AOREEMENT, MADE AND 6NTERED INTO THIS �(CJ� DAY
OF��, 19�, BY AND HSTWEEN �� ��1"�'�' `�"�'-
,�
HEREINAPT$R REFERRED TO AS "LAND OWNER", AND�rn�LCi'�R�'1J}-O�Y'�'l��t�
� � �pN�QO�' (
J
HEREINAFTER REFERRED TO AS "ADJACBNT PROPERTY OWNER".
IT IS HEREBY A6REED THAT A PARTY WALL WILL BE CON9TR(1CTED ON
THE PROPEATY LINE
ADDRESS OP ADJOININO PROPERTISS
�ZO� �c.s��o-c�. U�- ..
IN TiiE CITY OF l(7s�,!i Yr12S� , COUNTY OP ORANGE, STATB OP .
CALIFORNIA, A9 PER MAP RBCORDSD IN BOOK ,PAOE OF
MISCELLANEOUS MAPS, IN THE OFFICE OF TNE COUNTY RECORDER OF BAID
COUNTY. THE PARTY WALL SHALL BE PERMITTHD TO $NCROACH ��
�k s&� � �. �_�c�.
IN.wTTNEss wHEREOF, THE P�RTIEs HAVE ENTERSD INTO TRIS
AOREEMENT THE DAY AND YBAR FIRST ABOVE WRITTEN.
LnND OWNP.ti ADJACENT PROPERTY OWNER.
���,�.._.� ��-� -� �
SI ATURE L_�(� SIGNATURS
� "td� P� �afr%� �'_�{�nrnn Kwtwf����v
nME (TYPED OR PRINTED) NAME (TYPED OR PR2NTED)
Z�C�O GC�� ' e���'I� lQ�I0.0 i1�'C'P
A DRESS ADDRESS '
Witness: Witness:
Chr topher L. Blank hristopher L. Blank
�
State of California )
) ss.
County of Orange )
On April 19, 1996, before me, DELORES M. BECKERT, Notary Public,
personally appeared CHRISTOPHER L. BLANK, personally known to me (or
proved to me on the basis of satisfactory evidence) to be the person whose name is
subscribed to the within instrument and acknowledged to me that he executed the
same in his individual capacity, and that by his signature on the instrument the
person executed the instrument.
WITNESS my hand and official seal.
(SEAL)
DELOR6S M BECKERT
' COARri. I p69822 z�
Z �'�• . .' Nofary Publlc — CoNfomia
ORANGECOUMV
Comm. Ezpirey AUG 14. 19P6
i
LI
SUBSCRIBING-WITNESS CERTIFICATE ("WITNESS JURAT")
State of CALIFORNIA
County of ORANGE
On this the 19th day of April
�J
No.5908
1996 , before me, the undersigned
Notary Public, personally appeared CHRISTOPHER L. BLANK
NAME OF Sl/B5CRI81NG WITNESS
� personally known to me - OR -❑ proved to me on the oath/affirmation of
, who is personally known to me,
NAME OF PEFSON (CFEDIBLE WITNESS) WHO IOENTIFlES SUBSCRIBWG WITNESS
to be the person whose name is subscribed to
the within instrument as a witness thereto, who,
being by me duly sworn, deposes and says that
he (he/she) was present and saw
DElORE3 M BECK9ti
COMM. # 969822 �
� `�b' � NWory Publlc — Cal�fomla
ORANGE COUNTY
Comm. Expres AUG 14. 19%
Rajia Blank
NAME OF ABSENT PRINCIPAL SIGNER
the same person described in and whose name
is subscribed to the within and annexed
instrument as a party thereto, execute the
same, and that said affiant subscribed
n�s (his/her) name to the within
instrument as a w' ess at the request of
Rajia Bla
,mam�
'�SIGNATURE OF NOTARV
AL
Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER (PRINCIPAL)
� INDIVIDUAL
❑ CORPORATE OFFICER
nr�E�s�
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL
❑ ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
�XjCOTHER: Witness
ABSENT SIGNER (PRINCIPAL) IS REPRESENTING:
NAME OF PERSON(5) OR ENTITV(IES)
DESCRIPTION OF ATTACHED DOCUMENT
Party Wall'Agreement
TITLE OR TYPE OF DOCUMENT
one (1) Page
NUMBER OF PAGES
4/16/96
DATE OF DOCUMENT
SIGNER(S) OTHER THAN NAMED ABOVE
81993 NATIONAL NO7ARY ASSOCIATION • 8236 Remmet Ave., P.O. Box 7184 • Canoga Park, CA 91309-7184
i ,
�
SUBSCRIBING-WITNESS CERTIFICATE ("WITNESS JURAT"� No.5908
State of CALIFORNIA
County of ORANGE
On this the 19th day of April ig 96 , before me, the undersigned
Notary Public, personally appeared ChristoQher L. Blank ,
NAME OF SUBSCRIBING WITNESS
� personally known to me - OR -❑ proved to me on the oath/affirmation of
, who is personally known to me,
NAME OF PERSON (CREDIBLE WITNE55) WHO IDENTIFIES SUBSCRIBING WITNESS
to be the person whose name is subscribed to
the within instrument as a witness thereto, who,
being by me duly sworn, deposes and says that
he (he/she) was present and saw
�.e.�`'r
'' DELORES M BECKERT
' • COMM.I969ffi2 �
;' �a ., Notary Public — CWlfomla
r. ORANGECOUMV
• ' Comm. Expires AUG 14, 79%
rr'icV�V•
Kathleen Montgomery
NAME OF ABSENT PRINCIPAL SIGNEF
the same person described in and whose name
is subscribed to the within and annexed
instrument as a party thereto, execute the
same, and that said affiant subscribed
ni.s (his/her) name to the within
instrument as a witness at the request of
Kathlee on omery
NPM OF PRiNqP 151GNER ( N)
NA RE OF ARY
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER (PRINCIPAL)
� INDIVIDUAL
❑ CORPORATE OFFICER
TITLE(S)
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL
❑ ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
� OTHER: Witness
ABSENT SIGNER (PRINCIPAL) IS REPRESENTING:
NAME OF PERSON(S) OP ENTIN(IES)
DESCRIPTION OF ATTACHED DOCUMENT
Party Wall Agreement
T�TLE OR TYPE OF DOCUMENT
One (1) page
NUMBER OF PAGES
4/16/96
DATE OF DOCUMENT
SIGNER(S) OTHER THAN NAMED ABOVE
07993 NATIONAL NOTARY ASSOCIATION • 8236 Remmet Ave., P.O. Bos 7184 • Canoga Park, CA 91309-7184
J;M JEP�NINGS MRSONP,Y TEl''14-645-8512 Rpr 16,96
PARTY WALL A6REBN8NT
17:27 No.009 P.O1
THIS A6REEMENT, MAD6 AND ENTERED INTO THIS / S�. DAY
OF��, 19�,, BY AND BSTWEEN �C��F%��-A�'_
HEREINAPTER REFERRED TO AS "LAND OWNER", AND RT-� �' �-t�-� W�k��
HEREINAFTER REFERRED TO AS "ADJACENT PHOPERTY OWNER".
IT IS HEREBY AGREED THAT A PARTY WALL WILL HE CONSTRUCTED ON
THE PROPERTY LINE
ADDRE8S OP ADJOININO
�
��
IN THE GITY OF_ �`�STi� �S� , COUNTY OF ORANGE, STATB OP
CALIFORNIA, A3 PER MaP RBCORDBD IN BOOK ,PAOE OF
MISCELtANEOUS MAPS, IN THE OFFICE OF THE COUNTY RECORDER OF SAID
COUNTY. THE PARTY WALL 3HALL BE PERMITTBD TO ENCROACH � � wcC
S� � � PFz�'�`�?' C.�a�
IN.WITNESS wHEREOF, THE PARTIE3 NAVB ENTERED INTO THIS
AOREEMENT THE DAY AND YBAR PIRST ABOVE WRITTEN.
�L� �
�
� � ► � `
L• • aY?' �.-r.:
► •• -�
� ►.
�� 1.n%r3.
��.
ADJACENT PROPERTY OWNER.
�, �� �
S GNATURL
A�-r.�� E- �o.Do�av
NAME (TYP�D OR PRINTED)
�90 � P,4[�d v P(:a�E
ADDRESS
G�srw- w�Es � cA Q LG
�Witness: � ,
C ' s top,her..I.,;. Slank,
State of California
ss.
County of Orange
On April 19, 1996, before me, DELORES M. BECKERT, Notary Public,
personally appeared CHRISTOPHER L. BLANK, personally known to me (or
proved to me on the basis of satisfactory evidence) to be the person whose name is
subscribed to the within instrument and acknowledged to me that he executed the
same in his individual capacity, and that by his signature on the instrument the
person executed the instrument.
WITNESS my hand and official seal.
(SEAL) �
Notary Publ c
w.����
� DEIORES M BECKERT
., �„_. COMM. f 96G814 �
: 'e � , Notary Pub9c — CONfomia
' �~ a' ' ORANGE COUMY
Comm. E�UesAUG 14. 19P6
, •
SUBSCRIBING•WITNESS CERTIFICATE ("WITNESS JURAT") No.ssoo
Stat@ of California
County of Orange
On this the 19th day of April 1g 96 , before me, the undersigned
Notary Public, personally appeared Christopher L. Blank ,
NAME OF SUBSCRIBING wITNE55
� personally known to me - OR -❑ proved to me on the oath/affirmation of
, who is personally known to me,
NAME OF PERSON (CREDIBLE WITNESS) WHO IDENTIFIES SUBSCRIBING WITNESS
to be the person whose name is subscribed to
the within instrument as a witness thereto, who,
being by me duly sworn, deposes and says that
ne (he/she) was present and saw
DELORfS M BECKHlT
�. �OMM.I Pdq822 3
'� ; Notory Pubilc — Catlfomia s
ORANGECOUNIV
Comm. ExqresqUG 14, 1W6
Arthur E. Goddard
NAME OF ABSENT PRINCIPAL SIGNER
the same person described in and whose name
is subscribed to the within and annexed
instrument as a party thereto, execute the
same, and that said affiant subscribed
his (his/her) name to the within
instrument as a witness at the request of
Arthur E.�( odllard
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent reattachment ot this form.
CAPACITY CLAIMED BY SIGNER �PRINCIPAL)
� INDIVIDUAL
❑ CORPORATE OFFICER
TITLE�S)
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL
❑ ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
� OTHER: witness
ABSENT SIGNER (PRINCIPAL) IS REPRESENTING:
NAME OF PERSON(S) OR ENTITV(IES)
DESCRIPTION OF ATTACHED DOCUMENT
Party Wall Agreement
TITLE OR TYPE OF DOCUMENT
one (1) page
NUMBER OF PAGES
4/16/96
DATE OF DOCUMENT
SIGNER(S) OTHER THAN NAMED ABOVE
�1993 NATIONAL NOTARY ASSOCIATION • 8236 Remmet Ave., P.O. Box 7784 • Canoga Park, CA 91309-7184
�
�DDHESS OF B
pWNER4 NAME IF
�vv�.
900 ELLESMERE AV
ANK, CHRISTOPHER L
ANK, RAJIA K
00 ELLESMERE AVE
STA MESA,CA 92626
uc. no:
u�r: CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: B 077341 PLAN CHECK NO: 01543-96 L
CONSTRUCTION TYPE: PERMIT TYPE: STR
UNT:
wern�c+f5NA1EJENNINGS, JIM CUSTOM MASO (714)645-8512
pW1pAC �g�N� 170 E 17TH ST
�noness:COSTA MESA CA �.�: 392707
92627 uxr: 206
UC�cD COHfP�CTOHS OECLAPATION: I Mreby a11im uMw pe�Wy d psr�vy tlw 1 em Icemed uMw pwi�iau d CMqer 8
( Y1tllq Wil�l J�BC�1M �/Q.b) f� QYYUII'.1(� dl! BYRW IOA Mld PfO�YtCI1� �i0�. Nld TY �CO11i0 9 N �I10 �pM dl�lflW.
TIC.NO.� 4547 uc.cuss:C 29 uc.No: 3927 7 EXP: 06/96
' `,�_ ;� 3 ~ 9S- ��a `�lJc.,_, �,.. �. _ _ .,)
,/NER BUILDEN OECLAR�TIOH: I Iveby dkm ivHs peuly d pxjury �hel I em q han IM CoNrtlan Licmee lew la �M
bw+q �anson (Seaion 1W1S Buaia�� md Ralmenro Cada: AM W a epvaY x1iT nV� e D�i �o mnwf. eEa. vnVow.
'-;y�d'n�. a rapai enY sVueluee. p'v b ea eiuenee. e6o 2pu'vm IM eppW�stY In we� pemi0 lo (Je e eqneE tlelemeN Net M a eM
-,. �ed W�� io IM peaacna d Ne Comrma� Lwema lew ICheqr 9(mvna�q with Swion )000) d Divcion 3 d tb
nan eM Prdm+'an Codel u tM M a aM u uem0� �hsahom W �M bem la Ihs eAeO� uemqon. MY vublbn d Sed'an
�t.s M enY eODM1��u I« a De�mil a+bpr+� Ne eVWirsM �o a avd G�Y d roi more Nen IMa hued�ed do0ees �S500ll.
❑ ta,�,ainenw«ir«mr�ww..•..n.�a.nm:.ae�o��+.�.mmubwo�x.�eub.u��roe„ami�a
a Mered lar eeb (Senian'loa. Bi�vnv aM Prdeevans Cods: Tha Caarmws L'vua tewdoes ew erohm en ow�w d papeity
.�ro naa. d mw� �n�. d,a.ro me..w�.yn� i:�.ee> na.,� «ww� ne «n.� o�.� «*vim..•. n� �w ww
im0�metla ue ed iiueMed a atMed la �ab. tl. fowe.er. Ua dukuq a inpownaX u add wE1Jn aa Yeer d eanDbibn. IM
owewrbuikar v.i0 heve iM dndm d V�+�q M a eM did m� ddN a"vnpave lu tM WTae W sebl.
� 1. m ovn�m W �M pWMY. em exdmvM' caqretl�p'w4M1 &emeE canVMon b canatruC IM Mal� (Sedian )Ou. Busimea eM
Pmleaaian La�: TAe Cauream licans lew Eon nd WW b en or.ner d VWMY xfio bu'ds a impwss �Iwsan and xfio
eoNrws br arh pel�+ w9M1 a meurmMfl Iieam�A P�� b the Cuamam lioeins law'1.
� I em ecomq wdr Sxtion: . B.6 P.C.. tor Re muon:
De�e: ��
i eo ne.aev wnuy w� i� ew,.e a�a �w�.w,d m. ��a,u d c.n�. H..m� .m sdw cae. sea�. zsws. zssv. �d
�55�I. vd Nq I a vry Muro buYdinp ompb wA / wA mi (ercb an) � ro oompfy Mh mk pats catlm uk iM �puirtmsMe Ia
e permn Inmeuuwim a moEJrmion tromtM �i�wpe^rm D'm�riu Rmide�aW mm�ueion eOPkm'vuen aaeenq from tMea
yovieqna. I/ G \(�I
oae: 7 " �'.3' /� Md�w: A'A. _ � � �N poni
v'
WORKEN'SCOMPEN4�TONDECUH�TON:IMrab�eK vqxprupydpajuywaliM ' dWerniom:�
� I M1era eM va meinlew e cendirau W wneni m�atlrnw�a Iw xakari companwun. n qaideE la b� Seaian J)00 d iM lebar
Cade. fa �M pMmnvica d Ns wM la w1icA Ne penm u mueG.
� I Ma uq r.il me'v4en r.oeken' oompsuNion imueanoe. u�Wwb W Saion ]ro0 d the l�bar CoEe. br tM Ve�armenro W �M
�r-� �µ la xfilM IM peimn b iuuel. MY *'a�n' oompemeiion'vuurerca cenir vd pdicy wmbr ve:
� C�a: FARMRRSfiNn EXPIRES
aa�r+�mn,,: ntMn�na�uFann4F O1/O1/97
. �ia seciion need nd be canderoC I �M Pa'mA o M aro �uMis00dNn /JiWI a Im�.)
� I cenRy Nm in �he peAoimerce d IM work Ia r.�cn �N� pem�u u rowed. I WII na empby enY Ge� in airy menna eo ea io
beeoma eu4� �o iln v.oM�e' mnpensmion lew� d CeborMs. enE nOras tlW J I YauM baeans wbR� b iM woMrs'
mpsn bn prv+isian d Seaion 3]00 d �M labw ('•oda. I Yull f �wuh canph Wh IMw ,
i
ew� � � � AGdum: �. 1 �T , ....�ri .
rinp: Fellun ro��c�n worteri comp�rrutlon cm�rep� 1� unl�wNl, �ntl �lu/l �b/�el.n.mpr oy�r�fo eAMMI pNi/tl�� enJ
dvll Nw� iq ro om �1ndn0 flrouunE tlo/bn (Sl%GOOA M�CCltlon ro tlr� rosl ol romp�nvlbn, Camea� �s pov/0sE br /n
5xtlon 9)OS ol tlro LeDor COM, InMssl, �M alromry'� Iws.
CONSTHUCTION LENDINd RGENCY: I hereEy elfirm uMm paalry d prjury ihet �Mn u e mnetruqnn Imdi�p epericy la �M
panwmeMa d iM xoM1 la �MiW �he pamY b easd (�� �). GM. CI.
LENDEF'S NMIE:
LENDEP'S R�ONE49:
1 eenity Ihet I he`e reed No epplirsiion eM aete Ihet tM ebova'vJoemdian o earretl. I pns to eanpl/ xilh eE eny ud aoumY oedirercea
end steta kxe relelinp lo buiMup wn&rWian eN Iroreby eWwrzs'epreuntviro� d ihn ary to enler upon IM ebove�memioneE properry
lorinapedion purpoeen.
KAREN JENNINGS
.
� Dme:
(5t51�a6.WP) Whn�ButlEiq d Selery: Greer�Fb: Cariery-�pp4aN: Pink-Ravsur: GdEenraE-Aswcr
/ PERM NO: B 077341
GOVT: N SUPP: N
PURPOSE: CON
JOB DESCRZPTION : CONSTRUCT 60'X 6' HOGH BLOCK WALL SQ FT: 60
CLAIM VALUE: 2,000.00 CALC—VALUE: 1,200.00 GROUP OCC: U-2 /
COMMENTS: BLOCK WALL TO BE CONSTRUCTED HETWEEN 2894 6 2900 ELLESMERE
*�x��-x�***�-f�+�*+�**+�*+�+r*x�+�+t***+t*+t+t�-*�t�t+�x-f�f�x�*�r***+��-x��r*�r*�r**�ri�rt�-*+r�r*f��-*x�**x�x�*****�e**+�
Z O N I N GS ERTEB�AUCjKRSE 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
PARKING REQ: PROV; PARCEL: 13927213 ZNE: R1 REF NO;
PLANNING NOTES> PARTY WALL BTWN 2900 + 2894 ELLESMERE, 60LF WITH 40FT FRONT
> SETHACK.
*��******��***�***�***+�***+�**�***�***��**�r*�**+�**��***�***��+�*x����+�**�**��+�*�*�
D E V E L O P M E N T S E R V LI C E S R E Q U I R E M E N T�S
ZONING APPROVED BY T�,� DATE: ��
BUILDING APPROVED HY : DATE: �
APPLICATION ISSUED BY: DATE:
fEfE�E1E�E1EfEiEiE�EfE9E1EiE1EiE1ElElEiEiE1E iElElElEiElElEfElfif iE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SE MENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 40.25 ' S0
. SMIP/NON—RES
PLAN 26.16 .
ISSUE FEE
BOILDING—DIV—> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 40.75 0.00 '26.16 66.91 66.91 .00
REVENUE DIVISION TOTALS--> COLLECTED: 66.91 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
40,25 � .50 26,16
1E If iE 1f 1! 1k if 1E 1E 1! if iE iF iE if 1E if ik iF Ik iElf 1f 1E ik iE IE iE ik iE iE IE IE iE 1E IE 1E 1E fE iE iE iE 1E iE iF iE 1k iE iE 1! 1E 1F IE 1E fk 1f !k iF iE if if ik iE 1! 1Elk iE iE IE iE iE iE i! 1E 1E iE 1E �E iE
I N D I V I D U A L �'F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N� UNIT COST TOTAL COST
SFR 60 RES—CONCRETE HLOCK WALL"� / FT. 20.00 1,200.00
END OF FEES
�I�. _. _ - . � -^ I � ^
,� PDOL ,Pa �
CONSTRUCTION AND PLANNING�- Date Inspector qppROVALS Permit # Date Inspector
� APPFiOVAIS Permit #
rvice or Poie 52. Pool & Equipment Location •
1. Temporary Elr�"�' -
e-Undrgrnd. 53. Steel Reinforcement
2.
3. Electriwl Conduic UtititY•Undrgrnd. 54. Forms
4. ElCctrical Conduii�Undrgrnd. , 55. ElOctrical Bonding �
5. Steel Reinforcement �;2,(.I_gb %��/ 56. Rough Plumhing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TQ COVER�GUNITE
7. Footings (,i.�(�_��j �(,v�! 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Untlrgrnd., Test .
9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-TraO, � Undrgmd.
10. Scructural Floor System 61. APPROVAL TO DECK
11, Prppe�ty Sewer Line & House Connection 62. Backwash & Receptor-Finul
12. Sewer Cap � 63. Heater & Vent-Fina1
7 3. Roof Drains � 64. Piumbinq System - Final
14. Rough Plumbing ' 65. Etectrical�Final ' .
15. Raugh Electrical•Conduit � 66. Solah System-Finai �
76. Rough Electric Wiring 67. Fenting & Access Approval �
17. Raugh Wiring Sign 68. APPROVED FOR PLASTERING '
18. Rough EfectricaFT Bar Ce[ling 69. POOUSPASYSTEtviS PfNAL
19. Rough Heating & Air Conditioni�g FIRE DEPT. REQUIFiEMENT
20. Rough Factory Fireplace � APPROVALS Permit #
21. pucis, in Structure � 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping qGas OOiI
23. Gas Pipe-Rough & Test 72. Underground Ftush
24. Roof Proming 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing � 74. Overhead HyAro
26. T�6ar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Freme and Flashing 76. Dry Standpipe
28. Lathing & Siding ` 77. FIXED SYSTEM FINAL
29. In6ulation 78. FIRE PREV. FINAL
30. Drv�vall Nailing HEALTH DEPT. REQUIREMENT
31. Plascer Brown Coat 79. FINAI INSPECTION
32. Elecviwl Power Meter-Final 80. F000 CERTIFICATE ISSUED
33. Final Electric Notes: �
34. Final Heating & Air Conditioning ��2 �D �p 6 � �i� „[,� q�w ¢ � 6 �L�
i ' � ` j v /.
35. Final Gas�Pipe•Test � � _
- 36. Hood or Canopy . ' r
i .
37. Final Factory Firepiace
38. Final Plumhing _
39. Water Service-Fina4
40. Gas Service-Final
41. $olar pomesticFinal
42. Backflow Preventer
43: Batkflow �rrigation
44. Landscape IrriQation System
45. Sound AttenuaUon
46. Handicap Regulatio.ns ';
47. FINAL STRUCTURE & BUILDING (p/!G G
� �
48. FINALPLANNING .___�.
49. Eleccric Release to Edison `:
50. Ges Release to Southern California Gas Co
51. CERTIPICATE OF OCCUPANCY
No Date
�2
0
ti
w
W
R
F.
N
DIVISION OF BUILDING SAFETY
CITY OF COSTA fuIESA
AP'PROVED
� C'�Y�.. � �t Z3 �
This set ol plar�s and specifications MUST be kept on this job at aQ Um�
and 11 is wilaMul 10 make any changes w aitetatlOr, on same wittrout wrilfe�t
pertnGcsion from Ihe Division af Buildir�g and Satery, Ciry ot Casta Mesa.
The stamping of this plan �nd sD�catlons SHALL NOT be held to�Artnfl
a to be an approval oi the yiolat�n ol any provisions oi arry City ah�ste
Mesa Oid^�ance and�or Slate Iaw��. �
These U::� sd Dermit shall expi�e y Iimitation and became nuil an84oid'd
the 6ui(ding or •r�ark is not comman�ed artd maintamed active per UB�§303
(d) wilhin 180 days ol issua�ce. M m.
REfIDEMCE
R[bID[MC[
RESIDENCE
CIlE✓ ,C,�C
_ STREET � ,
SURVEY OF L�T LINE
MAY BE REQUIRED
I D� �/'3ia i-�
_M..�.,..... ____. _
� APPR.�y�D
' CIiY OF COSTA MESA
PLANNp�iG p�.
s�ccr io o�oo, oErr, ee�
�r�G-.�_ o�rn 4_z3-26
� 0� rLAtlyl�jp .
/� � �c�u.�tP����f�-��f'
REBfDEMCE
tl�
�
�
Cement Coping Outional —'
Channe161ock With 1-3/8�i
Horizontal Top of all
Fences
For Fences 5' or Less
Vert. Bars 3/8" �i at 4' -0" O.C.
For Fences Higher Than 5'
Vert. Bars 3/8"� at 32" O.C:
Fill Cells Solid With�Grout
Where Steel Occurs
Reinforcing Steel Shall
Conform to Sec.A-15: 39 _
A.S.T.M.
All Steel to be Lapped .�•.
24" or to Code
NATURALGRADE
TWO 3J8"¢ BARS
CONTINUOUS TOP
& BOTTOM
HORIZSTEEL MUST BE TIED IN
PLACE AT TIME OF TRENCH
INSPECTION.
TYPICAL 6��
•y
; '�:
.
�'a _
e 'p N
o A - -
D '
�-�►-- w ioTH
p SEE CHl
7 BELOW
D I �.
� - :
CONCRETE
BLOCK FENCE
FOOTING REQUIRE�AENTS CHART
GENERAL- NOTES
MORTAR: p�e Part Plastic Cement, and
Three Parts Sand
GROUT: One Part Cement Three and
One Half Parts S�ond
COPING: One Part Cement, Three
' Parts Sand
CONCRETE: Well Mixed C2-V2:3-I/2
I Max. of 7- I/2 Gollons of
;' j Water Per Sack of Cement
�I
GROUT MAY BE POURED FROM THE TOP
OF�THE FENCE IN CEI.LS WHERE STEEL
OCCURS.
CELLS AND AREAS OF HOR120NTAL REIN-
FORCEMENT SHALL BE CLEAR, CLEAN &
FREE OF ALL MORTAR UEBRIS, ETC.
ri OF EARTNTCOTH
V3 THE HEIGTH OF FENCE
BELOW BOTTOM OF FOGTIN6.
WIDTH . . . 14'� . . . 14� . 12".
THICKNESS . . . . . 10�� . . . . . . . . . . .10�� . . . . . . . 8�� �
DEPTH OF EARTHTOOTH . . . 24�� . 20�� . . 16�� . .
SPACING OF EARTHTOOTH. . 12' . . . 14' . . . . . . . . . . . 16'. . . .
City of Costa Mesa, California
Building Department
� � � . .. . _. _ . KEVI'�EP NOK e«
SCAI.E: I/2��= I'
12„
8 ,�
12"
16'
Ji� JENNIN6S MRSONPY TEL�714-645-8512 Apr 16.96 17�27 No.009 P.O1
r
PAATY WALL A6REHMHNT
THIS AOREEMBNT, MADE AND ENTERED INTO THIS Z�_DAY
OF � �, 19�, BY AND HSTWEEN �"�S N� L!�'k
HEREINAPTER REFERRED TO AS "LAND OWNER", AND V v��� ��
9
HEREINAFTER REFERRED TO AS "ADJACENT PROPERTY OWNER"
IT IS HEREBY AGREED TNAT A PARTY WALL WILL BE CONSTRUCTED ON
THE PROPERTY LINE
ADDRESS OP ADJOININO PROPERTISS
2r�i�-I ��c�r�- A� �
IN TRE CITY OF_�Ex,7I¢ /"L�£`-aA.. , COUNTY OF ORANGE, 3TATB OF .
CALIFORNIA, AS PER MnP RBCORD$D IN BOOK ,PAOE OF
MISCELLANEOUS MAPS, IN THE OFFICE OF THE COUNTY RECORDER OF $AID
COUNTY. THE PARTY WALL 3HALL BE PERMITTED TO ENCROACH ��C.�
m� �.�(- 513� � �2�Y 4 X� .
IN,WTTNESS wHEREOF, THE PARTIES HAVE ENTERED INTO THis
AORBEMENT THE DAY AND YBAR. PIRST ASOYE WRITTEN.
LAND OWNER
/^ �
ATURE
� � �i�
NAME (TYPED OR PRINTED)
2{�c� ��cc�t� �
AADRESS
ADJ
I
G.
�
[�i:'�;1a;7
NAME (TYPED OR PRINTED)
2�'1�{ �Cc�.se-�r� � .
ADDRESS
. Witness:
C S PHER L. BLAN
STATG OF CA[,IFORNIA
COUNTY OP ORANGE
On April 23, 1996; before me, DELORES M. 13GCKBR'I', Notary Public, personally
appeared CHRISTOPHER L. 13LANK, personally known to me (or proved to me on the basis of
satisfactory evidence) to be the person who name is subscribed to the within instrument and
acknowledged to me that he executed the same in his individual capacity, and that by his
signature on the instrument, executed the instrument.
WITNESS my hand and official seal.
(SEAL)
DELORES M BECKERT
COMM.I96'9822 =
; •• � NMary PubYe — CoAtomla s
' ORANGE COUMV
Comm. Fxphe� AUG 14. 1996
SUBSCRIBINGi-WITNESS CERTIFICATE ("WITNESS JURAT") r+o.seoa�'
State of Callfornia
County of Oranae
On this the z3ra ..: day of APril 1g 96 , before me, the undersigned
Notary Public, personally appeared Chcistopher L. Blank
NAME OF SUBSCFIBING WITNE55
� personally known to me - OR -❑ proved to me on the oath/affirmation of
, who is personally known to me,
NAME OF PEq$ON (CREOIBIE WITNESS) WHO IDEMIFIE$ $UBSCRIBING WITNES$
to be the person whose name is subscribed to
the within instrument as a witness thereto, who,
being by me duly sworn, deposes and says that
he (he/she) was present and saw
DELORES M BECKERT
COMM. i 969822 3
L•_ - Notary Public — Calltomia 5
� ORANGE COUNfY
Comm. Exptre�AUG 14. 1VP6
C.J. Levin ,
NAME OF ABSENT PRINCIPAL SIGNER
the same person described in and whose name
is subscribed to the within and annexed
instrument as a party thereto, execute the
same, and that said affiant subscribed
his (his/her) name to the within
instrument as a witness at the request of
� $IGNATGFE OF NOTARY
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and coultl prevent
fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER (PRINCIPAL)
�INDIVIDUAL
CORPORATE OFFICER
nr�ets�
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL
❑ Ai70RNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/COtySERVATOR
� OTHER:�f�(�j (��>
ABSENT SIGNEq (pRINCIPAL) IS REPRESENTING:
NAME OF PERSON($) Op ENi1TY�lES)
DESCRIPTION OF ATTACHED DOCUMENT
TITLE p�( TYPE OF
%fI � / / i '
. �
��023 %o
DATE OF DOCUMEfJT
SIGNER(S) OTHER THAN NAMED ABOVE
01993 NATIONAL NOTARY ASSOCIATION • 8236 Remmel Ave., P.O. Box 7184 • Canoqa Park, CA 9730941&i
i'
�� N 5 Y E C i I O N 6 T E S T 1 N G E N G I N E E R 5
CH Ele ICAL b PH V51 CAL A N A LY515
�.0. 90. 16016 • 1310 •iroa�+ Wey
Lonq B�acM1, Calil. 90806
(tl�� Q6�1355 • (ill) 63bI1B6 • (Ili� 8]8�6<)1
Since 1899
'�Ew0.CH 8 EN�IRONMENIAL TESTIN6
R R O 5 I O N E N G I N E E R I N G i A N A L Y S I 5
ISI�-0 N o.�M1 N�ro�� St�ea�
$anta Ane, Celifotnie Y])01
()la) 531•1pI5
June 25� 1968 Examination: SC68-378]
COMPRESSION 1EST5 ON GUNITE CYLINDERS �%�{����j
Jos. M. Nenley /
1973 Newport Blvd.
Costa Mesa, California 92627
PROJECT
ADDRESS
17 x 32 Swim Pool far J, MITCHELL
2900 Ellesmere, Costa Mesa
SAMPLE FROM /#1 - 8otton Oeep End: !i2 - Si de wal l at 1 i te:
li3 - Bond Beam deep end
ARCMITER CONTRACTOR
Lester Paley Blue Haven Pools
FNGINEEN SUBCONiRA[iON
- Same - Century Gunite
SPECIFIED
MIX 4- 1 STRENGTH 2�000 p4i
DATE CAST
DATE TESTED
CYIINDER NO.
COMPRESSION
TOTAI IOAD, L85.
POUNDS PER SQ. IN
COMPLIANCE
6-17-68 SIZE: Nl - 6-1/8�� x 12�'�
#2 - 5-3/4�� x 12-5/8"
6-24-68 #3 - 6�� x 12��
lA
7-Day
66,000
2,240
1B "HOLD"
za
7-0ay
68,500
2,635
28 ��HOLD��
7-day test complies wfth specifications.
MADE er
OEIIVENFU BY
CYIINDERs Jos: M. Henley J.M.H,
oisrxieuTior+: �" �/ � � /L{/' ��
.--6ost�Nesa Btdg. Dept.
Century Gunite
Blue Naven PooTs
3A
7-Day
$5,500
3,025
3g HOLD'�
iECEIVFD ON
��
�dECEIV�D
9UIlDING SAFETY DEFf.
JUN 2 t; 1968
Jos. M. Henley , ��
AM
7,8�9�W�ll,1E,'� �3,4�5�6
.�-
G` 1 �
•LL NE>OA1S �PE St�N�lt!fO �4 !w� ._(�ryr�OIN}I�L pq04l4tv Of CLICNTS. AVTMORIZ�iIOM GOH PVBLICITION Oi OIIR REPOPTS, CONClU510N5. ON EA.
iw�<TS �/�O� O�+ c� .�cp �. ..r u, v�H+��O s�ENO'�. O�w WwiTTErv �VnROVaL �5 n MUiV�I PROiECT10N Ip CCIENTS. THE PVBLK �HO OVnS[Lv[5.
CITY OF COSTA MESA
CALIFORNIA 92826 P•O. BOX 1200
FROM THE OFFICE OF THE PLANNING DEPARTMENT
:3eptember 23, 1968
J. Mttchell
2900 F1lesmere Avenue
Costa Mesa� Calltornla
Dear Pool Owner:
The Costa Mesa Planning Department has been notified of the completion of
your swimming pool.
So that your pool will be a safe one and for the purpose of advising
you of your responsibility regarding the requirements of the Costa Mesa
Municipal Code, we quote Section 9298.9:
l. No swimming pool shall be constructed closer than five (5)
feet to any property lines, measured from water line of pool.
z• No swimming pool shall be constructed under any electric power
lines or on any electric power easement.
3. No swimming pool shall be constructed unless the yard surrounding
such pool is completely enclosed by a fence six (6) feet in height
and has a self-closing and locking type gate or gates.
This courtesy letter is directed to you so that you will be aware of our
ordinances and can make a complete safety check of your pool area.
Sincerely yours,
��i�!'�(.�� �
William L. Dunn
Director of Planning
�
'�CI7k'JF COSTA MESA
CONSTRUCTION PERMIT
ApPlicant lo ftll In all spaces exceD� those wilhin �eavy borOer lines antl sign all aDP�opriate tleelarations.
- Project Address ' � •��/ N P.Yi
Applicant's Mailino AdAress '�I�3�,I�� l !T E G(��( �� �l�
Owner'sName ��mL,s ��'� !l/�YLNC<L chone��9•37ye
Address ?9n v �GLCS/l7 C�.0 �. ; GM
/
Arch/Eng. License No.
Address �
COntractor's Nam O /N Phone� �/ 3���V/�
Addresslmailing)� " ' � �ff/'/'76Y//
City License No. � %�e.3
LICENSED CONTRFCTOR DECLFRATION
1 hereby alfirm tnat 1 am li<ensetl untler provislons of Charter 9(commencing
with section 7000) ot DlviSion 3 of tha usiness antl Professions Cotle, antl
my Ilcense is In tull (orce ntl eflect.
..__.__"___ �_i� �� ... .. R/L�L/J
'ORKERS' COMPENSATION DEC RHTION
�ereby a18rm Ihat 1 have a certific oi consent lo salf-insure or a certiflcata
.t Workers' CompensaUon Insura t, or'a cerHBea coOY �hereot (Sect�on
3800, Lab. C.) � 9O /I�
PoIicY No. ��S' S�" omPanY -iE (A/A �. 1 i
�Certifietl copy Is hereby fumishetl.
Certifietl copy is flletl with the city Bulltling Dlvision.
Date Applitant
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(Thi55ection neetl not be completetl if the permlt is for one huntlretl ($300) or
less), •
I certity Nat in the per/ormance of the work tor whlch this permit is issuatl, I
shalt not emPloy any pnrson in any manner so as to become subject to the
Workers' Compensation Laws of Calltornia.
Date Si9nature
NOTICE: If, alter making this Geclaratlon, you shoultl become sub)ect to the
Workers' Compensation provlsions of the Labor Cotle, you rtiust torthwith
compty with� such provisions or. thls permit shall be tleemed revoketl.
CONSTRUCTION LENDING AGENCV �
I hereby�aftirm Ihat there Is a constructlon lentlin9 agency f0� the pertormanca
of the work tor which this permit is issuetl= (SecHon 3097 Clv. C.)
LentlGr'S Name
Ixntler'S Atltlress
OWNER BUILpER DECLARATION ' ' ' '
I hereby affirm that I am exempt irom the C6ntractor's License Law tor the
following reazon (Settion 7031:5 Business and Professional Cotle: Any <ity or
counry whicM1 requires a permit to construct, alter, ImDrove, tlemolisn or repair '
any st�uch�e, pnot to (tz ISSuance, also �equire5 the applicant fo� such pe�mit
'o tile a sig�ea statement that he/she is Iicensed pursuant to Ihe provisions of
he Contractor•s License Law (Chapter 9(mmmencing wlth Section 7000) ot '
)ivision 3 of the Bu5ine55 antl Professions Cotle) or that ne/5M1e is exempt
nerefrom antl the basis for the allegetl exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil
�enalty ot not more than tive huntlred tlollart (5500).
I, as owner ot tha property or my employees with wages as their sole
compensaUon, wi�l Oo the work, antl the structure is not (ntentletl or offeretl
for sale (Section ]044, Buslneis and Professional Cotle: Tne Contractor's
License Law tloes not abP�Y to an own¢r Of d property wno bulltl5 or IrtlprOv¢5
the�eon, dntl who tloes such work itim5elt/h¢�self o� [hrough his or M1er own
employees, Provitletl tha[ such improvements are not.intentletl or otferetl�for
sale. It, however, the Duiltling or improvement li soltl wlthin one year of com-
pletloq the owner will have the burtlen of Oroving h¢/she tlltl not bulltl or im-
�1rove for tne purpoze ot sale).
LJ I, as owner of tha prOperry, am exUUSiv¢ly contractlng wi[h IIce05etl con-
tractor5 to construct the project (Section 7044, Business antl Professions Cotle:
The Conlractor's License Law dOeS Oot aOPly to dn owne� of property who
bulltls or Improve5 the�eOn, dntl who COn[�act5 fo� such projecis with a Con- �
tractor(s) Iicense pursuant to the Conbactor's License law).
❑ I am ezempt unaer $ecpan , 8. 8 P. C. for this reason �
Date Owner
I. herebvi certify Na[ 1 have reatl thls aoolication ana state roat tne above
OFCONSTRUCTION L1 NEW LJ AOD LI ALTERATION LJ REPAIR
CONVERSION ❑ DEMOLISH ❑ OTHER
TYPE OF PERMIT LJ GRADING LJ FOUNDATION LJ STRUCTURAL
❑ TENANT ❑ EI_ECTRICAI. ❑ PLVMBING ❑ MECHANICAL
�OOTHER C�O�%F
PROJECTDESCRIPTION�� Sc�.FT. �/OO S[� F o, cCuaarv V �
CONSTRUCTIONTVPE VALUATION$ DOU�
ZONE GRADING GU. VDS. ACRES
Remarks:
3er Sink
9ackflow Prevencer
3ackflow Irrigation
Bathtubs
Clarifiers
Dishuvasher
Drinking Foun[ains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink -
lavatories
P-Trep
Roof Drains
Reinspection Fee � $25'
Boiler
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ o-i oo,oao sru O i oo,000
�nspecuon�.
Si9nature _ � �ate �%�� �
Driveri' L�te se 55 � / �
- AOPlitanh Pink - Accounting; Goltlenrotl --Assessor
$25
Showers
Service Sink _
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet �
Water Heater
Warer Service ,
�
� Isue Fee
IANICAL
Hood or Typel ❑ -
Canopy Typell ❑ ,
iefrigeration System ,
00.700,000 BTU ❑100,000 BTU
System Repair/Alteration
laue Fee
A.P. �p
S Main Bu
E
T Front
8 Rear
A
�C Right
K Left
S
Ping. Ref. #
Use of Building:
Planning Notes:
Auromatic Washer
Construction Pole Su
Cooking Unit
Dishwasher
Dryers ❑Gas ❑E6
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Dispoul
Generator �65 KW
6044 9/2�/83� 3Ie5� TL
Zone'
Park.Fees $
ELECTRICAL "`
.Transformer ❑ 15-50 KW
❑ 50+KW
Merer �upto100amps'
Merer �over 100 amps �
Sub Panel
Motors � 61 H P � 1'h - B
InaSolar �9-75 HP �16�
' Microwave
� Pole Light
Range .
Sign �
Standing Sections
5 KW Trash Compactor -
FEES
O
N
I
N
G
R
E
Q
U
R
E
N
E
N
T
$ 3 • Reinspection Fee $25 �ssue Fee $ 3
fEES
PUBLIC SERVICES RE�UIREMENTS: �
� Zonin9 APPraved BY Date �
Application Approved By Data �
. Application Issued By � � / Date
' ,SUMMA V F FES�IP ' $ � SO
BUILDING PERMIT $ �� ��
PLAN CHECK ' $ PERMIT
PLUMBING $ ISSUANCE . $
PLAN CHECK $ ENEPGY P.C. $
ELECTRICAL , $ ' GRADING $
PLAN CHECK $ MICROFI�M � $ ��� � ��/�
MECHANICAL $ TOTALFEE $ +..L�'"`�
$ 3 PLAN CHECK . � $
�
,�
CONSTRUCTION AND PLA I t PO(,. a SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pooi & Equipment Location �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3..Electrical Conduit�Utility-Undrgrnd. 54. Forms �
4. Electrical Condui[-Undrgrnd. ' � 55. Electrical Bonding
5. Steel Reinforcemen['. • 56. Rough Plumbing & Pressure Test -�
6. �Electrical�UFER Grnd. � � � 57. APPROVAL TO COVER-GUNITE � "
iF
7. Footings , � • 58. Electrical Conduit-Undrgrnd. "
8. Foundation � 59. Gas Pipe, O Undrgrnd., Test `'
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. �
10. Structurel Floor System 61. APPROVAL TO DECK
71. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer_Cap 63. Heater & Vent-Final ��
13. Roof Dreins 64. Plumbing System - Final ,
74. Rough Plumbing •. � 65. Electrical-Final
15. Rough Electrical-Conduit . 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING
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 #
21. Ducts, in Structure 70. Underground Hydro
• 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
` 24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathin9 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78, FIRE PREV. FINAL
30. Drywall Nailing � HEALTH DEPT. REQUIREMENT
31. Plaster'Brown Coat 79. FINAL INSPECTION
32. Electriral Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing �
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation �
44. Landscape Irrigation System
45. Sound Attenuation �
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING q•Z9�J? � 00� � ��')
48. Special Requirements Completed �
49. Electric Release to Edison �
50. Gas Release to Southern California Gas Co .
51. CERTIFICATE OF OCCUPANCY
No. Date ,
�
/
PF0.IELTROOPESS 7C�JO r��r'SKE�tE AV
OWNEP'SNAME: A��ar�t�� CIIl1T..rilO.�`/!'�H L
aooeess: At,ptiFt, kA.7IA K
).900 r_'�.,r'S�ERE AVE
C'OSTA N.r:SA, CA 92626
AflCNIENGINEEB:
ROOflESS:
flEG.NO.:
UNIT:
UNIT:
PEPMITTEE:G.P�, CnNJ�IR;iC-:',OV (7_4)633-9744
aooness: 22'.4 Ptlkit 5
ORAv�d Cw 92667
UCENSED toNTflACTOH oECtABRiION: I nereGy aflirm tlut I am Ikense0 unaer ptwi9on5 of Ctupter 9lcommenting witn Settion
7000� ol pdsion 3 0l t0e Bu5ine55 ana Pmlessqns CWe. a(M rtry license a in tWl farte an0 efleq
cirvuc.:0�)7�1�R:, STRTELIC.:JE1S%S: C� 'Ti
Da�e: —1_I� Sipnature: _ _ _ —
WOBNEPS'COMPENSRTIONDECIANpitON: ItrereOyallumtlutltuve eN1iW�eo�tonSenlloSell�in5ur2oraCeflititalea�Worker5'
Compensatmn Insurxnce. or a cendieC copy inereot I�ction 3800. LaO. CI.
POLILY NO.: I. Z J I.1 j.j E%P. ORTE: O 1 IO S I 9 3
COMPANY: S �/� i E
7 Cenuied covY �s nereoy Iumisnea. � Certifietl coOY ���letl wit� t ly Builtling D' ision.
OaR: —/ � — � AOPlicanC ��
E%EMPr10N FHOM WONI(EXS' COMPENSITION OECUNA710N: (iNs sectio ne not �e mmpeteG ii ttre pemn ¢ iw ore huMrcd (5100) or less�.
I ierlily ��a� in I�e peAorman[¢ oi I�e work lor w�ic� I�is permii is i55ue . stwll na� employ any Derson in any manner so aSlo become
Subject lo Ihe Worker5 ComOensalion Laws al CalifOmia.
Date: Signaiure:
NOTItE: II, alter makinA ��is Ueclaration, yau s�ouW Eecome w�l�� �o t�e Wofrcers' Compensation D�ovisions ot ihe Labor
CaCe. you musl IoMwilh Comply with Sut� provisqn5 or tks perrtn� Shall Ee UeertreO revokeE.
CONSTflIltTION IENUING PGENCY: I �ere0y affitm Inal l�ere is a constmction len�inp aAency for Ihe pedormance ol t�e work br
w�ic� Nis permil is issued (Seclion 3097. Civ. CI.
LENOEP:
aooxess:
OwNEN BUILOEP OECLl�NATION: I ne�e0y allirm ina� i am exemp� Imm �ne Contractors' State License Law lor ihe followinA �eason
(Seciion 703t.5 8usiness anA Pmlessional CaOe: Any ci�y ol coumy wnich reQuires a permit Io mnstruct, alter, imD�ove, tlemolish, ar
reWir any slmclure. O�ioi to its issuance. also requiRs tne apWiCant lor such Oelmil to file a sipneA sta�ement Ihal he/she is Iicense0
pursuani io ihe provisions al l�e Comracmrs' Staie License Law �COaO�ar 9 kommencinA �1� Section 7000) ol Division 3 0l ��a Business
ano Prolessions fA0e) or Ihal ne/sne is e�empl IneRlmm an0 iha ea5is lar tAe alleqea evemption. Any violation of Section 7fp1.5 Oy
any aODlicani fof a permil SuL�et15 Ihe ap�litanl IO a tivil penaliy 01 n01 mom lhan Irve hunAreE O011ars (5500�.
I. as owner al I�e pmDeny ot my em loyee5 wit� wapes as tAGr SOIe compensation, unll Co t�e work. antl I�e
❑ s�mcture Is not intenCeO or ailerea lar sale (�cuon 76ta. Business ana Pmteuional COEe: ine Contractors' State License Law
aces nol apply lo an awn¢� ol a O�oOeIIY w� �45 Or im0«'u 1�¢re0n, anJ wiw tlo¢5 suc� wOrk himsell/h¢rsell or throu0h
nis or �er own emDloyees, pwviGeE IOaI suc� impmvemenis are not inlenOeG or ollereU far sale. If, flowever Ihe builtlinp or
imOrovement is sdd �.+iNn one year oi cortqhGon, Itk awner will have t�e Ourtlen of D�avinq �¢/5Ae Eid not bui10 or improve
lor Ine pWpose ol salel.
I, as awner ol ine propeny. am exclu5ively conlraclinp vntA IicenSeA coniratlors lo tonsVGcl �ne pmject (Section 704C. Business
❑ an0 Proleuims CaGe: Tlie Canvactori State Lcerae Law Eces nd aDW �o an mmer al prapefry vrta GudGs a imprara ihereon
ana wno contrans fo� suc� pmjxls witA a wmratloqs) license pursuant to t�e Coniracmrs' S�a�e Litense Law�. I am aware
�na� omol ol inen Worker's Compenutwn insurance staula he Orwiae0 ta me.
� I am ¢vempt uMee Section: B. 8 P. C.
lor Inis reaton:
Oaie: O�mer.
I ao nere0y cen�ty tnal I am aware ol ana utMerstana Ilre repuireminis oi Calilomu Healtn ana Shcery COUe Seclians 25505, 25533, and
2557� antl ��at 1 or any lutut¢ OuilEmg o[Cupanl wilUwill nol (tirde one) neeE to wmply with Saitl slate COEa and t�e requiremenls lor a
peimit lor consimcuon or moEdicalian IrOm Ine Air ualny ManaOement Oisiricl. flesiGenlial consimctian a001iutions are exempi imm
inese vmnsions
Dale: AVO���anl:
I M1erepy C¢tliiy IAai I �ave reaG I�is appliCaUon anU Slale Ilui I�¢ aEOve inlormaiion i5 torre[I. I agr¢e Io tOmply with all [ity antl [ouniy
aiainances and siate laws relaiing �a Guiltling conStruciqn ana �ereP/ auilprue�::�enta(rves a� ihb db �o emer u on �he aDove�membnctl
pmpeny for inspection ourposes. /'�� ���...�
Date-_'_�� Si9naiure�/v""—/r _
onver's tirense or Socia� Securiry
Ifiai-a6 Wmle-6utlding: Green—Cotle Enlorcemen�: Canary—AOOLcam; Pink—Bevenue: Golpenrotl—Asseswr
CI': Y Or' COSTA N.ESA - BUILDING PdKvi'i
PtRN.IT NO: B OS9821 PLAN CH'r:CH NO: 04321-92 S
CONSTHJC':ION :YPE; P�R:�:IT :YPE; STR
JOH DESCRIP:ION ;�i.F CZ'iY SiANDARD BLOCK WALL
rLAIM VAiJE; i00,00 CALC-VA..L'E; 100,00
n«.ZN. .�G; i: 0�90?_
G�iVT; h SuP'�; '�
r� �.i PUS � : O"•'; :
s� t' , �
GttOJP OCC: tt 3 /
COMMENTS: X
#���#tce���*;�*<�K�z���xxtt#��z#����tsr***�r*„#n�exstttt��x�r*�u�K�x��,x,:n�x�z�u#a� :+��r,•:�r-�r
Z C1 ti I ti G K t Q U I R� M �; N'i �
S E'" B A C K S
------------ NAiN BD:LDING ---------- ------- — ACCESSOttY dUiLilING ------ --
FRNT: 70 FT �N �itAR; FT Z(v FRNt: F1 il� RtAii; r"' Ca3
I,EFT; FT iN HGdT: FT '1N LEFT; FT T,i tiGHS'; r".i II�
PARKING REQ; PROV: PAftCEL• 13927213 ZNt; rti Rcr' NO:
PLA,VNING NZSiES> >' :.F, 6' rIiG"r1 17ETURN v�A„L TO B�. CONSTttUCTtD dc;TWF:t,v THr.
> HOJSr' AICD 'Hc RT.GHT S'IDr: PROPfiAIY LINE, �
#utt��#�trx<�t��.�#n#�rrt�u �#xitu�u#,��ttu�#*#�#x��u��rt**�rust�##�+�trrt��u�itira#ttit#ia';sr*kx xtt+�+t�x
D E V�,. O P v c N 1 S �. R V i C E S R E Q J I R E M �: �� a` S
'LONING APPROV�D BY W�I�- ilA't'H; I�i:�S-( �i t-
HUILDING APPitOVED BY ; DA"i'i.: �'S"
.�7"'—
APPLICATiON ZSSiJED 8Y; �-�t- ll�'i�; �(��� �j�
iEiEiE#if1!#7E9E'lE1FiEY'iE7FK'if##iEliifRRRX%'�Y'A�R'itRfi#fFStitR'iYX�%RRR'R fi�f R�! %ltRttlt�IT'iF1I'IEiFK•.:,SftFiS'iE% h11 An:Y '.('if
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LEGALIZATiON;N H' �: E S ti M M A H Y ST&L�CTJitAi� SE�;�EN� :Y
BLDG P:✓.T PLUNt1i,�G riLtCTttIC N,dCtiriNIC rIRE.' 'Sv;:P/R��� GRr�J:,yG
PERMIT 1:�.00 ' ' ' ��0
,; .b"''l:Y/kt`w�;tt::,
PLA;d 9.'IS =. ; ° '�. --
ISS�i�: k�'F.E • ' ,
BUILll1VG-DiV-> �ERh::'i iSS:Jt. PT,AN-Ciir'.CK TO?A�, i+AID �UE
TOTALS----> 1�.�0 0.00 9.75 ?.5.2� .. . '?�.2�-• ' .00
� ..f, .
REVfiNOE DIVISION TO�'ALS--> COliLECTED; 25.7:.i OVa'A/5tiOt1'': 00
BLDG PYT r�!,U.�,�IhG �LcC�'rt:(' :K'r.CHAU�C r'IltE S�VTl�/iOT G�1AL ,i� P.A�-Cri;.C�t
15.00 ,50 � 9,"/�
#iE###�i�r rtxirtiiiF%1tfF)f�x`i.`#iFR!EfEil �#if iFit��###K�#<k!f#1ffF###iflE�!F#l69f###H�#12itkY.Y.#tt%K ###.KrFif f:�::#tt#ik
i N D I V Z ll U t1 :. F E c; N R k�: A K D O W V' '
/
TYPE QTY D t S C d; P'' Z O Si J�ti:" COS'' � •O'.':1 , COST
SFti 5 RtS-CO\CHE'i� d1,OCK ✓IP?.L / FT, 20,00 � 100,00
tND Ot r�;d5 ,
EXPIRED �.
in!�omplete InspeC;(pns
, �S
'?�te — - -- $jg . .
Z�4'3
�
N
"� T POO, oPA
CONSTRUCTION AND PLANNING
APPflOVALS Permit# Date Inspector AppROVALS Permit# Date Inspector
1, TemPorary Electrical Service or Pole . 52. Pool & Equipment Location --
2, Soil Pipe-Undrgrnd. , 53. Steel Reinforcement �
3. EleCtrical Conduit Utility�Undrgrnd. 54. Forms
4. EleCtrical Co�duit-Undrgrnd. 55. Efectrical Bonding
5. Steal Reinforcement 56. Rough Plumbing & Pressure Test
6. EleCtrical 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, O Undrgrnd.
70. Structural Floor SYstem ' 61. APPROVAL TO DECK --
11. Property Sewer Line & HouseConnection 62. Backwash & Receptor�Final ��
� 2• Sem'e� CaP ', 63. Heater & Vent•Final ''
13. Roof Drains ' 64. Plumbing System � Final �
74. Rough Plumbing , . -� 65. Electrical�Final
75. Rough Electrical-Conduit �. 66. So�ar Svsterp-Final
16. Rough Electric Wiring 67. Fencing & Access ApProval
17. RoUgh Wiring $ign 68. APPROVED FOR PLASTERING
�
78. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL �
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Siructure 7p, Underground HYdro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas PiPe-Fough & Test 72. Underground Flush -
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro •�-
26. T�Bar Ceiling (Structurall & Monocoat 75. Dry Chemical -"
27. Frame and Flashing 76. Dry Standpipe ,n `y
28. Lathing & Siding i 77. FIXED SYSTEM FINAL t�. .
29. Insulation � � 78. FIRE PREV. FINAL '
30. Drywali Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat I ( 79. FINAL INSPECTION
32. Eleetrical Power Meter�Final � 80. FOOD CERTIFICATE ISSUED
33. Fin�l Electric � ' Notes: l.'
34. Fin21 Heating & Rir Conditioning (�/�7/qZ Q� � /.O_ . c.���, -
/ / ( C1}I-N�•
35. Final Gas Pipe-Test ' l l '�
��
36. Hood or Canopy �
i
37. Final Fac[ory Fireplace
38. Final Plumbing i
39. Water Service-Final
40. Gas Service-Final
�
41. Solar pomestic-Final
42. Backflow Preventer ' E p
43. Backflow Irrigation �„ � p�8 �f15{�CtIW1S
44. �andscape Irrigation SYstem � ��� -
1$
45. Sovnd Attenuation
46. Handicap Regulations � �_ _
47. FINALSTRUCTURE&BUILDING - _ '_ - - -(���
� �a��,
48. FINAL PLANNING �
49. Electric Release to Edison � �
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
TYPICAL
Cement Coping Ootional —�
Channel Block With 7-3/8�
Horizontal Top of all
Fences
For Fences 5' or Less
Vert. Bars 3/8"¢ at 4' -0" O.C.
For Fences Higher Than 5'
Ven. Bars 3/8"� at 32" O.C. �
Fill Cells Solid With Grout
W here Steel Occurs
Reinforcin9 Steel Shall
Conform to Sec.A�15�39
A.S.T.M.
AIISteelto be Lapped
24" or to�Code
NATURALGRADE
� .'•� •.���- .e
TWO 3/8"Q BARS p �
CONT�NUOUSTOP ��
& BOYTOM
L
►iOR1i5TEEL MUST BE TIED IN �
PLACE AT TIME Of TRENCH I
INSPECTION. p' L
��
� �
�
rw
a =
a
> Z
0
H
—WIDTH
SEE Cna
BELOW
6�� CONCRETE BLOCK FENCE
FOOTING REQUIREMENTS CHART
GENERAL- NOTES
MORTAR: pne Part Plastic Cemenf, and
Three Paris Sand
GROUT: One Port Cemenf Th�ee antl
One Nalf Paris �ond
COPING: One Part Cemeni, Three
Parts Sand
CONCRETE: Weil Mixed 1:2-I/2:3-I/2
Mar. of 7-I/2 Gollcns of
Water Per Sack of Cement
GROUT MAY BE POUPED FROM THE TOP
OF THE FENCE IN CELLS WHERE STEEL
OCCURS. -
CELLS AND AREAS OF HORIZONTAL REIN�
FOflCEMENT SHALL BE CLEAR, CLEAN &
FREE OF ALL MOfiTAH DEBHIS, ETC.
H GF [4RTMTCOTH
i/� iNE HEIGTH OF FENCE
�LOW BOTTOM OF FOGT�NG
SCALE: I/2"= I'
WIDTH 14" . . . . . . . . . . .14" . 12". . 12„
THICKNESS 10" . . . . . . . . . . .10" . . . . . . . . . 8��. 8�.
pEPTN OF EARTHTOOTH ... 24'� 20�� .. 16��. ... 12��
SPACING OF EARTHTOOTH. 12' 14' ..... 16� 16�
City of Costa Mesa, California
Building Department
1..�•.�'�qp NOV. &:.
APPF�OVED
City o` �r.s;a �;c�a Building D�pt.
ev ----��4- --..._ „'�: l� (`
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THF��
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6S��z1
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. • . .,.;;U.i3f.: �
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SPECii'i��.:il�'ry•�•> .'.i , • •� r , •"�!S AND
FR06t TH�y,: ,i ��F EcO:Lr :l.�. i� ` ��, r'=IAL
Sl.ID PL.l;.;S A;:D SPSC;Frp71C..:: , � i,, �' �' �: �.. :'�:'o I7!
GUILUIf:i:OP PJ.TION35C:F'I.._'.' . '�4± r''fie'/Gtii!NG
IN VICLtaTIG!� JF TH16 �: � _ . � ����1 (�:�: :�:; ,�'.'"'}'7 ��EN
TFiF. CITI. � Ci.. �.,i? L'� hf;y.:fH:::7,,;�.,e �.;Af10E OF
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NOTE '
ADDITIONS, DELEfIONS, OR CORR[CTIONS SHALL �
6E AFPROtrE9 BY TH� FLAty1!IR�G DEPARTMEWT I
�/i 555�
������ .
� , /�� C0� � � U�
�x�;
P !NG D�T.
BUBJECT TO 6LDp. DEPT. Qt�,
� �c���` �� �2
ter_ oA
DRxf09 O► PLAl1NfN0
11[flOtMt[
PNOJELTRUOflE55: z9OO ELLESMERE �AV
OWkE:{�NAME: BLANK, CHRISTOPHER L
f nooeess: BLANK, RAJIA K
� 2900 ELLESMERE A�'E
COSTA MESA,CA 92626
PPCHIENGINEEN:
AUDflESS:
HEG.NO.:
UNIT:
UNIT:
PEHMITTEE: HORIZON SKYLIGHTS ( 714 ) 586-7246
aooxcss: z5162 MADEIRA
LAGUNA HZLLS CA 92653
LICENSEO C RCTOP UECIAflATION: I hereby allirm ��ai I am Iicense0 unCer pmvisions ot C�aD�er 9 gommencing wil� Section
7000) ai Ui 9 of Ine Busfness 0 Pmlessions Cotle. ana my license is in full larce anU ellecl.
c�c L'� STpTE LIC.: Q 1 2 O H 4 / c�ass: g
r�a ,/
��o Signaiure: —(�—o�`/
OflK NS' C ENSFTION �ECIABATION: I her¢�y ai�irm Ihai I �ave a tetli�tale ol Consenl �o SelbinsUre or a cerii�iCate o� Workers'
Comvenution nsurance or a cendieU coDY ��e�eol (Section 3800. LaU. C�.
roucrNo.:0625551-93 E%P.DATE: O�/OZ/94
�ere�y fu ' eE. Il'1 Cenifietl capy is IileO wit� t�e ciry BuilAinp Division.
Aoo�icanc '% "a ' 7�/
IHEflS' COMPENSATIDN DECUPATION: (T�iS SMlion neea noi be tomple�eG il ��e permii i5I0r one huMrN (5100) or Ir55�.
I cetlily Inal in y7qyetlarmance of I�e work lar w�¢� ��is permil rs issuetl. I s�all not employ any person in any manner sa as lo Uecome
5u0ject �o Ihe `7io�kers' Compensalion laws ol Calilomia.
�ate: SignaWre:
NOTILE: I�, atl¢r making �his Oetlara�ion..you S�ou10 �etome SuElep lo lhe Warker5' COmDe����on provisi0n5 01 �he LaGor
COCe. you must �onMnih camply vrit� suc� prmdsions or IN5 permit stwll Oe CeemeG revakeA.
CONSTBUCTION LENOING pGENLY: I here�y a�firm Ihai Ihere i5 a ConSimtli0n lentling aqency lor l�e pedOrmant¢ ol ��e vroM for
which Ihis permil i5 issu¢a (Seclion 3097, Civ. C�.
LENOEfl:
aooeess:
OWNEfl BUILOEP DECLAPRTION: I hereby allirm I�al I am exempt Irom I�e Conlraciars' Slate Litense Law far �Ae fallowinp reason
�Senion 7031.5 Business anJ Prafessional CoOe: Any city ol counry wAich repuires a permit m constmct, aller, improve. GemolisA, or
�epalr any simcture. O�ior to its issuance. atm requires I�e a071icant lor suc� Oermit ta file a signeE statement tAat AYISAe is Iicen5e0
pursuam io ihe pmvisions ol lhe Camracmrs' State License Law �ChaD�er 9(commencinp vnin Sectian 7000) al 0ivision 3 of ine Business
anA Prolessions COtle) ar ��at he/she is exempt t�er¢Irom antl Ihe Easis for Ihe allege0 exemption. Any violation oi $ection 703L5 Gy
any aDo�icani for a permit suUjecis t�e appliWnt ta a ciNl penalty of not moa t�an INe �utMreO EWlars (5500�.
I, as owner ol the pmpeny or my em7loyees wit� waAes as their sole camDensation, will Ao ihe work, anA tAe
❑ stmcmre is noi imenUee or ollerea far ule �Section 70aa. Busineu and Proteuional Coae: The Contractors' State License Law
eoes not apply to an owner of a propeny who UuilCs ar imWoves tllere0n, anU who tloes suc� M'ork himsell/nersell or ihmuAtl
his or her own employees, pmviCetl �hat suc� impmvemems are noi iniendetl or alfereG br sale. I�, Aowever lhe builtling Or
impmvemem is salU wit�in one year o� compleiion, �he owner wili have ihe 6urtlen ol O�ovinp he/s�e ditl not huiltl or impmve
lo� ine purpose ol Sale).
i, as owner oi me propeny, am excWsively comrac�inp wilh licensea conlractors to conslmci t�e prolect (Seciion 7694, Business
❑ ana Pmlessions CoCe: TAe Coniracmrs' State License Law Aoes not apDN �o an owner oi pmDeM w�o �wl0s or impmves ihereon
antl wh0 conlratl5lor SUC� pmjetls wilA a tonlratlOr�s) license pursuan� lo Ihe CantraCiors Slale LitenSe Law�. I am aware
Nal pmol o� I�eir Worker'S Compensa�ian insurance ShoulE Ge pmvi4eU �o me.
� I am exempl unEer Senian: B. 8 P. C.
lor �nis reason:
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 067499
PERMIT NO: B 067499 PLAN CHECK NO; 02057-94 S GOVT: N SUPP: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE; ALT
JOB DESCRZPTION ; INSTALL TWO (1) NEW SKYLIGHTS SQ FT; 650
CLAIM VALUE: G50.00 CALC—C'ALUE: 650.00 GROUP OCC: R-3 /M-1
COMMENTS: SMOKE DETECTOR(S) REQUIRED ZN HOME.
�arit�#iF*�rie+t+�****+���-+�***x�***�*�***it�r�ir*«+E*�+�*io-+tr***�*****�*+�*r�cit-�*+a*iF�la***�c*��*rr��cx�+E
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT IN RGFiT: FT IN
PARKING RE¢: PROC': PARCEL: 13947611 ZNE: REF NO:
PLANNING NOTES>
Y
ik if !f 1f �f'If A4 1k'lE Y-4 1E'1f iE 1f 1Fif #?f �f 1E 1f iE iE iE 1E1f 7t�)k iE'lE if'M�ik i! 1f i! 1E 1E if 1f 1f if iF'lf 1F'1(�iFil'1E 1F +FK if +E if if ifiFif i4 1�'k�lE if iE iF'k iP ibih if'K 1Eif 14iF+f #
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 APPRO�'ED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: �//v �— DATE; G� �--
ififiEiFlE1EiE1PiEiEiEiF�fiFiflEiEif9E4-ifiE')EiE1Eif $ 9i�iFiF i��:�it�iflFi�F�'i�iFk��E9LiF�'*ifaFiEiE1R1FiEiEifiF�3s �iF� .±F�iE�E
1EiEiE?EififfkiliFikffiEifiF#'�icifkiciflEifiEiliE#fifiEiE�lfiEif�lEiEiFif�iEifiFiElEifi�ifiFiFiFiFlf±hRiEiEiEafiFiEiFifi�-ifihRiFififiF±fif :aFifiF..�ifiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG FMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 19.00 .50
SMIP/NON—RES
PLAN 12,35
ZSSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CFIECK TOTAL PAID DUE
TOTALS----> 19.50. 0.00 12.35 31.85 31,85 .00
REVENUE DIVISION TOTALS--> COLLECTED: 31.85 OVEA/SHORT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
19.00 ,50 12.35
iE if iE 1f iF ik 1c if if �1FlE �lE iF if +F fE iF iE i"t if if� iE if iF iE iF if if iF iE iM 1E K M �f iE iF if-+4 if iF iE if if 3f k 3E i!� if-1E if iE i! iF if iE Y-�f IE iF iE iF K iF il� ic �tG iE iE aF?F iF iF iE if iE ##�1F
I N D I V I D U A L F£ E H R E A R D O W N
TYPE QTY P E S C R I P T Z O N UNIT COST TOTAL COST
Date: owner. I SFR
I ao �ere�y cenily i�a� I am aware ol ana undersian0 ihe requirements ol California Healt� antl Salety Code Sections 25505, 25533, antl
25534 antl ihai I or any tulure builtling occupant will/will noi (circle one) nee0lo comply with 5ai0 s�a�e codes antl �he repuiremen(s �or a
Oe�mil lo� cons�mclion or mo0ilica�ion imm Ihe Air Oualiry Managemen� OisUicl. Fesitlential con9mction appliwtions are eaemp� �mm
Ih¢SE pfDvi5i0n5.
Oale: ApDlicanl:
I here�y certify Ihal I have reatl Ihis application and slate
ortlmances antl slatelawsrela�ingio �uilding consiruction;
p�qp[f1}��0� i05pEL1i0fl O�fpO5P5.
is correcL I aB�e?.Io comply wi�� all ci�y antl counry
nia�ives oi Ihyccl�y �a enter upon I�e a0ove�men�ionetl
'�a�e'. � O' /'� Signalure:
� er's License or Sociai Secunry
164t�46 Whne—BmlOing; Greon—CoOa Enlo¢ement: Canary—ApO�icanl: Pink—Revenua: GolOenroC—Assessor
65Q ALTER BY VALUE RESIDENTIAL NOZONE
END OF FEES
1.00 650.00
ul �616i412—�0161914 T 4 T �1.85
�ATE: 06/08/94 TIME: 1i:24
CL�N5TRUCTION AND PLANNING � POOI & SPA
�APPROVALS Permit# - Date Inspector qppROVALS Permit# Date Inspecior
�. Temporary Electrical $ervicE or POIe _ 52. Pooi & Equipmen[ Location
2, Soil Pipe�Undrgrnd. - ' 53. Steel Reinforcement
3. Electrical Conduit Utiiity-Undrgrnd. 54. Forms
4. Eiectrical Condua-Undrgmd. 55. Electrical Bonding
5. Steel Reinforcemenc 56. Rough Plumhing & Pressure Test
6. Elecu�cai UFER Grnd. 57. APPROVAL TO COVER�GUNITE
�. Fooungs 58. Electrical CondumUndrgrnd.
8. Poundation 59. Gas Pipe, O Undrgrnd., Tesc
9. Vdate� Pipe�Undrgrnd.. , 60. Backwash Lines, P-Trap, G' Und:gmd.
t�. Structurai Floor Svstem 67. APPROVAL TO DECK '
17, Proparty Sewer Line & HouseConneciion 62. Backwash & Recepto�'�Finat
72. Sewer Cap � 63. Heater & Vent-Final
13. Roof Drains 64. P�umbing System - Final
74. Rough Plumbing 65. Electrica�-Final
15. Rough Electrical�Conduit 66. Sotar SYstem-Final
76. Rou9h Electric Wiring 67. Fencing & Access Approvai
17. Aough Wiring Sign 68. APPROVED FOR PLASTERING
78. Rough Electrica��T Bar Ceiling 69. POOLlSPA SYSTEP:iS FINAL
19. Rough Heating & Air Conditioning PIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS �� Permit #
21. DuCtS, �n Structure 70. Underground HYdro
22. DuctS, Ventilating 77. Produc[ Piping OGas �Oil
23. Gas P�pe�Rnugh & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorayeTank �Gas ❑Oil
25. Roof Sheathing 74. Overhead Hydro '�
26. T�Bar Ceihng (Structurail & Monocoat 75. DrY Chemical ' _
27. Prame and Flashing `-`�_�( ��� 76. Dry Standpipe •
28. Lath�ing & Siding 77.-' FIXED SYSTEM EINAC � �
29. Insulation 78. FIRE PREV.�FINA� �
30. Drywall Nailing HEALTH DEPT. REQUIREINENT
31. Plaste' B�own Coat 79. FINAL INSPECTIQN �
32. Electrical Power Meter�Finai $0. FOOD CERTIFICATE ISSUED
33. �inal Electric Notes:
34. Final Heating & Air Conditioning �
35. Final Gas Pipe-Test .
36. Hood or Canopy � �
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Finat
40. GasSe:vice-Eirial
41. Solar pomestic-Final
42. Backfiow Preventer
43. Batkflow Irrigation
44. Landscape Irriqation SYstem �
45. Sound Atienuation �
46. Hand�cap Regulations
47. FINAL STRUCTURE & BUILDING �-���C� �w�
46. FINAL PLANNING � '
49. Electric Reiease to Edison �.�
50. Gas Reiease to Southern Califomia Gas Co � � '
51. CER7IFICATEOFOCCUPANCY
No. _ Dare
;' ' f -.
�`'140��- —
Ap�1 BLL'�--
(���} 0�2
�p vt 6t�f:'12
:�
"<�:?
i
m
;
/
N
� x 6 `C �iL/^/G .�iJ � �6- a. �.
HORIZON SKYLIGHTS �
25162 MADEIRA �a X,��b����r ����r�r `
I.A(3UNA HILLS, CA 92653 •
_ 714586-7246 SK f�G/TE ..SyS �s�$ �.�¢� ��� ��LlG'�
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