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Home My WebLink About1040 EL CAMINO DR - Building PermitsC�11-�5 i s �� e� ►a17�-rt4t-�,��NC� �1t�� BY- P43}cm- 4A /4t�/ CjWgf S . (r4oNf wjei - co simF . PROVED 'OF COSTA MESA NNING DIVISION DITIONS. DELETIONS, IECTIONS SHALL 13E BY THE PLANNING DIV. . I �� F f T• � t 81FJ �, �.�^ 1 11 November 25, 2008 To: �Q� c alii CITY OF COSTA MESA P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 DEVELOPMENT SERVICES DEPARTMENT Building Safety Division Code Enforcement Communications County Clerk County Planning and Dev. Services County Registrar of Voters County Tax Assessor Engineering Division (2) ESRI Fire Admin, - Training Officer Fire Admin. - Mark Brown (Station 6) Fire Prevention Irvine Ranch Water District Mesa Consolidated Water District AT&T Broadband Newport -Mesa Unified School. Dist.(2) Pacific Bell Police Dept. - Planning & Research Sanitary District Engineer Sanitation Division Office So California Edison Company Southern California Gas State Board of Equalization U.S. Post Office -AIS :' U. S. Post Office, Adams Thomas Brothers Time Warner File (2) The City of Costa Mesa would like to inform you of the following address change: OLD ADDRESSES 1011 EI Camino Dr. 1031 EI Camino Dr. 1013 EI Camino Dr. 1033 EI Camino Dr. 1015 EI Camino Dr. 1035 EI Camino Dr. 1017 EI Camino Dr. 1037 EI Camino Dr. 1021 EI Camino Dr. 1041 EI Camino Dr. 1025 EI Camino Dr. 1045 EI Camino Dr. 1029 EI Camino Dr. Your cooperation in this matter is appreciated. Sincerely,`%/ MEL LEE, AICP Senior Planner Attachment: Project Site Map cc: Vi Pham. Administrative Services/MIS Reve Pacific Attn: Kirstin Emershaw, Partner 230 Newport Center Drive, Ste 210 Newport Beach, CA 92660 NEW ADDRESSES A.P. NOS See Attached Project Site Map 141-671-07 141-671-17 Budding Division (714) 754-5273 • Code Enforcement (714) 754-5623 • Planning Division (714) 754-5245 FAX (714) 7544856 • TDD (714) 754-5244 • W vxi.costa-mesa Aa.us PROJECT ADDRESS: UNIT: 1040 EL CAM I NO DR ADDDREs owxE ESS: FOLEY PAUL STEPHEN ADDRESS 6700 1, OCEAN FRONT NEWPORT BEACH,CA 92663 AflCHIEN GINEER: 714) 548-4049 flEG.NO.: ADDRESS: UNIT: PERMITTEE: D M MC GAHEY (805)646-0353 ADDRESS: 88A,22�0 W. EL ROBLAR ((�199qq LICENSED CONTRACTOR IiELCAAATION: hereby alfirm That am licensed underr prroovisions O ORA, 9 (commend with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. /J� STATE LIC.:5892.i2 �[7��C/uySS�: H-1 Date /s Signature. _a'_—Lr"�� _19DRKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of co m to sell -inti r a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800. Lab. C). POLICY NO.: EXP. DATE: COMPANY: i Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. ,te. Applicant: ipipaiW7 ROM WORKERS'COMPENSATION DECUM710N: (This Section need not be completed it the permit is lar ane lTundred ($lfgl or less).n the penarmance of the work for which this permit is issued. I shall not employ any Derson in any Afiner so as to become Workers' Compensation Laws of Calimrma. ,I ^rri//�/,.yJ`_/ — �— / � Signature' If. atter making Ihis declaration, you should become SuDjecl to the Workers' mpens n provisions pl the laboru must forthwith comply with such provisions or this permit shall De dee tl revakION LENDING AGENCY: I hereby affirm that there is a construction le n y for the performance of the work forrmit is issued (Section 3097. Civ. Cl. LENDER: ADDRESS: ADD BATHROOMS SINKS, "2" IN UNIT A, "1" IN UNT B, OWNER BUILDER DECLARATION: 1 hereby atlirm that am exempt tram the ontractors Stale License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed Statement that helshe is licensed pursuant to the provisions of the ContractorsState License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Cade: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion. the owner will have the burden of proving he/she did not build or improve for the purpose of sale). ❑ I, as owner of the property. am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. & P. C. fat this reason'. Date: Owner I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant w I /will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Dale. Applicant: I hereby certify that I have read this application and state that the above information is correct. I 7d as and stale laws relating to building construction and hereby authorize representatives of tl openy ai inspection purposes. _ iD 1` �7� Signature to ca mply wit all city and county to e➢teru 0above-mentioned i-Iff"rver's License or Social Security p 4-'-- 1A41 4A tear -aa whop—mum- anon—cnno Fnlnmcmnm c„—m.mm Pink—Revenue: Goldenrod—Assessor ------------ MAIN BUILDING ---------- CITY OF COSTA MESA — BUILDING PERMIT FRNT: FT IN REAR; FT PERM NO: P 065578 PERMIT NO: P 065578 PLAN CHECK NO: N GOVT: N SUPP: Y CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: REP JOB DESCRIPTION REPLACE WITH NEW PLUMBING FIXTURE SQ FT: CLAIM VALUE: iE ♦E IE If if iE 1E * IE 1E IE ♦f iF 1F 1E *!E if iE 1E iE 1f if 1E 1E iE IE IE 1E IE IE IE CALC—VALUE: GROUP OCC: R-3 / COMMENTS: OMMENTS: 111 INUNIT NITE PERMITE SUPPLEMENTE # P -65272E * 1&k iE 8E 1E 1E IE 1E ICETHISt iF iE iIS E iE iAE iE iE iTOIE fPE 1EE 1RE fME lIf iTE 1E IE 1E IE IE IE DATE: Z O N I N G R E Q U I R E M E N T S APPLICATION APPLICATION ISSUED BY: S E T B A C K S DATE: DATE: ------------ 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: 14166513 ZNE: REF NO: PLANNING NOTES> > iE ♦E IE If if iE 1E * IE 1E IE ♦f iF 1F 1E *!E if iE 1E iE 1f if 1E 1E iE IE IE 1E IE IE IE 1F iE * * 1t iE iE iE 1E iE IF iF iF iF iF if iE iE 1E iE iE 1F * IE iE iE 1E iF iF * IE 1E 3E iE * M iE iE * * iE iE 1E iE iE 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 ZONING APPROVED BY _ DATE: BUILDING APPROVED BY DATE: APPLICATION APPLICATION ISSUED BY: :' DATE: DATE: iE iE iE 1E iE IF iE iE IE IE iE iE IE 1E 1E iE iE iE 1E 1E iF 1E If iE IE IE IE*44*♦E IE 1E 1F 1F if iF lE iF iE*iE iE iE 1E*IE*iE♦f IE 1E IE iE 1f iE IE IE iE♦F IE 1F 1E 1f♦E iE iE iE 1E 1E 1E 1E 1E ♦F ♦f iE iE iE iE iE**iE IE 1F 1f iE 1E if iE lE lE iE if iE LEGALIZATION:N F E E U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 28.00 25% SMIP/NON—RES PLAN ISSUE FEE 10.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 28,00 10.00 0.00 38,00 38.00 .00 REVENUE DIVISION TOTALS--> COLLECTED; 38.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 38,00 iE iE if kit iF*if iE iE if IE 1E 1E 1E kiE 8E IE iE iE iE iE***it iE if iF it iEit iE 1l iE iE lE if iE***iEiE iE IF if it iE k iE k IE iE***1t iE iE 1E 1E 1E 1E iE iE iE 1E *IP 1E iE iE 1E 1E 1F 1E iE I N D I V I D U A L x`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 %f PLU 4 WASH BASIN7,00 28.00 END "^^OF FEES 1 01 00153273-00153273 T CIT 38.00 DATE: 21/L15/94 HOE: 14:25 CONSTRUCTION AND PLANNING ! APPROVALS Permit # I . 1.'Temporary Electrical Service 6! Pole - 2,,,Spjl Pipe-Undrgrnd.. ?^ ,)I 6�triral Conduit ULlity-Ua8;grnd. =4. Electrical CondvarUndrarndr ^•�'�h?cincal UFER-Grnd. ;.;7U �abtirt4s to rounoat on m ? •`J ater P. a-Undr (nd. . P 9 10. Structural Floor System 11. Property Sewer Line_p House Connection Date Inspector POOL A APPROVALS Permit # r63, Heater & Vent -Final 52. Pool & Equipment Location 13. Roof Drams 53. Steel Reinforcement 64. Plumbing System - Final 16. Rough Electric Wiring • 54. Forms 67. Fencing & Aocess Approval 5i� Electrical Bonding 17. Rough Wiring Sign b(i. Rough Plumbing & Pressure Test 68. APPROVED FOR PLASTERING Wr APPROVAL TO COVER.GUNITE 5 Electrical Conduit-Undrgrnd. 19. Rough Heating & Air Conditioning 59, Gas Pipe, 0 Undrgrnd., Test FIRE DEPT. REQUIREMENT .-60. Backwash Lines, P -Trap, 0 Uncirgrnd. -61; APPROVALTO DECK A'PPROVALS;'-94?er6it;h , 62: Backwash & Receptor -Final Date I Inspector 12. Seger Cap r63, Heater & Vent -Final t 13. Roof Drams 66, Solar System -Final 64. Plumbing System - Final 16. Rough Electric Wiring • 14. Rough Plumbing '- 65, Electrical -Final 15 Rough Electrical -Conduit 66, Solar System -Final 16. Rough Electric Wiring • 67. Fencing & Aocess 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 A'PPROVALS;'-94?er6it;h , 20.-9oU0 Factor3 Fia�!ace ,;,� 'r = ? 21. Duces, iq7Strupture'1.r •• •- - _ '70. Urnferground Hyt+-,-o 22. Qucis, V�ntileIiny r 71. Product,2ipinig O'Gas 00,1 23.'Gas,Pipe Rougb &Test `72. Underground FiZs - 1 24.tiooLFrmning• "r = - 73.''UndergrndlStoratj;ank 0Gas C! Oil,' 25. Roof Sheathing , ,;; - - 74.,0verhead Hydro - •' 26. T -Bar Ceiling (Structural) & Wggcrgoat - •;' 75. _[)ry Chemical - = \• 27. Frame and Flashing, -� 76. `Dry Standpipe _ 28. Lathing 81 Siding - •• 77. IXED SYS�ENfFCNAL .r. '29. Insulai,q 78.; ,IRE PR -EV. FINAL .: 0 10. Dryv.all Nailing '• It ^,.:: HEALTH DEPT.-R£QUfREMENT _ _ 1. Pia,ter Gtp."n-i:o,W. -: �•, 9. FIN,4L I�1 FCTIQfJ :32. Electrical Power Meter.finalTr. x 80. 'FOOD CERTIFIW. E ISSU�D `Notes: " '34. •Finati Ne.;ung-& Req Cpriditipnirtg„ r _ �� f a 35. ,Final Gay Pipq-Test 36. Hood or Canopy !_ 37. finai'Factory Firepl1ce' 18. Final Piumbi ng t29. water Service-Fin6"p+ I 4 ; - " 't • r AO. Gas Serv,ee-Final r41. Solar Comestic-Fina] F r ✓ $2. Backflow Preventer 43. Backflow Irri-"tion 5' T i - :R , :• 4 •44. Landscape Iri7gatipn System r• ♦ ' r - -? ? _ .45. Sound Attenuaticin' r i 46.'Hand icapRegulations F a 7 47. F INAL STRUCTI?RE & BUICDING r .. .., 48. PINALPLANNING; �--0--- J 49. Eiectric Release to Edison ,. , 5j0. Gas Release to Southern California Gas Co - , 'sat. CERTIFICATE OF OCCUPANCY- _ Date T PROJECT ADORESS: lj4n r.r--y..n DR UNIT OWNER'S NAME: FU_ EY, PAUL STEPhtuN P C ADDRESS: 6700 W OCEAN FRONT NEWPORT BEACH,CA 92663 714) 548-4049 ARCH/ENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: D M MC GAHEY (805)646-0351 ADDRESS: 820 W. EL ROBLAR OJAI CA 93023 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing ith Section 7000) of Division 3 of the Business and Professions Code, and my license is in full farce and effect. CITY STATE LIC.: 589272CLASS: B-1 Date: _�� - !,q Signature: _p•�� "-� WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sbins a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3B00. Lab. Q. POLICY If EXP. DATE: COMPANY: ❑ Demand copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date. Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need nor be I cell that in the performance of the work for which this permit is issued, I shall no subject to the `Workers Compens cion Laws of California Date: / ` F Signature NOTICE: If. after making this declaration. you should become subject to the V Code, you must forthwith comply with such provisions or this permit shall be CONSTRUCTION LENDING AGENCY: I hereby aRum that there is a construction which this permit is issued (Section 3097, Civ. C). ' LENDER: ADDRESS: i any person in a�nne�gas to •/ oovision5 of the Labor performance of the work for CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 065272 PERMIT NO: P 065272 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: REP JOB DESCRIPTION REPLACE WITH NEW PLUMBING FIXTURE SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: X Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 1416651.3 ZNE: REF NO: PLANNING NOTES> *aE fE*ie*iE1eiE*iE iF ieeeie iE of i('if if lE jE 1E*iE*1E*iE Rf*iF jt lE iE 4f ie*4E 9E if iE iEifiEeE YrK*ie is iE SE*iE iE aE#{fK*ie 1F iE*iE %ii ie lF*3E lE fE#*ie iE .� D E V E L O P M E N T S E R V I C E S1, R E Q U I R E M E N T S ZONING APPROVED BY �" DATE: BUILDING APPROVED BY i:\ DATE: APPLICATION ISSDED BY; _ �GiZI DATE: �L, ie*#afiFaEiElfiF#aEN"N"}E'X•'N"%E'N"N'ae#* xx TFirr iFlfiEaFfEfeifiElFi6iFiF' -*;ii iFiFiFif �iE eE #' * iF * iE if iE iE if if iF iE iF iF 1e # * if iE ie iE dE 9E iE'R ee ?E iE iE ie if 1E if pE ie ie * 1F fE aE 1E ae ff 9E 9E 9F ie it iF 3F of of * TF' if iE iF if iF iP jE iE ?f eE iE 1f * 1E iE iE iF se iF iE iE aE # if LEGALIZATION:N F E E JS U M M A R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from theContractors' State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/RES GRADING (Section 7031 5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish. or PERMIT 1 3 3 (� ' iR of iE iE iE It iF if iE iE ie 7i' 1f iE iE lE iE iE 9e iE'1E if iE jE jE aE iE iE it iE iE eE X"%1h N 9E * iE iE iE * io- iE iF 3f jE aE if iF if 9f iE ie 1f aF is 9F iF * iF jF iF 9E if repair any structure. prior to Its Issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business .00 25% SM I P / NON —R E S and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ISSUE FEE 20 .00 -- TOTAL COST I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—>r PERMIT ISSUE PW—CHECK�i TAJ �i PAID DUE ❑ structure is not intended or offered tar sale (Section 7044, Business and Professional Code: The Contractors' State License Law TOTALS ---- > 133.00 2 0 , 00 0.00 5 7t. 0 153.00 does not apply to an owner of a properly who builds or improves thereon, and who does such work himself/herself or through' 8 WATER CLOSET (TOILET),, 7,00 .00 his or her own employees. provided that such improvements are not intended or offered for sale. It, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION ' TOTALS--> COLL EC.TED : 153. 00 OVER/SHORT: .00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC t T.,— nMIP/TOT GRADING PLAN—CHECK Las owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business E) no Professions Code'. The Contractors' State License Law does not apply to an owner of properly who builds or improves thereon and who contracts lar such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. i for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533. and 25534 and that I or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit lar construction or modification from the Air Quality Management District. Residential construction applications are exempt from these provisions. Date: Applicant I hereby certify that I have read this application and slate that the above information is correct. agree to comp withal city an county ordinances and stale laws relating to building coosbucrion and hereby authorize representatives of this city a Pemtha above-mentioned properly for inspection purposess.. Date: / x v / Signature: Driver's License or Social Security n: 164646 White—Building: Green—Cade Enforcement: Canary—Applicant: Park—Revenue: Goldenrod—Assessor 01. 00152080-03152080 T CfT 153,00 DATE: 12/10/93 TIME: 16 14 153,00 is jE # aE aE * Bf aE if iE iE iE # it iR of iE iE iE It iF if iE iE ie 7i' 1f iE iE lE iE iE 9e iE'1E if iE jE jE aE iE iE it iE iE eE X"%1h N 9E * iE iE iE * io- iE iF 3f jE aE if iF if 9f iE ie 1f aF is 9F iF * iF jF iF 9E if I N D I V I D U A L. `L�IF E E B R E A K D O W N TYPE QTY D E S C R I P T I (i UNIT COST TOTAL COST PLU 4 SINK, BAR 7,00 28.00 PLU 2 WASH BASIN 7,00 14,00 PLU 8 WATER CLOSET (TOILET),, 7,00 56,00 PLU 4 FIXTURE SET/TRAP W/P ING 6 BACKFLOW 7.00 28,00 PLU 1 RAINWATER SYSTEM — P DRAIN 7,00 7.00 ENw6F FEES 11 11 01. 00152080-03152080 T CfT 153,00 DATE: 12/10/93 TIME: 16 14 CONSTRUCTION AND PLANNING APPROVALS Permit W. Date Inspector POO, ;PA 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 Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel 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, D 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, Roof Drains 64. Plumbing System - Final T 14. Rough Plumbing 65. Electrical -Final , 15, Rough Electrical -Conduit ' 9 66. Solar System -Final 1.6. 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 APPROVALS Permit # 1 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas D Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank D Gas D Oil 25. Roof Sheathing 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. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: �•// T ` C`t 11CL C )Zjt� V � 1 $ v t 34. Final Heating &Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace ' '--- 38. Final Plumbing J �`-4: 39. Water Service -Final 1 40, Gas Service -Final , 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING i 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. _ Date - PROJECT ADDRESS: 1040 EL CAM I NO DR' OWNER'S NAME: FOLEY, PAUL STEPHEN ADDRESS: 6700 W OCEAN FRONT NEWPORT BEACH,CA 92663 ARCH/ENGINEER: 7 1 4) 548-4049 ADDRESS: REG.NO.: UNIT: UNIT: PERMITTEE: D M MC GAHEY (805)646-0353 ADDRESS: 820 W. EL ROBLAR OJAI CA93�3 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions o C apter 9 (commencing wi Section 7000) of Division 3 of the Business and Professions Cade, and my license is in full force and effect. CITY LIC / ' STATE LIC.: CLASS: (09 sa9z7z -1 — li= Signature: _ lo _ WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self- s or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800. Lab. C). POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for ong undyed ($100) or less), certify that in the performance of the work for which this permit is issued, I shall not employ any person i cry .so as to become sublect t the WorkersCoomrpensation Laws of California. y Signature: NOTICE: making this declaration, you should become subject to the Workers'/orepponeiiII& provisions of the Labor Code. you must forthwith comply with such provisions of this permit shall be del revf CONSTRUCTION LENDING AGENCY: I hereby affirm that (here Is a construction lendj> cY for the performance of the work for which this permit is issued (Section 3097, Civ C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the CoetraCtorS' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars (5500). I, as owner of the property or my employees with wages as their sale compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code'. The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her awn employees, provided that such improvements are not Intended or offered for sale. It, however the building or improvement is sold within one year of completion, the owner will have the burden of proving all did not build or improve for the purpose of sale). I, as owner of the property. am exclusively contracting with licensed contractors to construct the project (Section 7044. Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon and who contracts for such projects with a coniractogs) license pursuant to the Contractors' State License Law),I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: 0. & P. C. for this reason. Date: Owner I do hereby cantly that I am aware of and understand the requirements of California, Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to comply with said stale codes and the requirements for a permit for construction or modification from the Air Quality Management District. Residential construction applications are exempt from these provisions. Dale: Applicant: I hereby certify that I have read this application and stale that the above information is correct. I agree to ordinances and slate laws relating to building construction and hereby authorize representatives of this city to pro gr ins pC lion purp05¢5 �9 Date: � ^ � � Signature: Y � // Driver's License or Social Security r: 1641 46 Wbire—Building: Green—Code Enforcement: Canary—Applicant, Punk—Revenue: Goldenrod—Assessor and CITY OF COSTA MESA — BUILDING PERMIT PERM NO; M 065579 PERMIT NO: M 065579 PLAN CHECK NO: N GOVT; N SUPP: N CONSTRUCTION TYPE; V—N PERMIT TYPE: MEC PURPOSE: REP JOB DESCRIPTION ; NEW GAS CONNECTIONS TO "4" NEW STOVES SQ FT; CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 / COMMENTS; "4" NEW GAS CONNECTIONS , ONE IN EACH SEPARATE UNIE, A,B,C, & D Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 14166513 ZNE: AEF NO: PLANNING Ni > I. !! i! i! iE iP iE iE iP iE 1E * * iE 4 it iE 1E iE iE iF 1E iE iE lE lE lE 1E iE 4t it it it it ie iF 1E BE * iF iE iF iE it iE 4t i! 1E iE JE ie * * iE iE iH ie iF ■ ie iE iE RE iE fP it if iE iP iE iF iF if if 1E iE * iE if iE D E V E L O P M E N T S E R V I C E Sr. R E Q U I R E M E N T S ZONING APPROVED BY BUILDING APPROVED BY ; ISSUED BY DATE: DATE: iF if k Bk *! * M 1f JE * * * * 1f iE iF lF 1F iF iL 1E M It 1! if 1F 1k 1f !E JF JE 1f !! R! 1E RE 1f 1H iE iE f! if iE 1E 1E iE 1L 1F 1E 1E lk iP 1E BE Jt 1t 4t ik * 1E lE iE M * 1E Bf 7F'XE iE iE if iE iE aE lE * fE iE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 3,00 PLAN 255 SMIP/NON—RES ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 3,00 15.00 0,00 18.00 18.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 18,00 OVER/SHORT; ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK . 18.00 1E iE JE iE 1f iE k!!!f if 1E iE it iE it M!P iF iE 7f * * #!F!F!E JE * iE Jf BE 1t it it iP ik ie * * * iE iE iE ie iE BE 1P k 1F iE * RE iE iE if k it k 1F fE 1E iE iE iE it * it iE 8! BE iE 1E 1i if iF iE iE BE 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 MEC 1 GAS PIPING SYS 1 — 4 OUTLETS 3,00 3.00 END—OF FEES 01 00153274-00153274 —f•E7a•T 18.00 DATE: 01/05/94 TIKE! 14:26 ' CONSTRUCTION AND PLANNING POO. iPA Date APPROVALS Permit Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd.- 53, Steel Reinforcement 3;'Pi gctrio' I Conduit.UtilityNndrgrnd. 54. Forms '.4. Electrical Cond0it•Undrgrnd. 55. Electrical Bonding ' 5. Steel Remforcem6 56. Rough Plumbing & Pressure Test .#'-ElcctricalUFER'Crnd 57. APPROVAL TOCOVER•GUNITE - 7.'P 4ti rias 58. Electrical Conduit-Undrgrnd. 0;•,Fovndation 59. Gas Pipe, O Undrgrnd., Test '-' 9,, -Water Pipe-Undrgrnd. 60, Backwash Lines, P -Trap, D Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line-& Hoi.3e Connection 62. Backwash & Receptor -Final 12. Sewer Cap _ _ 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbirtg' 65, Electrical -Final 15. Rough Electrica Conduit r 66. Solar System -Final 16. Rough Electric�,Viring 67. Fencing & Access Approval 17. Rough Wiring Srgn 68. APPROVED FOR PLASTERING 18, Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air CzSrdit,omng DEPT. REQUIREMENT i _FIRE APPROVAUS-:.�'Pert�it # �' 20.rRough Factory Fi'Feplace -" a ti,+ a .t t- c 21In-Strttct UFS Wnda/grquild'HyTlS'O .,.Ducts, 22. Duc+'3, VAniiiating- <' y �jt. Prod uctTGAg Li` rias Doi[ 23.-,Gaspipe,Roudh &'{est '. tr c -72. Underground Flu3tr. 24.:Aoof. FrA"ming' > ,? T y ! ! 573 t Jndergrndt Stora;. - Tank G' Gas ^ 0'rr 25. Roof'Shpthing ,_' :r ' „�; "x -74., Overhead Hydro~ J 26. T -Bar Ceiling (S[ri1Gturall & Zonocoat 76�Yry Chemical " - 27." rame and Flashirr§. m 76.�Dry Standpipe � t 28. Lathing & Siding ''�.Y _ •• u s 77.y -FIXED SYS?E6'f,;INAL•' '29. Insula ti0r > y -t # .-, 78.g -FIRE PREV. FAA1- �30. DryYA'all NaiLng �- i �-'"r r, HE-ALTH:DEPT:f}EQUIREMENT r- 1. Piaster B wp Coo{:, IN P.�CTI�' . ., _79.`'�INAL t-82.t:EIectridFPo6aer 61bter-Final r �u 1 ( IF. �--- ^ ;60,,:FOOD/ CERTIFFICA-VE ISSUED, _33. Final ElfS-;tric_ ; i84., Finat Heal ,nA A3- Cone'itioni_rg.. 35.,finat^Ga�Pipe.TeFt° 36. Hood or`Cano Py YT - --- -- 7. Finzf7Fartory FvEpi,ace .-. -'fir .. ' �• ' - r) •-� -' i - !48. Fin4t'PlgrPbing . � ag. Water Service -Finis! t I: q0. Gas Service -Final' 41. Solar Domestic -Fria! `: -' •• t C• I r < 1 -t '42. Back Ilow'Preventer n. 43. Backflow irri&tion t ,- - - 'C y `24. Landscape IGiigalloq. System •+r; , r i7 _ {J v5. Sound Attenuation r 'A 6. Handica0. iequlaIiors 47. ^FINAL STR=TURE & BUILDING s I r -1 w -� r -� r r � r 48.'OINAL PLANNING .49, Eleio.ric Release to Edison - '$0. -Gas Release to Southern CalifprniaGas Co ,51. CERTIFICATE OF OCCUPANCY No. Date I/ I PROJECT ADDRESS: 1040 EL CAMINO 'DR UNIT: OWNER'S NAME: FOLEY, PAUL STEPHEN ADDRESS: 6700 W OCEAN FRONT NEWPORT BEACH,CA 92663 ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: PRECISION ROOFING (714)248-8418 ADDRESS: 27302 VIA BELLA CAPISTRANO BEACH CA 92624 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. DCITYate .:058378 STATE uc.:644595f $ Dale —1_ 31n q Signature: 'A A✓ - WORKERS' COMPENSATION DECLARATION: hereby affirm Ihat I hdlcafe of cons I to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800. POLICY NO.: EXP. DATE: COMPANY: ❑ Carried copy is hereby Iuroished. ❑ Certified copy is filed with the city Building Division. Date' /�Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred (5100) or less). I candy that in The peflOne a et the work for which this permit is issued, I shall not employ any person in any manner so as to become sublet) to Ih�kars' Compensation Laws of California. - 1 Dale _ /- SignaWre', /� NOTICE: If. after making this declaration, you Should become suble to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the ContractorsState License Law for the following reason (Section 7031.5 Business and Professional Cotle'. Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for Sale. If, however the building or improvement is sold wiloin one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I. as owner at the property. am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(S) license pursuant to the Contractors' State License Law),I am aware that proof of (heir Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section B. S P. C. for this reason Date: ___ Owner I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle Anel need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives at is city to enter upon the above-mentioned properly for inspection purpose4 Date. _uu- .AIf— Iq Signature44 Driver's License or Social Security a: 1641-46 White -Building: Green -Code Enforcement: Canary -Applicant; Pink -Revenue: Goldenrcm-Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06587 PERMIT NO: B 065872 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT SOB DESCRIPTION ; T/O s SHEATH REROOF W/COMP & BUILT—UP SQ FT: 8,500 CLAIM VALUE: 8,500.00 CALL—VALUE: 8,500,00 GROUP OCC: R-1 /M-1 COMMENTS: REROOF 3500SF 4 UNIT APART W/COMP, 900SF GARAGE W/BUILT—UP Z O N I N G R E Q U I R E M E N T R S E T B A C K S p (�� tRED ------------ MAIN BUILDING ---------- --------- ACCESSORY BUFjQW------- 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: 14166513 ZNE: REF NO; PLANNING NOTES> icor)t��E�E�Eitif+ExTtit�E*�Eitit�r�Eitie�Lit�E�EiE+tit*ititx�r�6��Ex�E**�E�E+tfE.E*�ie�E*xitTL��*�E+tax+Eieita6�r�iraEifitit�Eit*+E+t�* D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE; BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: BE**Rr 4E fE iE �E eE �L BB*9E BPS*iE iE iE 9E ar �L��"�iF F6 iF 3F �E'�E��E3FTr iF3F'iFrt � *�#"iF'4E �E *iB+E �E***+� E aE iE �E* �E+eifiLtriE�PiEititit*it�tytTtitk+tftiritatatiEiEir�Eitx+ritx�k*�-+E+Eft**Tr�EEr�L*yE+r�F*�-x*yE�E*aeTritir+rit+F+r�Lat+E+t*iter**�E�E�y6�-it LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 108,00 .85 SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 108,85 0,00 0,00 108,85 108,85 .00 REVENUE DIVISION TOTALS —> COLLECTED: 108,85 OVER/SHORT:. ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 108.00 .85 iE iE iE iE iE iE iE iE if i6 iE iE if iE ie if i! it if iE iE iE iF k ie iE iE iE iE * iE i6 iE iE iE * iE ie iE if iE iE iE iE iF iE iE if iE iE iE iE ie iE iE if iE * ie i(-ik 9f iE if iE iE if iE iE iE 1E iE iE if if 9f * 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 8500 REROOF BY VALUE RESIDENTIAL NOZONE 01,00 8,500.00 END OF FEES gl 00154545-0 T 0154546 Til 108.85 AT's 01/31/94 TIME: 09:43 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL PA , 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 Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58, Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P -Trap, ❑ 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. Roof Drains 64. Plumbing System - Final 14. 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑Gas OQil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑Gas ❑Oil 25. Roof Sheathing 2 C( � 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 PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical 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 Domestic -Final ca 42. Backflow Preventer 43. Backflow Irrigation - 44. Landscape Irrigation 0item L'•Y-q (,�,� Gt2�lC 5 K 14; 5hp��i'4`` .'�- 45. Sound AttenuationLe�+wv/� 4 O_ - ` 46. Handicap Regulations T / !D- , ... 6��. 47. FINALSTRUCTUROP8JOIDING Z_f�{.i�t� &u�• 48. FINAL PLANNING 49. Electric Release to EbIstr;M, `- - 50. Gas Release to SoutF}ern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. `Date PRDJWT ADDRESS: 1040 EL CAMINO DR UNIT: ow NE NAME: AD FOLEY, PAUL STEPHEN aoDREss: 6700 W OCEAN FRONT NEWPORT BEACH,CA 92663 ARCH/ENGINEER: NEG.NO.: ADDRESS: UNIT: PERMITTEE: D M MC GAHEY (805)646-0353 ADDRESS: (�.T7jj8�2270 W. EL ROBLAR 99qq LICENSED CONTRACTOR EPUATION: I hereby affirm that I am licensed once rCppm'visi9 s opc&a ,ar 9 (commencing wi h Section 7000) of Division 3 on the Business and Professions Code, and my license is in full force and effect. CITY LID 060 99p STATE LIc.:589272�/ CLASS : B-1 Date: j Y Z Signature:�`—"— WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a candidate of cont to self -ins r a candidate of Workers' Compensation Insurance, or a carolled copy thereof )Section 3800, Lab. C). POLICY NO.: EXP. DATE: COMPANY: ❑ Candied copy is hereby furnished. ❑ Certified copy is filed with the city Building Division, Dale: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred p$lN0rless). I sanity that in the penprmance of the work for which this permit is issued, I shall not employ any person in any n r S ecome subject to the WorkersCompensation Laws of California. - Date: �'— S —/ ! Signature: c NOTICE: If. after making this declaration, you should become subject to the Workers' Cam nsatlon fu ons of the Labor Coi you must forthwith comply with such provisions or this permit shall be deemed fivoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending a r the performance of the work for which this permit is issued (Section 3097, Civ, C) LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance. also requires the applicant lot such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than live hundred dollars ($500). 1, as owner on the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' Stale License Law does not apply to an owner of a property who builds or improves thereon. and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). - I.as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business 1-1noProfessions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B 8 P C. for this reason'. Date: Owner'. I do hereby certify that I am aware of and understand the requirements of California Health and 25534 and that I or any nature building occupant will/will not (circle one) need to comply with s permit for construction or modification from the Air Quality Management District. Residential these provisions. Safety Code Sections 25505, 25533, and aid state codes and the requirements for a construction applications are exempt from Date Applicant: I hereby certify that I have read this application and state and the above information is correct. I ordinances and state laws relating to building construction and hereby authorize representatives of 11 property for inspection purpogses. Dale: — ' Signature: Driver's License or Social Security p: to comply with all CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 065582 PERMIT NO: B 065582 PLAN CHECK NO; 00062-94 S GOVT; N SUPP: N CONSTRUCTION TYPE; V—N PERMIT TYPE; STR PURPOSE; ALT JOB DESCRIPTION ; CONST. 3'X6'8" LAUNDARY DOOR SQ FT: 600 CLAIM VALUE; 600.00 CALC—VALUE; 600.00 GROUP OCC; R-1 / COMMENTS; CLOSE EASTSIDE EXIST. DOOR 6 OPEN A NEW DOOR @ SOUTH SIDE MMM MM M M MMMMMM M M M M M M M M MMM M M M MMM M MMMMMM MMMMM MMM M M M MMMMM M MM M MM MM M M M MM M M M M MMM MMFF M M M Z O N I N GS E R T E B Q A U C I K R S E 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; 14166513 ZNE: R3 REF NO - PLANNING NOTES> RELOCATE EXTERIOR DOOR TO EXISTING LAUNDRY ROOM. M MMMMMMMM MM MMMMMMM M MM MM M M M M M MM M MMMMMMMMMMMMM MM M M M M M M M MM M M M M MMMMMM MM M1rH.if MM M MM M MMM 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 e,• ; I« DATE: BUILDING APPROVED BY ; DATE: APPLICATION ISSUED;BY: CJ DATE: 7 MM M M MM M M M M M M M M M MM MMM M MM MMMM MMM MM M M M MM M M MMilM M M MM MMMM MM M M M M MM MM M MM M M MMMMMMM M M M M M LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 17.00 .50 SMIP/NON—RES PLAN 11.05 ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 17.50 0,00 11.05 28.55 28.55 .00 REVENUE DIVISION TOTALS--> COLLECTED: 28.55 OVER/SHORT; .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 17,00 .50 11.05 M MMMMMMMMMMMMMMMieM iP iE iH Rl MRf M1E iEM if 1E lE Mie BE if MiE iE 7E iEMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM 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 600 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 600.00 END OF FEES '1 0015"279-001532931 TtllIT 22.55 u1;TF_: Di/06/94 TIME= 15:41 !/ CONSTRUCTION AND PLANNING 'r APPROVALS Permit # Date Inspector - POOL a SPA APPROVALS- Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement E(e„ctrlcal Conduit Utility-Undrgrnd. 54. Forms -4' Electrical Condtstt-Undrgrnd. 55. Electrical Bonding S. Steel Reinforcement 56. Rough Plumbing & Pressure Test -,E;Wctrica'UFEFFOrnd. - - 57. APPROVAL TO COVER-GUNITE 7: Footings - 58. Electrical Conduit-Undrgrnd. �8T-Foundation r- 59. Gas Pipe, ❑ Undrgrnd., Test - �q;' Vtlater Pipe-Undrgrnd. 60. Backwash Lines, P•Trap, 0 Undrgrnd. 10. Structural Floor System 61, APPROVAL TO DECK 11. Prdperty Sewer Line,& Ho6se Connection 62. Backwash & Receptor -Final 12. SQ&er Cap - 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing; 65, Electrical -Final 15 Rough Electrical -Conduit 66, Solar System -Final I 16. Rough Electric Wiring 67. Fencing & Access .Approval 1 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning f' _ _ _FIRE_ DEPT. REQUIREMENT N ti APPROVALS Pernirt # t 20. rjio* Factory Fiteplace _ _ _ 21..Ducts, !n-Str=ure, - s _ 70. Ur dergrou7td Hydro 22..Du6g_, Vantiletinj'* 71. Produc4iirig C'G4 ❑Qil 23. GasApe'Rough & Test - - -72. Underground Flush,. • �_-, - - 24.r6tooFFraming• r �13. Undergrnd,'Storage,TackQGas 00R 25, Root Sheathing ,r. 74, Overhead Hydro 26. T -Bar. Ceiling 1StrLwtur4 & tvlgnocoat ,}^ '' 75. ,icy Chemical -, - 27. Frame and Flashi% j•; m ;I-`'QY Lv�' 76. Dry Standpipe X38. Lathing & Siding - '- - 77._FIXED SY5TEAT�tINALs r� _ 9. Insulation ; 78.'�IRE PREY. FINdkL ^ 30. Drywall Nailing fi ALTH''QEPT?REQUYRENENT 11. P,asterBio.vnGoai•79.•FINALINS0•ECTIOtN Y �'• •32 Electrical Power Meter -Final - 80. ~FOOD CERTIFICATE ISSU,I D C - 33. Finq} Electric , r - Notes: - i64.:Finai.Heming & Air Gontf tinning _ - -;r 35. ;KinafGa�!Piperfest 1 1 A'rb' 36. Hood orCanopY • x, ^ r 37. f iniC.Faaiory Fireplace--- # i �38. Fina.-%utnbing- 139.'AaterSerwcetinaT" 40. Gas Service -Final L .4:'rr a 41. Solar Domestic -Fina] ••, _°`' 42. Backflow Preventer ; - - I- . 7 -+ 43. Backflow Irrigation' 4. Landscape Iri patian System 45. ;Sound Attenuation _ "' � ,'< 1 46.-Handirap3legulatigns 4 _ •� . �. T 47.FINA,LSTRUCTURE&BUILDING �Z�`� L 48. PINlL PLANNING 49. Elecliyic Release to Edison < r 150. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date _ r City of Costa Mesa i �C� Building Safety Department CERTIFICATE OF OCCUPANCY NO 1 V C P. O. Box 317 Costo Mesa, California The Building located at 1.040 ED C.=dmo Drive.,Unite Ax BxCe aTA D has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group H i Occupancy. Use of Building £O'urpl= residence with atta6ad 09AM Legal Description, Xat 50, TmCt 39M (See reverse side for Metes and Bounds) Building Permit No. 19023 Electrical Permit No. 19659 Plumbing Permit No. 42960 Floor Load Signs have been installed as Room Capacity Signs have been instaled as required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C. 17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency. (b) A new certificate of occupancy shall be obtained whenever there is a change in: 1) Occupancy classification of a building or portion thereof 2) The number of apartments or guest rooms 3) Ownership If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California Administrative Code, Title 8, Chapter 9, Article 8. Number of apartments— 4 and/or guest rooms ISSUED TO: Building Official D31111w-Bruwiel EaterpriseG by _ Date April ?22 1964. This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Fong Bu34–tM-11-BS-S-B F LICENSED I Applicant to fill in all spaces except those within heavy border lines and.sign all appropHate.declarations. .. CITY OF COSTA MESA CONSTRUCTION PERJVIIT PERMI O: TRACT NO. - LOT. NO. UN1T NOr Duct - Under Ground ' ' . . Project Address /� h E/' � 4_,4 i Jin Backflow Preventer ,� Backflow Irrigation I ELECTRICAL $ Policy No.✓/ / Company ' Certified copy Is hereby furnishetl. Cert Ti d co y I i with the' cit B In Division. �//j 1 yN 94-5 Applican Bathtubs , _ Clarifiers Applicant's Mailing A ly zi/�-�FIVi•0 Date EXEMPTION ORKERS' COMPENSATION DECLARATION (This section need not be completed if the permitlis for one hundred ($100) or less). ' I certify thatiin the performance of the work for, which this permit is issued, I shall not employ any person m any manner so as to become subject to the TYPE OF CONSTRUCTION NEW ADD,- ALTERATION REPAIR' - El ❑DEMOLISH •❑ OTHER Drinking Fountains - yrd^dress Owner's Name kr k -h - '4L_!�./-P!r IPhone' -ry —7 CONVERSION _ t DESCRIPTION OF. WORK/USE OF BLDG. Ap # comply with such provisions_ or, this,. permit shall be deemed revoked. - CONSTRUCTION, LENDING, AGQNCVJ - ' - I herebyjafflrm that there is a construction lending agency for the performance of the work for ,which, This permit - is issued (Section' -3097 Civ. C:) ' Lender's Name / Add7ess [ l0 _ ��') (�]/A - , - l S Main Buildin( Arch/En 9, • License No. TYPE OF PERMIT '❑ GRADING•. FOUNDATION STRUCTURAL, E T Front + _ + ( r I - ' ❑ TENANT ELECTRICAL PLUMBING ❑ MECHANICAL B Address .. -` - _❑ .❑ ❑'OTH ERI' Rear Contractor's Name 'e Phone• - _ 0 g,%i�-S ht Right Address;(mailing)' PROJECT DESCRIPTION S4. FT. ' OCCUPANCY f - �� n // 'L - CO N STRUCTION TYPE 'VALUATION$ S Left City License No. ' �(- 5' CONTRACTOR OECLAAT - ZONE GRADING CU.YDS. ! ACRES I , s Ping. Ref. ' RON 1 hereby affirm that I am licensed under provisions of Charter 9 (Commencmg with section .7000) of 'Division 3 of the Business and Professions Code, and ' Remarks: , $15 �\ my license is in full f rcend. flezd. •_ J + License Clice No: J I I Boiler Date_ Signature _ - Duct - Under Ground ' ' Bar Sink V WORKERS' COMPENSATION DECLARATION' iereby affirm that I have a certificate of consent to self -insure or a certificate I - Workers'- Compensation ,Insurance, -or a- certified -copy thereof (Section '- J800, Lab. C.) /t�z Backflow Preventer ,� Backflow Irrigation I ELECTRICAL $ Policy No.✓/ / Company ' Certified copy Is hereby furnishetl. Cert Ti d co y I i with the' cit B In Division. �//j 1 yN 94-5 Applican Bathtubs , _ Clarifiers ❑'I am exempt under Section B. & P. C. for this reason ly zi/�-�FIVi•0 Date EXEMPTION ORKERS' COMPENSATION DECLARATION (This section need not be completed if the permitlis for one hundred ($100) or less). ' I certify thatiin the performance of the work for, which this permit is issued, I shall not employ any person m any manner so as to become subject to the , Dishwasher Drinking Fountains t $ ' ;moi DO Workers' Compensation Laws of California! I f , . Date Signature Floor Drains Reinspection Fee 'NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation 'provisions of the Labor Code, you must forthwith Floor Sinks - comply with such provisions_ or, this,. permit shall be deemed revoked. - CONSTRUCTION, LENDING, AGQNCVJ - ' - I herebyjafflrm that there is a construction lending agency for the performance of the work for ,which, This permit - is issued (Section' -3097 Civ. C:) ' Lender's Name Gas Service "Outlets ' Interceptors -- Kitchen Sink A. Lender's Address _ - - - OWNER BUILDER DECLARATION 1 ;^ I herebv affirm that I am= exempt from the Contractor's License•Law for the Lavatories _ an •efrom and the basis for. the r 11.5 ,by any applicant for a top Roof 1 Roof Drains ,penalty of not more than five hunurea conarsjt nuul.- , �U I; as owner of the property or. my, employees with wages as their 'sole •compensation, will do the work, and theestructure isnot intended or offered i for sale (Section+7044, Business and Professional Code: The Contractor's Licen Se,Law doesinot applylto an owner of a property who builds or improves thereon; and�who does Such work. himself/herself ogthrough his or her own employees, provided that such improvements are not intended or offered for sale. If,'however, the building or'improvement is sold.wlthin one year of com- plellon,'the owner will have the burden of proving he/she did not build or im- prove far the purpose of sale). , 1 Relnspection�.Fee I , $15 ' SMTP I ' - I I Boiler I� Duct - Under Ground ' ' r 01� ,ISSUANCE Duct - Structural r con- ❑ I, as owner of ;the property, amSe tion 7044, contracting with Professions Tactors to construct the project (Section 7044, Business and Professions Code:The-Co r improves :License .Law does not apply tfor s ch projects'property-who I- builds or improves thereon; antljwhoicontracts for such projects with acon-. tractor(st license pursuant to the Contractor's License Law). I am aware that off their Worker's Compensation insurance should be provided to me.i - - Ducn- Ventilating -'- - — I ELECTRICAL $ Exhaust System ❑ Multiple Ell.proof 1 � $ Firepl/Fact .'Blt. ICBO * I I ❑'I am exempt under Section B. & P. C. for this reason Date Owner 1 I i 1 hereby certify than have reao this application and state that -the above + information is correct. I agree to�Coces mply with all city andicounty ordinan and state laws relating building rr��truction, and hereby authorize repre- { sentatives of this: city, to ter• pof the above-mentioned -propartyfor inspection purpoi �� {�jjj�z I Heating System & Ducting ❑0:100,000 BTU ❑100,000BTI 1 t $ ' ;moi DO r I 1 Reinspection Fee $15 ' ,,S�,'� Signature �L/y'LYn 'tom Date_ Driversd License or SS » ,� I IF 0865-46, rev. 10184 White - Building; Canary - Applicant: Pink - Accounting; Goldenrod - Assessor 0 n Service Sink Sewer Cap; Sewer Conine Solar Collectors ..j. r Solar Piping Solar Tank Swimming Pool w/Spa' Urinal Water Closet .Water Heater " Water Service Planning I FEES ' Issue Fee IANICAL + r Hood or' Type 1 ❑' r ,Canopy Type I I ❑ ' n I Refrigeration System 00100,000 BTU ,0100,000 BTL mperi r I 1 Issue Fee It , $ 3 Automatic W Construction Dishwasher- '- Fan V F.A.U. Fixtures Device Boxes Outlets Switches, Garbage Disposal Generator 00-5 KW L i Reinspection Fee ' Approved By , ",8700- .7/02%86 : Zone 'Accessory Building: • Parking Req./Provided • ELECTRICAL I + 1 Transformer ❑ 1550 KW I 1 C] 50+KIN Meter ❑up to 100 amps Meter_[Iovec100 amps - Sub Panel I i Motors ❑0-1 HP 01'h ,8 Inc. Solar 09-15 HP 016.15+ Microwave + Pole Light Range Sign I ;Sfanding�Sections 1 5 KW I Trash Compactor 0 $15 Issue Fee REQUIREMENTS: i I � I I 1 •n , I °'5:00. TL FEES i i 4 z O N I N G R' E-: Q. M T S 11 1 I SUMMA -97 -OF FEES BUILDING,PERMIT $ ' SMTP $ • PLAN CHECK ; $ PERMIT ' I� PLUMBING 1 $ r 01� ,ISSUANCE $ PLANCHECK i25%, $ 1 I ENERGY-P.C. ' $ I ELECTRICAL $ + GRADING 1 � $ ' PLAN 'CHECK 450%1 $ I MICROFILM j $ MECHANICAL i $ 1 I TOTAL FEE t $ ' ;moi DO PLAN CHECK 125%' $ i + CONSTRUCTION AND PLANNING Date APPROVALS Permit # Inspector POO, SPA - 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 Conduit-Undrgrnd. 55. Electrical Bonding " 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO_COVER-GUNITE - '7. Footings - - 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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. Roof Drains 64. Plumbing System - Final' - 14. 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro _ 22. Ducts, Ventilating 71. Product Piping 71Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas 000 25. Roof Sheathing 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. Electrical 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 7%JALrr-,D 39. Water Service -Final , 40. Gas Service -Final v` R'1 41. Solar Domestic -Final's tri � 42. Backflow Preventer ;;I- n.h i 4�3. Backflow Irrigation 4 44. Landscape Irrigation System 45. Sound Attenuation' rFt �6. Handicap Regulations -}. 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 5$. CERTIFICATE OF OCCUPANCY No Date CITY OF COSTA MESA CALIFORNIA 92626 P.O. BOX 1200 FROM THE OFFICE OF THE DIRECTOR OF BUILDING SAFETY May 18, 1978 Compliance survey of structure at 1040 E1 Camino Drive, Costa Mesa The following items will need to be taken care of in order for building to meet code requirements. Apartment C. 1. Repair bathroom floor 2. Replace step to apartment (stairway) 3. Replace tile around valves at bathtub wall Apartment B. 1. Provide shower stall strainer Laundry Room 1. Remove shelf in front of electrical panel. 30" clearance in front is required. 2. Provide new P/T relief valve for water heater. Drain to exterior. General 1. Repair carport plaster at east and west wall for one hour rating. RICHARD HANHART Building Safety Director L-41 OF : STA MESA* CALIFORNIA 92626 P.O. BOX 1200 FROM THE OFFICE OF THE DIRECTOR OF BUILDING SAFETY June 1, 1978 TO WHOM IT MAY CONCERN: The property at 1040 E1 Camino Drive does comply with the Uniform Building Code to all intent and purposes. An inspection was made on Wednesday, May 31, 1978. Yours truly, WILLIAM B. KU ER Asst. Director of Building WBK:cb W. � 1901,9. ` F,OSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX SIT COSTA MESA, CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT COSTA MESA, CALIFORNIA I0 MAIL ses CITY Garden Grove No530-1160 ARCHITECT IGNEER Walters • & Son NpbR. 3-6700 .LESS 'P36 Heliotrope, Corona del Mar TEL. NO. —' OM 3p15H 17 REAR YARD_ EFT 51 ' RIGHT 10, DESCRIPTION OF WORK X 1 EXTERIOR WALL ` COVERING USE OF BUILDING 5/ 'HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE '[O COM. PLY WITH ALL CITY ORDINANCES AND ST LAWS ELATING BUILDING CONSTRUCTION. SIGNATURE OF PERMITTE AUTHORIZED AG NT FE RECEIVED :9AR 8 196 FINANCE DEPT. APPLICATIOICjFQRCgEFMA MESA BUILDING For Office Use Only I RECEIPT NO. PE{t!/1(111p1 IPI( RECEIVEp BY O CHIYED DATIE155UUMD //�/�� 6 MAP 1 9 10_I BUILDING ADDRESS FIRE ZONE TYPE GROUP APPROVED BY DATE ZONING ZO ` NO. PLAN UBE OF N W BWLDIN LEGAL ' ' •1 O�r 7"?_EBCRIPTION /� A. P. NO. TJ NOTE: NO EAVE OVERHANG SHALL BE LESS THAN SO" TO SIDE 3 REAR P. L. EAVES ALLOWED (U. B. C. REQUIREMENT) YARDSAPPROVED YARDS APPROVED - MAIN BUILDING ACCESSORY BUILDING ( FROMC/L STRE FRONT FT FT. R. SIDE FT. FT, l L. HIDE FT. FT, REAR 'r FT. DISTANCE BET. BET. MAIN R MAIN BLDGS. ACCESS. BLDGS. VAR.# DATE C.U.P. # A APPROVED' APPROVE 3 -g-e3 DATE a SO. Fr. (�sd THH AMOUNT SHOWN UNDER VALUATION IH FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. VALUATION' PERMIT FEE $ PLAN CHECK TOTAL FEE § 5 I Z dU Z Z Q O am C3 J � J r7 � Q Z Q Zm 1 W -10 mZ J W W O= zF- W0 V) CIE -O Z Q U 32773 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 shR — 171Pn1BOO 102 a***S.00 CIISA APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely R I D Y D TE Ec � _ BUILDING D /t �D� DDRESS-�y�'�OWNER //`� ✓ ` L/!i / 'L A.P. NO. MAIL G �pNf^ : -ADDRESS/��TEL. BUILDINGADDRESS ro-- E- NO.CONSTRUCTION TRACT LCITY IBLOCK LENDER .BRANCH OWNER ADDRESS %�� S 14 ARCHITECTTEL. OR ENGINEER N 0. FIRE R7,GROUP ADDRESS ZONE TYPE 'APPROVED q CONTRACTOR i- BY DATE— �� / ADDRESS �( (-.Q-[ �•r�7/�� ^LJ EL /I��¢ya clTv .LL/X j/4 Gcz� or �j' O-7`��CJ ZO - NO. OF PIANS USE OF N BUILDING STATE 'J /' 7� CITY h LIC. NO. f/(i / LIC. NO..�' / YAR SAPPROV ED MAIN BUILDING YARDS APPROVED ACCESSORY BUILDING SIZENO. OF BLOGS. (FROM C/L STREET) OF LOT NOW ON LOT FRONT FT. '�— USE OF / EXISTING BLDG. R. SIDE FT. FT SIZE OF NO. OF NEW BLDG. ROOMS STORIES L. SIDE FT. FT. EXTERIOR WALL COVERING ROOF COVERING REAR FT. -----FT— USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN SLOGS. ACCESS. BLOW. VAR. C.U.P. # DATE APPROVED APPROVED RY _3 ., DATE I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. 1 hereby certify that I am properly licensed as a contractor under SQ. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Divisicn 3, Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business i and Professions Code. Division 31 Chapter 9. Signature of r r % -"� Permittee f :7 VALUATION fl" l% $ % �D `� My PERMIT FEE $ V / PLAN CHECK $ Authorized Agent TOTAL FEE $