HomeMy WebLinkAbout1099 EL CAMINO DR - Building PermitsCITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT /P98-00335
- PERMIT PERMIT NUMBER
(714) 754-5273 Fax (714) 754-4856 PLUMBING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 1099 EL CAMINO DR
Suite No
Vicinity:
Parcel Nunmber: 14162311
Status:
ISSUED -`
Applied:
04/29/1998
Issued:
05/05/1998
Applicant:
FINNEY, MICHAEL
Address:
_
Phone:
• "- Zip:
-
-
-
Owner:
FINNEY, MICHAEL
-
Address
FINNEY, MARGARET
\^�
.COSTA MESA,CA
Phone
-
1099 EL CAMINO DR
'" Zip: 92626
Contractor:.
NOCK•PLUMBING
Address:
11612KNOTT ST
"-)
'
Phones7148951246
:
p _ -
GARDEN GROVE,CA
Zip��92841
'License 707775,
/.o a`
_
WLTE
Arch l Eng:
I
ti
Address:-
.. -
-
Phone:
�
,
-
Zip:
"
- License: _
..
SCOPE OF PERMIT
. rJNSTALL'DISHWASHERt I -i
FEE SUMMARY/
AMT QTY
/t
:AMT/
QTY
- -
- AMT
QTY -
ISSUE FEE
$22.00
-
Laundry Tub / Washer
-.$0.00 ::-0
Sump Pumps
. ' $0.00
0
Backflow irrigation
$0.00 0
Landscape Irrigation
$0.00
0
Swimming Pool -
$0.00
0
Backflow Preventer
$0.00 0
P -Trap
$0.00
0
Trap Primer'
$0.00
0
Bathtub -
$0.00 0
Pressure Regulator
x,$0.00
0
Urinal ' -
$0.00
0
Clarifier System
.$0.00. 0
Process Piping (per 10 ft)
$0.00
0
Vacuum Brkr Bkflow(1-4)-
$0.00
0
Connect (Ice,Soda,etc)
10.00 , 0
Receptors ,:. "
".'
$0.00,
0
Vacuum Brkr Bkflow(5+)
$0.00
0
Dental Units
$0.00 0
Septic Tank -
$0:00
' '01
Wash Basin
$0.00
0
Dishwasher
$8.75 1
Sewer Cap ,for Dem_ o'"
$0.00
-0
_
Wash Basin Set
$0.00
0
Drain, Floor
$0.00 0
Sewer Connect,' i ,r-"-$0.00
;' 0
Waste and Vent System
$0.00
0
Drain, Rainwater
$0.00 0
Sewer Private Line_ `• '
. $0.00 _
_''
-.0 -
. Water Closet (Toilet)'
$0.00
0
Drain, Roof
$0.00/ 0 -
Shower' `- -
- $0.00
0
Water Heater/.`vent
$0.00
0
Drinking Fountain
$0.00 0
Sink, bar
$0.00
0
Water Piping (Inst or Rep.)
$0.00
0
Expansion Tank
$0.00 0
Sink, commercial
$0.00
0
Water Re -pipe
$0.00
0
Gas Earthquake Valve
$0.00 -0
Sink, Floor -
$0.00-
0
Water Service
$0.00
0
Gas (1-4 outlets)
$0.00 0
Sink, kitchen
$0.00
0
Water Softener
$0.00
0
Gas (Over 4 outlets)
$0.00 0
Sink, service/mop '
$0.00
0
OTHER
$0.00
Gas Repipe
$0.00 0 -
Spa (private),
$0.00
0
VIOLATION
$0.00
Gas Service
$0.00 0
Spa (public) -
-'$0:00-
0
PLAN CHECK
$0.00
Interceptors (Grease, Oil) $0.00 0
REINSPECTION
$0.00
0
Interceptors (Sand Auto ) $0.00 0
TOTAL CALCULATED FEES:
$30.75
COMMENTS f SPECIAL CONDITIONS
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In 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 must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate o1 consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit Is issued.
My workers' compensation Insurance carver and policy number are:
Cartier: Policy Number.
(This section need not be completed Il the permit is valued atone hundred dollars ($100) or less.)
❑ I certity that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that i1 I should become subject to the workers' compensation provisions of Section 3700 of the La Code, I shall forthwith
comply with these pro
Applicant Signature: �\ I -�\� Date: 7
WARNING: FAILURE TO SECURE VJORKER.S' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000). IN ADDITION TO THE NST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS 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
Ice and effect. Lic. a Class M
oniractors Signature: I �� Date: I S
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lenders Address:
Signature: Date:
OWNER -BUILDER DECLARATIONS:
I hereby effirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or 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 or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or 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 (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or 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 o1 completion, the owner-bullder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors license Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec.. Business and Professions Code for this reason:
Signature: H - rr--rPe7n. Date:
Owner ID verified by drivers license. � � ❑ Yes} Ej No Drivers License No. Expires:
Verification of Ownership by (type of document, Le. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certity 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 authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Code).
❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certity a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mase Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
....................................................................................................................................................................................................................................................................................
2 Does or will the eDPlicant or present or future builtling occupant need to file a regisirallon form for acutely hazardous materiels? ❑Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
....................................................................................................................................................................................................................................................................................
3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Cade provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
.................................................................................................................................................................................................................................................................................
4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes [INo
....................................................................................................................................................................................................................................................................................
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application aaernitit for such construction or modification
from the South Coast Alt Quality Management District or from any other air pollution control district or agency? UYes U No
(Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits).
............................................................................................................................0-......................-out........-u-nd...........................................................................................................
6 WIII any pen of the fedlity to be consimcted under This permit be within 1000 feet from the outer boundaries of a school? ❑Vas ❑ No
(It yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
............................................................................................................................................................................................................................................................
7 If apermit from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been matle4 ❑Yes ❑ No
....................................................................................................................................................................................................................................................................................
8 (If yes", attach certificate of compliance from me appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the Information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signature Of Leg Owner(s) r
And/Of 4
onzed Applicant Date
GOD" INSPECTIONTYPE gATE III®Al5 CODE INSPECTIONTYPE am ITITIA�
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re -Root 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
2446-48
I _ e
03-10-2009 InspecReporting Request Reorting Page 34
11:53 am Costa-Mesa,�A --C* ty Of
Requested Inspect Date: Tuesday, June 30, 2009
Site Address: 1099 EL CAMINO DR CM
A/PID Information
Activity: P98-00335 Type: PLUM Sub,Type: Status: EXPIRED
Const Type: V -N Occupancy: Use: Insp Area:
Owner: FINNEY MICHAEL
Applicant: NOCK, FON
Contractor: NOCK PLUMBING Phone: 714 8951246
Description: INSTALL DISHWASHER.
Requested Inspection(s)
Item: 150 MISCELLANEOUS INSPECTION
Requestor:
Assigned To:
Action: Time Exp: _
Inspection Histo
Item:
150 MISC
Item:
52 SOIL I
Item:
54 WATE
Item:
56 SEWE
Item:
58 SEWE
Item:
60 ROOF
Item:
62 ROUG
Item:
72 GAS F
Item:
74 BACK
Item:
76 BACK
Item:
78 WATE
Item:
80 WATE
Item:
82 DISHV
Item:
84 LAWN
Item:
88 MISCE
Item:
90 GAS F
Item:
92 WATE
Item:
102 ROU
Item:
108 GAS
Item:
110 SAC!
Item:
116 POO
Item:
120 SOLE
Item:
208 FINA
Requested Time: 08:00 AM
Phone:
Entered By: ZWART_B K
Action: EXP Expired
}t -go -9
REPT131 Run Id: 12231
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
PLUMBING PERMIT
.lob Address:
1099 EL CAMINO DR
Status: ISSUED
Suite No
Applied: 09/26/2000
Address:
Issued: 09/26/2000
Vicinity:
Parcel Nunmber:
14162311
ISSUED BY:
Applicant:
STARK, CHRIS
Address:
7229 VARNA AVE
Phone: (818)407-1247
-
NORTH HOLLYWOOD,
NORTH HOLLYWOOD, CA Zip: 91605
Zip: 91605
Owner: FINNEY, MICHAEL
Address 1099 EL CAMINO DR
Phone:
COSTA MESA, CA Zip: 92626
Contractor:
ALAP ASSOCIATES GP
Address:
7229 VARNA AVE
Phone: (818)407-1247
-
NORTH HOLLYWOOD,
CA
Zip: 91605
-
License: 771905
Arch / Eng
Address:
-
_-
Phone:
Zip
License:
-
SCOPE OF PERMIT
C/O WATER HEATER.
FEE SUMMARY
AMT
QTY
'..AMT
QTY
AMT
QTY
ISSUE FEE
$23.50
Laundry Tub / Washer
$0.00 -
-0
Sump Pump -
$0.00
0
Backflow irrigation
- $0.00
0
Landscape Irrigation
$0.00
•-0
Swimming Pool.
/ $0.00
0
Backflow Preventer
$0.00.
0 -
P -Trap
$0.00
0 ':
' -Trap Primer
- $0.00
0
Bathtub
$0.00
0
Pressure Regulator
$0.00
0
Urinal
'$0.00
0
Clarifier System
- $0.00
0
Process Piping (per 10 ft)
$0.00
0
Vacuum Brkr Bkflow(1-4)
$0.00
0
Connect (Ice,Soda,elc)
$0.00
0 -,
Receptors
$0.00
0
"Vacuum Brkr Bkflow(5+)-
$0.00
0
Dental Units
$0.00"
0
'Septic Tank
$0.00
0
,-Wash basin"
$0.00
0
Dishwasher
$0.00
0
Sewer Cap for Demo
$0.00
0
.. Wash Basin Set
$0.00
0
Drain, Floor
$0.00
0
Sewer Connect
$0.00
0
. Waste and Vent System
$0.00
0
Drain, Rainwater
$0.00
0
Sewer Private Line
$0.00
0
Water Closet (Toilet)
$0.00
0
Drain, Roof
$0.00-
0
Shower
$0.00
0
Water Heater/vent
$12.30
1
Drinking Fountain
$0.00
0
Sink, bar
$0.00
0 -
Water Piping (Inst or Rep.)
$0.00
0
Expansion Tank
$0.00
0
Sink, commercial
$0.00
0
Water Re -pipe
$0.00
0
Gas Earthquake Valve
$0.00
0
Sink, Floor
$0.00
0
Water Service
$0.00
0
Gas (1-4 outlets)
$0.00
0
Sink, kitchen
$0.00
0
Water Softener
$0.00
0
Gas (Over 4 outlets)
$0.00
0
Sink, service/mop
$0.00
0
OTHER
$0.00
Gas Repipe
$0.00
0
Spa (private)
$0.00
0
VIOLATION
$0.00
Gas Service
$0.00
0
Spa (public)
$0.00
0
PLAN CHECK
$0.00
Interceptors (Grease, Oil) $0.00
0
REINSPECTION
$0.00
0
Interceptors (Sand Auto ) $0.00
0
TOTAL CALCULATED FEES:
$35.80
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754.5626
2446-46(6/00)
C
DECLARATIOMS C)
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit Is issued.
I have and will maintain workers' compensation insura9 , as r cured by section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued.
My workers' nsaeon Insurance carder an c r o er are:
Carrier: I Policy Number:
(This section need not be completed if the ermif is v 'u d at o e hundred dollars ($100) or less.)
❑ 1 certify that in the pertormanc oVrh,,cs permit isissued, I shall not employ any person in any manner so as to become subject to the workers'
cempen of C ' I O ald become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
wit these q
plicent
Sig
Date:
W URE TO SECURE W R5 ENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADD TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION S OF THE LABOR CODE, (MEREST, AND ATTORNEYS FEES.
LICENS ONTRACTORS DECLARA
I eby affirn the icensed under p visions Ch pte 9 (commeQring with Section 7000) of Divis' a Business and Professions Co W and my license is in full
force end e . Lia aClass N
Contrac I's Signature Date:
CONSTRUCTION-LENDING AGEN .
❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued, (Sec. 3097, Civil Code).
Lender's Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such pernit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or 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 (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or 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-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractors)
license pursuant to the Contractors License Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certify 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 authorized by this
pernit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, Calitomia Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certity a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at anyone time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
I will thea licent or resent or future buildin occu Oanl need to file a re istration form for aculel hazardous materials? Y
2 Does o pp p g p g y ❑ as. ❑ Na
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet o1
compressed gas at standard temperature and pressure).
.....
........_..........__.........._........._........_........._......._.
_............._................................................. ____....... _... _.................................................................................................... ............................. ............................................ _..............................
3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
apartment of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
...................................................................................................................................................................................................................................................................................__.....................................................................................................
4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
..............................._........._......__....._._............_................................................................... ___....___._....................._.._.—................................ __............................ __............................. _.......... _............. _.......... _...... ...._......
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication apermil for such constmction or modification
from the South Coast Air Duality Management District or from any other air pollution control district or agency? Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
...................................................................................................... ................................................................................................... ............-.................................................................. ..._....................................................................................
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Ves ❑ No
(If yes', the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
..........................................................................................._..... ......... _..._...................................................................._._........................._._.__.............................. ....................................._.............._....................._.........._..............................
7 It a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
._................_._......__.......__..........___.......__.__....._..__......................._._...................................._................................._.............. _.......... _...................... _................................
8 (If 'yes", attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATI� OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state e a ci or in Ices relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection urposes. I gia;,nit to occupy or allow occupancy of any building authorized by this permit until final inspection.
e Own s) to
d/Or ze can Date
CODE I, INSPECTION TYPE PATE INTMALS CODE If INSPECTION TYPE PATE jJTMA
1616 Fixed System Final Fire Prevention 206 Final Mechanical /
1266 Pool Spa Final 208 Final Plumbing a1
200 Final Re-Root 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Buili ing/Occupancy
-I
_-N
ADmRESSX11MUDIN0: 1099 EL CAMINO DR
OMNE�,NAMElFtMcyrN:FINNEY, MICHAEL
ADDREsSFINNEY, MARGARET
1099 EL CAMINO DR
OSTA MESA,CA 9262-55'4'6-4460
APPL. MUM ADDRESS:
UNIT: CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: P 077149 PLAN CHECK NO: N
ARCHITECT OR EMINEER: UC. Ni
ARCH. OR END'S ADDRESS: OMT:
CONmACTORSNANEPACIFIC ROOTER PLUMBING (714)964-4822
caxrRAcrowslluum18437 MT, LANGLEY ST
ADDREss:FOUNTAIN VALLEY CA uCNG; 525932
92708 UNIT; J
LICENSED COMRACTORS DECLARATION: I hereby affirm under penally d perjury Hal am licensed under provlsiona d Chapter 9
(commencing with Section 7ODD) of Dwison 3 of the Business and Parameters Coda, and my license is in full forte and ei
CITY LIC. NO.; va��e�uc.cuss:C36 LIC. NO.: 5 2 5 9 3 2 E�XP/::
Data: 4 - / J / r Connector: �Q, O Ae
r -
OWNER BUILDER DECLARATION: 1 hereby affirm under penalty of perjury thin I am exempt from the Commctas License Law fa the
Idow'vg reason (Sedan 7031.5 Business and Rdessions Cade: Any cry or county whim n mores a permit to construct, titer, improve,
demolish, or repair any structure, prior to ns esuance, also requires the applicenl for each permit to fila a signed statement that he or aha
licensed W nuant to the previsions of Ne Contractors License Law [Chapter 9lcommandng with Section 7000) of Division 3 of the
eand Rofidmmw Gehl or that he or she is Metals therefrom and the basis for the alleged exemplion. My voln d atioSection
5 by any applicant for a eerm4 subjects, the applicant to a civil penalty of her more than five hundred dollen ISSai
1, as owsar of the propeany or my, empktyee with wage as their ads compematon, will do the wak, end Iha structure he lad intended
or offered far "a($mtim 7044, Business and Professions Cade: The Contractors License Lew does rat epplyto an ownerol propend
who builds or improves thereon, and who does such work Nms or hersell or thragh he or her own empbyeea provided that such
prwemema are not intended or dlemd fa sale. H, however, the buikirg or improvement a sold within ate year of mmpldon, the
owner-0uiker will have the burden of proving he or etre did net build or improve fa the Ouryee d sale).
1. as carrier of the property. am exchumey, mmracting with licensed contracture to comead the project (Sector 7D44, Business end
Profaneness Code: The Contractors License Lew does no appy to an owner of pngeny who builds or improves [hereon and who
contracts for such projects with a contmda(s) licensed pursuant to the Connectors Uconsa Law). s+u I
0 1 am exempt under Section: B. A PC., fa this raawn: '-
I do hereby ceniy that I an aware of and understand the requirements of California Health and Safety Cade Sections 25505.255 . ad
25534, and that I or any MUM Duikiny compact will / will not (desk one) need to comply weh raid state odea and the requirements M
a parmn faconstmctioner modification ham the Air arit—ylUmagemxt Daniel. Residential construction applicetionaere exempt from these
pmviaions.
Data: Applicant
WORKER'S COMPENSATION DECLARATION: I hereby, affirm under penalty of perjury one of da folkwirp dadualiona:
have end wilt maintain a cenAicata d consent to each -inure M worka i' commendation, as provided fa by Section 3703of the Labor
Coda, far the maintain
m of the work fa which this penmh n tomi
-.fl I have and aril maintain warrant compensation insurance, m required by Section 37M d the Lobar Code, for the pedamenm d the
X0 won far whtwthis mymawoued.MywakaBO'D n ASSO Mailpol�number am: EXPIRES
Career
Policy Number. NWC211JUVU2 09/24/96
a section need rat be completed y the perms, is for one hundred dollars ISIM] or less.)
tJ I codify that in the pedamexe of IM work fa which this permit o ®uad. I shat) not employ any penin in eery, manna x as to
become subject to Me workers' eomperearbon laws of Crd and agree that 'd, I should become subject to the worked
compensation pmvisiotn d Section 3700 d the Labor Code. I a d1 to with cannot, Ali thea previsions.
Date: Y /�_ f C Applicant: %/,i , VAS
Wam/n�llure ro axon wadrai compxutlon covarsps M ureas 1, of shall ublscf en w oyer m cdmlral penaltlu and
civil paws Meto ons hundred thouuM dollar ($100,000A In addifb m a cast of compsnaar on, ch mspas as provided for /n
Section 3106 of Me Labor Coda, Interest and aMmaye leu.
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of Milian, her them is a construction lending agency, for the
performance of the wak for whim this parva is issued (Sedan 3097, cin. C).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have mad this implication and data that the seems infolmalion is correct. I agate to comply with all city and county ordinances
and state lawn relating to building constacrain and hereby authorize reaesentativx of this any to enter upon the above-mentioned propend
for in,pada,par,imeaJIM MAYNE
Date: L( — / r—Ts
(515146.WP) Wblle-Buildkq A Soley; G.,Rle: Cammy- ppfica t; Rnk-Ramenm: Goldenrod-Asseaor
PERM NO: P 077149
GOVT: N SUPP: N
ONSTRUCTION TYPE: V -N PERMIT TYPE: PLU I PURPOSE: OTH
OB DESCRIPTION REPAIR SEWERCONNECTION UNDER RESIDENCE SQ FT:
LAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
OMMENTS: TWO CLEANOUTS
RhsER6ReH6d�RtdEHt�drRERt�*****RfdEit4t*dtiFRtiERERtiEiE+tdFdf**RE dfdEdfdEdtiEdtlERfif3EiEdfiEdE�-RFiEREdE*RE Rt deRE�*d�dtdr**�*�-�PRt-*�s**
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 ----------
FT IN REAR: FT IN
FT IN RGHT: FT IN
ING REQ: PROV: PARCEL:
NING NOTES>
>
--------- ACCESSORY BUILDING---------
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN
14147504 ZNE: REF NO:
iE dE dE lE iE RF iE RE * 3E IE dE dE 1E'lE dE iE dE dE dE dE dE iE 1E * if RE 1h Rf !F iF irk * * * * SE * RE SE RE Rf iE ih SE 3k 1E 1h 1E 1E if 1E lE lE RE iE 1E lE 1E 1E RE dE iE dE dE iE RE iE RE if iE dE iE iE RE RF 1E ilk
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 DATE:
UILDING APPROVED BY n DATE:
ICATION ISSUED BY: l� DATE: I(�
3E iE 1E 1E iE df RE If -RE RE Rf 1E RE RE dE RE iE 1E7F�F�F3F3F3F�F�F3F�FiF�F iEifiF�3f ��iaf�ic�isr�3F3F dF 1EiE RF RE 34 RE Rf*Rh REif-
LIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
IT 63.00 v
TCOT
258 4=
SMIP/NON-RES
PLAN
o7
ISSUE FEE
20,00 (,R
BUILDING -DIV->
PERMIT
ISSUE PLAN -CHECK L—
= TOTAL
PAID
DUE
TOTALS ---- >
63.00
20.00 ;- 0.00
'-,183,00
83,00
.00
REVENUE DIVISION TOTALS-->
COLLECTED:,
83.00
OVER/SHORT:
,00
BLDG PMT
PLUMBING
ELECTRIC MECHANIC jFIIRE
SMIP/TOT
GRADING
PLAN -CHECK
83.00
v- ,� -
RE 3E 3E'lE dE dE RE * * 1E'IE IE RE dE 1E'IE RE 1E 1F iE iE RE iE iE 1E IE Rf RF iE R(-* Rf RE RE RE R6 RE irk RE RE RE RE RE RE * 1E RE
RE RE SE dERE HE dE iE
1E 1E RE 1E Rf * 1E RE * * RF RE * RE fE * RE RE RE RE 9E RE RE RE
I N D I
V I D U A L'= IF E E --B
R E A K
D 0 W N
TYPE QTY
D E S C
R I P T I OWN
Vn
UNIT
COST
TOTAL COST
PLU 1
BATHTUB
/s r
+7.
)
j
7„00
7,00
PLU 1
SHOWER
i
7,00
7,00
PLU 3
WASH BASIN
7',00
21,00
PLU 2
WATER CLOSET (TOILET') ` 77:00
14,00
PLU 2
FIXTURE
SET/TRAP WENDP���
Kip
7,00
14,00
�D TE�j
�l(�
hl)' 14, }.`lir-5 T: i,
-,
CONSTRUCTION AND PLANNING
'"4 APPROVALS Permit # Date
Inspector
POOL A
"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.•E1ectrical Conduit-Undrgrnd. -
55. Electrical Bonding _
-
5.'Steel Reinforcement.
56. Rough Plumbing & Pressure Test
- 6. Electrical UFERGrnd.
57. APPROVAL TO COVER-GUNITE
.._
7. Footing5
56. Electrical Conduit=Undrgrnd.
,
8. Foundation
59. Gas Pipe, EJ Undrgrnd., Test
9. Water Pipe-Undrgrnd. _
60. Backwash Lines P;Trap, O Undrgrnd. `
10. Structural Floor System
61. APPROVALTO.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_
4-t'j, �iy
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 Heafing & Alt Conditioning
-
w ' -
FIRE DEPT. REQUIREMENT -
APPROVALS' PeFmit # -
20. Rough Factory Fireplace - -
- T,
21. Ducts, in -Structure • - -
- ,�
70. FUnderground Hydro
22. Duffs. Ventilating
_
",`
71. Product Piping ❑-Gas OOil
23, Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
-
' 73. Undergrnd. Storage Tank 0 Gas 0 Oil
25, Roof Sheathing
-
74. Overhead Hydro
26. T -Bar Ceiling (Structural) & Monocoat
-
75. Dry Chemical
•i
27- Frame and Flashing
76. Dry Standpipe _ ' . •- -
28. Lathing & Siding -
-
77,- FIXED SYSTEM -FINAL -
. 29. Insulation
78:FIRE PREY. FINAL
„ r
30. Drywall Nailing
•-
- •_ :HEALTH DEPT. REQUIREMENT -
31. Plaster 6rown.Coat
79. FINAL I,`NVECT,ION
32. Electrical Power Meter -Final
-
80.. FOOD CERTIFICATE ISSUED-
-
33. Fina.( -Electrics
34. Final -Heating-& Air Conditioning
Notes: 4�fj'���-
35. Final Gas Pipe -Test '
„_
36. Hood or Canopy
- -
-
37. Final Factory Fireplace.
5- -I f.J7 ,��fy ��;•- �' -
38. Final -Plumbing
r
39. Water Service -Final
V- F `
40. Gas Service -Final
-41. Solar Domestic -Final•
"' - - te
42. BackflowPreventer -
...
•,. =, _ -
43., Backflow Irrigation
44. Landscape Irrigation System ' _'
'
-r
45. Sound Attenuation
r
46. Handicap Regulatioris
47. FINAL STRUCTURE & BUIEDING
T,
48. FINAL PLANNING:
-
49. Electric Release to Edison
50. Gas Release to Southern California Gas Go
51. CERTIFICATE OF OCCUPANCY
No. Date
(Il'Y OF COSTA MESA
CALIFORNIA 8262&1200
DEVELOPMENT SERVICES DEPARTMENT
BUILDING DIVISION
P.O. BOX 12DD
NOTICE OF PERMIT EXPIRATION
To: Pacific Rooter Plumbing
18437 Mt. Langley Street
Fountain Valley, CA 92708
Project Address: 1099 El Camino Drive
Costa Mesa CA 92626
Date: 5-15-97
Permit: # P77149
Our records show that the listed permits were obtained for property improvement or alteration at
the above address and the project was not properly completed.
The permits were obtained by: ( X ) Contractor
( ) Owner
Name: Jim Mayne Phone:964-4822 License Number:525932
To construct or install: REPAIR SEWER CONNECTION UNDER RESIDINCE
The permits are valid for 180 days from issuance or your last inspection, per Section 106.4.4 of
the 1994 Uniform Building Code. Should we not hear from you within 10 days, your permits
will expire and additional fees will be required to finalize the permit. Your permits will expire on
May 25, 1997
Please be on notice that without a valid permit and required inspections completed, you will have
encumbered your property with an illegal structure.
If you need assistance, please contact THE BUILDING DIVISION, at (714) 754-5273,
between 8:00 a.m. and 4:30 p.m.
77 FAIR DRIVE
Building Division (714) 754-5273 Code Enton�ement (714) 754-5623 Planning Division (714) 754-5245
FAX (714) 754-4856 TDD (7141 754.5244
4. Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
PERMIT Nil TRACT NO. LOT NO. UNIT NO.
PITY OF COSTA IV1E5�1 CONST F3JJCTION PERMIT - ^ P #
Project Address I/�Qv- _
Applicant's Mailin ddress m
Owner's Name � t— one
Address ioFi E.1 GlYllnd
Arch/Eng. License No.
Address
Contractor's Nam Phone
Address (mailing)
City L'stense No.
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing
with section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and effect.
License Class License No.
Date Signature
WORKERS' COMPENSATION DECLARATION
hereby affirm that I have a certificate of consent to self -insure or a certificate
Workers' Compensation Insurance, or a certified copy thereof (Section
00, Lab. C.)
Policy No. Company
BCertified 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 one hundred ($100) or
less).
I certify that in the Performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the
Workers' Compensation Laws of California.
Date Signature
NOTICE: If, after making this declaration, you should become subject to the
Workers' Compensation provisions of the Labor Code, you most 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's Name
Lender's Address —
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the
following reason (Section 7031.5 Business and Professional Code: Any city or
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 Contractor's License Law (Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code) or that he/she is exempt
ierefrom and the basis for the alleged exemption. Any violation of Section
J31.5 by any applicant for a permit subjects the applicant to a civil
enalty of not more than five hundred dollars ($500).
1, 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 Contractor's
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 com-
pletion, the owner will have the burden of proving he/she did not build IT im-
prove for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed con-
tractors to construct the project (Section 7044, Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who
builds or improves thereon, and who contracts for such ormects with a con-
tractor(s) license pursuant to me Contractor's License Law). I am aware that
of of their Worker's Compensation insurance should be provided to me.
I am exempt under Section B. & P. C. f_A this reason
Date
1 have read
I agree to c
I
o building
to enter ,
Signature �a
Drivers' License or
TYPE OF CONSTRUCTION LI NEW'IJ ADD LJ.ALTERATION CJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF—BLDG.
TYPE OF PERMIT LJ GRADING
❑ TENANT ELECTRICAL
❑ OTHER
PROJECT DESCRIPTION SQ. FT.—
CONSTRUCTION TYPE VALUATIONS
ZONE GRADING CU. YDS. AC
J FOUNDATION LJ STRUCTURAL
PLUMBING ❑ MECHANICAL
Remarks:
Bar Sink
Backflow Preventer
Backflow Irrigat' n
Bathtubs
Clarifiers
Dishwasher
Drinking Fountai
Floor Drains
Floor Sinks
Gas Service
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto -Wash
Laundry Trays
A. .
S Main Building:
E
T Front
B Rear
A
C Right
S Left
Ping. Ref. #
Planning Notes:
ES Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Elecl
Fan
F.A,U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator 1:10-5 KW E
Reinspection Fee I $15 I 1 Issue Fee 1$ 3 1 1
Boiler
Duct- Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. Bit. ICBO #
Heating System & Ducting
E10-1 00,000 BTU 1:1100,000
Reinspection Fee I $15
0865-46, rev. 5/88 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor
Hood or Type ❑
Canopy Type I I ❑
Refrigeration System
00-100,000BTU 0100,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
FEES
$ 3
Zone
Accessary Building:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 15.50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter Dover 100 amps
Sub Panel
Motors E10-1 HP ❑ 116 - B
Inc. Solar ❑9-15 HP EI 16 -
Microwave
Pole Light
'Range
Standing Sectio,
5-15 KW I I Trash Compactor
Reinspection Fee $15 Issue Fee
DEVELOPMENT SERVICES REQUIREMENT
Zoning Approved By
Building Approved By
Aoolicition Issued By
SUMMARY OF FEES
BUILDING PERMIT
$
PLAN CHECK
I
PLUMBING
ENERGY P.C.
$
PLAN CHECK
25%
$
ELECTRICAL
$ Z.G .CtJ
PLAN CHECK
50%
$
MECHANICAL
$
PLAN CHECK
25%
$
T
N
G
R
E
Q
M
T
S.
FEES
SMI P
$.
PERMIT
ISSUANcE
$
ENERGY P.C.
$
GRADING
$
MICROFILM
$
TOTAL FEE $ '" ' 00
Qt 000.136602-00036602. Ti
DAT€: 06/29/89 TIME: 15:55
26J10
I 'CONSTRUCTION AND PLANNING
APPROVALS Permit# DateInspector
POOL 'PA
APPROVALS Permit#
-.
Date
Inspector
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location
2. Soil;Pipa-Undrgrnd.
53. Steel Reinforcement
3-,,'Electrical Conduit Utility-Undrgrnd.
54. Forms
'
•'4_Electricat Conduit-Undrgrnd.
55. Electrical Bonding
'
- 5• Steel-Reinforcement
f•
56. Rough Plumbing & Pressure Test
: -
�
,bdctrical LIFER Grnd.
Y1
57. APPROVAL TO COVER-GUNITE
7=,:Footing£
58. Electrical Conduit-Undrgrnd.
7�.+
' 8'-Fo1jndation
59. Gas Pipe, O Undrgrnd., Test
-
9,.Mhei Pipe-Undrgrnd.
60. Backwash Lines, P-Trap, ❑ Undrgrnd.
10. S�,'ucRj'ural Floor System
61. APPROVAL TO DECK
-
;+'l
11. Property Sewer Line & House Connection
62. Backwash & Receptor-Final
12. SevvdP Cap
63. Heater & Vent-Final
+
13. Rooi'Drains
64. Plumbing System - Final
- •14. Rough Plumbing
65. Electrical-Final
_'=r
15. Rough Electrical-Conduit
66. Solar System-Final
16: Rough Electric Wiring
r i<
67. Fencing & Access Approval
117. Rough Wiring Sign
68. APPROVED FOR PLASTERING
,18; Rough Electrical-T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19: Rough Heating & Air Conditioning
i
_
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
20. Rough .Factory Fireplace
.,
21. Ducts, irl:Structure
70. Underground Hydro
22. Ducts, Ventilating
71: Product Piping ❑ Gas ❑ Oil
23. Gas Pipe.!Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing
74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat
75. Dry Chemical
27. 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
r F, if
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
I[Isoct10nS
45. Sound Attenuation
46. Handicap Regulationsaw
pate ..�
47. FINAL STRUCTURE & BUILDING
>'+
48. Special Requirements Completed
49. Electric Release to Edison
/! U
50. Gas Release to Southern California Gas Co
r fir'
51. CERTIFICATE OF OCCUPANCY
No. Date
r
A
Applicant
to fill in all spaces except those within
heavy border lines and sign all appropriate declarations.
7• '
;'CITY OF COSTA MESA. - - -- -
CONSTRUCT,IONPERMIT '.
- ", -
- 4-
z 4e0! Tl.
071. 1'2/ 11 /83
-
PERMIT NO.
— — O Dl ''
TF;ACT NO.
1
LOT NO. -
i
BLD
Project Address' &A
ApphcanYs Mailing Address - '' - a� -
Owner's Name „ ^ Pb e.J S �,
Address. -01 Al ,
Arch/Eng: _ License No `
TYPE'OF CONSTRUCTION. •LJNEw LJADD - 'ALTERATION' "REPAIR •
❑ CONVERSION ❑ DEMOLISH ❑ OTHER- '
e � �
DESCRIPTION OF WORK
t , ., - - _
A.P. # . -
?one'.
S
Main BwlihrSg.
Accessory Building
Z
TXP,E'OF PERMIT . GRADING. ` FOUNDATION ❑STRVCTURAL
❑ TENANT :❑ ELECTRICAL ❑ PLUMBING MECHANICAL 1
BOTHR _ 1 -' -
ElE
PROJECT DESCRIPTION: 54. FT. - •OCCUPANCY
, CONSTRUCTION TYPE VALUATION $
ZONE GRADING CU.VDS. ,ACRES
-
T
Front' -
1 - i t
N
B
A
Rear
-
N
Address
Contractor's Name— _ li6 e 5�� 3 13'
C
K
Right
G i
` -
Address',(mailing) y 'aQ5 S
,�gs/.Z'1
City License'No. �/ V
LICENSED CONTRACTOR DE LARATION
S
Left
'
R
E
Ping. Ref.
Pafk.Fees$' It
O
Remarks:-
I,
Parking Req./Provided'
-
F
1, hereby affirm that 1 am licensed under provisions of�Charter9 (commencing
with iectlon 7000) of, Division 3 of the Business and Professions Code, and
my license is in full force and eft t. '/I�� n
License Cla I �Q •L� e�9�e No. [7
j"!„_`�
_ -
t
Use of Building:
i ,
R
E'
,
PLUMBING FEES
Plan Notes:
9,
a
M
E
Bar Sink ,
ShOw¢fs .-
' _
N
y�-�}g..,•��lll.._Qn
Date- - E Signet
WORKERS' COMPENSATION DEC LA'RATION"
hereby affirm that I have a certificate of consent to self -Insure or a certificate
-`Workers' Compenspation'Insurance; or a'Cartif,"�etl;'copy"thereof Section
-."'300, Lab. CJ o39 N
'Policy No. C_om pony _
1s�y�ertified copy is hereby furnished. '
- Backflow Prevente(i
I
_ Seivice Sink _ _ _
-
I
T
S
Backflow lirigation ' ' 1 Sewer Cap ` - •
ELECTRICAL ,FEES
'
Bathtubs
�:
Sewer Connection
Automatic Washer
'Transformer ❑ 15-50 KW
Or
L9 Certi£ d XXis filed with the city Build' g Di Isio
Date � X3 Applicant-* A,
Construction Pole Sub. 1.
i ❑ 50+ KW '
-
1• Clarifiers Solar Collectors
-EXEMPTION FROM WORKERS"COMPENSA N DECLARATION
(This section need not be completed If the permit is for one hundred ($100) or
Dish VYdshef s !
-
Solar Piping • ^
Cooking Unit '
-
Meter -❑up to`100 amps" Iless).
i'
certify that l the Performance n the work for;as to this Oel u Isissued, to t,
shall not employ any person In any manner so,as to become subject to the
Workers' Compensation, Laws of California.i' 1
Drinkin Fountains
9
-'
Solar Tank j'
Dishwasher
Meter El 100 amps' i
Floor Drains 1,
`
Swimming Pool w/Spa
Dryers ❑Gas'. ❑Electric
'Sub Panel
' - 1
Date. Signature
NOTICE: If, after making this declaration, you should become subject to the
Workers' Compensation. provisions of the Labor Code, you must forthwith
Floor Sinks
Urinal
Fan
'Motors ❑0.1 HP 01'/z- 8 -
Gas Service.: -outlets'
r .
Water Closet'
F.A.U. 1
•Ina Solar'❑9-15 HP❑16-1$+
-
comply with such provisions or, this, permit shall bel deemed revoked. ,
CONSTRUCTION LENDING AGENCY -• I -
1 nt¢!C¢ptore I
Water Heater _
Fixtures
Microwave
•
Ihereby affirm that there is a construction lending agencyfor the performance
of the (work for which this permit is Issued-(Section."3097 Clv. C:)
Lender's Name - _ "' l
Len Ger's Aacross ` '
OWNER BUILDER DECLARATION '' -
Kitcfieri Sink
_
Water Service ,' - -
Device Boxes
Pole;Light l
Lavatories
_ -
'_ ` a'- i
Outlets
Range 1
I hereby affirm that I am exempt from the, Contractor's License Law for the
following reason (Section 7031.5 Business aad.Professloaal Code: Any city or l
county which requires a permit to construct, alter,improve; demolishor,repalr)
any structure; prior to its issuance, also requires the applicant for such permit
to file a signed statementthat he/she is licensed pursuant to the provisions of
the Contractor's -License Law (Chapter 9 -(commencing with Section 7000) of
..:division' 3 of the Business and Professions Code) or that he/she is exempt
�y,refrom and the basis for the alleged exemption. Any,violation of Section
^'31.5 by, any -applicant for a permit subjects the applicant to a civil j
`. ,natty of not more than five hundred dollars ($500). i
I❑ I, • as ownerof thei Property tor,- my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered ,
p—Trap.
p,
Switches
-
.Sign '
-
.Roof,Drains' L 1 1
Garbage Disposal J Standing Sections '
•' V '
- _
Generator 065 KW ❑5-15 KW Trash Corn actor
P l
i :
:Reinspection Fee- .
r -
- $25 ,' Issue Fee„' ' i $ ,3
_
QL1 d' '
Reinspection Fee $25 Issue Fee ' $"3 ,
- 'MECHANICAL
-
'- FEES
PUBLIC SERVICES REQUIREMENTS:
' tb
Zoning Approved By ` Date
Application Approved By I I Date
• ' - j
Application Issued By Date %� /S%��
for sale- (Section 7044, Business and Professional Code: The Contractor's
License Law does not apply to an owner of a property. who builds or improves
thereon, and IWho'does such work himself herself or through his or her own
/ 9'
that such Improvements are not intended or offered for
employees; ever, the
sale. If, however, the building a Improvement proving he within one year of cam-
plebe n, the owner wl11 have the burden of proving he/she did not build or im-
rove for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Cori -
tractors to construct the project (Section 7044, Business and Professions Code:
-The Contractor's, License•Law does not apply to an owner of propertywho-
builds or improves thereon„and who contracts for such projects with a con-
-
Boiler ? T. 1 ' '
, _
Hood or Type I ❑
, -
Canopy i Type II ❑
I
r
Duct -Under Ground
Duct -Structural
Refrigeration System : '
❑0-100,000 BTU 0100,000 BTU
Duct - Ventilating
1
BUILDING�PER MIT $
SUMMARY OF FEES
r
SMIP $
Exhaust System ❑ Multiple ❑'
-
System Repair/Alteration
tractor(s)' license pursuant to the Contractors License Law). 1
❑(Yam exempt under Section B. & P. C. for this reason
PLAN CHECK $ '`
PLUMBING $ '
PLAN CHECK $�
ELECTRICAL $
PERMIT ,
'ISSUANCE $ I
ENERGY P.C. 1 $ `
GRADING $
-
Firepl/Fact. Blt. ICBO.#
Date : • Owner + r
Hereby certify that I have read this application antl state that the above
I n format i on -is correct:'I agree to comply with all -city and county ordinances
Heating System & Ducting
❑0.100, 000 BTU ❑100,000BT
-
and state laws relating to building construction, and her authorize repre-
sentatives of, this c'yi to enter upon the above-mentioned propert for
ins ectipn purposes
P Q�
Signature Date f -a f-_�
Drivers' License or 55 #
PLAN CHECK $
MECHANICAL $
PLAN CHECK $
MICROFILM $
TOTAL FEE i $ • k
-
Reinspection Fee ' $25 Issue Fee $ 3
CMF -0865-46 rev. 7/83- ”"White- Build Ing; Canary '-Applicant;'Pink - Accounting;'
Goldenrod - Assessor- - •'- -
^' - -- -
-•--
_ _ __. _ L .. .- �..
CONSTRUCTIONANDPL NIN '-.
__ POOL 'A-- -
Date•
APPROVALS_ ;Permit # -
inspector-
- ' - -
- APPROVALS- Permit
Date -
Inspector
1Z.1. Temporary Electrical Service -or Pole..;
52. Pool & Equipment Location-. -
-
-2.Soil-Pipe-Undrgrnd. -
-
:
: 53. Steel Reinforcement'
'
t3. Electrical Conduit Utility-Undrgrnd. •
r I
- 54.; Forms'
-.4.'•Electrical Conduit'Undrgrnd.-
55. Electrical Bonding
Steel Reinforcement.
_
56. Rough Plumbing & Pressure Test-
t 6. Electrical.UFER Grnd. _ . ;� =
-
• 57. APPROVAL TO COVER-GUNITE
7..'Footings
,
_ _ _
- 58. ElectricaFConduit-Uridrgrnd. . .
8.'Foundation
_
59. Gas Pipe, 0 Undrgrnd.; Test • '•
9. Water Pipe-Undrgrnd.
'60. Backwash Lines, P -Trap, 0 Undrgrnd.
10: Structural: Floor. System . -
- -
. 61.`APPROVAL•TO DECK -
11. Property Sewer Line & House Connection
_
-
62. Backwash& Receptor -Final
12. Sewei Cap ••:�
r
63. Heater & Vent -Final
13.; Roof Drains
64. -Plumbing System;- Final-
14. Rough -Plumbing
65.••Electrical-Final
-
`15. Rough Electricat=Conduit ' , -
_-
• "'
66.'Solar 'System -Final,
-
-. 16.; Rough Electric Wiring .. I -
�- -
- I,
67.'Fencing.&`Access Approval '
' 17. Rough Wiring Sigri
-
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 i
'
21. Ducts, in Structure ',
70. Underground Hydro
r
' 22. Ducts; Ventilating..
r
,
71. Product Piping'D Gas 00il
23. Gas Pipe -Rough & Test i
I
i
72. Underground Flush
?4: Roof Framirig I
_
73. Undergrnd. Storage Tank 0 Gas 0"Oil
25, Roof Sheathing t
-
_
74. -Overhead Hydro
26' T -Bar Ceiling (Structural) & Monocoat' .-
' I •
- -
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 r !
,
HEALTH DEPT. REQUIREMENT
31! Plaster Brown Coat
i 79. FINAL INSPECTION
32: Electrical Power'Meter-Final r
80. FOOD CERTIFICATE ISSUED
33. Final Electric _ i
f
Notes:
34. Final'Heating & Air Conditioning
•- ` -
35. Final Gas Pipe, -Test
36. Hood or Canopy •
•t
' r " - - -
37. Final Factory Fireplace - !
-
-
38. Final -Plumbing
39. Water Service -Final
40. Gas Service -Final
41. Solae.Domestic-Final
r-
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
I7'
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
'-• -)
-- -
- -- -- - --
l
r
50. Gas Releaseto�Southern California Gas Cc
•,. ,
?
, "
51. CERTIFICAT.EOF,„OCCUPANCY!,
No. ' Date' - - -
-
?0?G
COSTA MESA BUILDING•SAFETY.DEPARTMENT
P.O. BOX 917- COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
TYPE.OR PRINT
COSTA MESA, CALIFORNIA
OWNER, Mesa del Mar Development Co.
ADDRESS 3800 E. Coast Highway
CITY Corona del Mar, Calif No:OR3-4220
CT ORENIGENEERMa CCO Realty Co. NobR3-4220
ADDRESS same as above
CONTRACTOR Macco Realt Company
ADDRESS same as above
CITY same as above
SIZEOF LOT 721 X 97' I ND. OW DP SLUGS.
NON LOTn
USE OF none
EXISTING BLDG.
SETBACK LINE FROM p
CENTER OF STREET- 44 1 EAR YARD28 1
SIDEYARDI LEFT 51611 I RIGHT 51
DESCRIPTION OF WORK
S ZIE DINaG11611X54121 NO ROOMS 6 STORIES 1
EXTERIOR WALL -wood 'I ROOF wood shake
Plan 400-A
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 1S CORRECT AND AGREE TO CON.
PLY WITH ALL CITY ORDINANCES AND STATE.LAWS REGULATING
BUILDING CONSTRUCTION.
SIGNATURE OF
PERMITTEE 7y�YMTacco RealtyOm ny _
AUTHORIZED AGENCl/–
FEE RC sJ!VcL_b'
oLS
APFA�PERMIT
I1Uf{{NGT
..
CI FbrrC6ffi&6Tuse^A6*
j',
RHCHIFT NO.
�p�Jp��{�ryyO
R
D T IHCHIV D
DATEISSUED
%� Z Z G3
JUL 2 4 1963
BUILDING
ADDRESS
FIRE / �/
qi
ZONE TYPE F' GROU
APPROVED
BY DATE
ZONING
ZONENO.
UHE OF NHW
E-1
FLANHOF 2
BUILDING w att gar
LEGAL
Lot 60 Tract 5023
DESCRIPTION )
A. P. NO. none
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
SO" TO SIDE S REAR P. L.
EAVES
ALLOWED (U.'B.C.REQUIREMENT)
YARDSAPPROVED
YARDS APPROVED
MAIN. BUILDING
ACCESSORY BUILDING
(FROM C/LST EET)
FRONT FT.
FT.
R. SIDE FT.
FT.
L. SIDE - FT. 7,FT.
REAR FT. U
FT.
DISTANCE BET.
BET. MAIN S
MAIN BLDGS.
ACCESS. BLDGS.
VAR.#
DATE
C.g.p'#
APPROVED
APPROVED
W.L.D. I
T 7-22-63
dwellinp 1896 1.
garage 483 E.f.
SO. FT.
THE AMOUNT SHOWN UNDER VALUATION ID FOR THE
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
VALUATION
//
PERMIT FEE $ 1P/O'^—�
$
20,288.00
TOTAL FEE �