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Home My WebLink About933 EVERGREEN PL - Building Permits(714) 754-5273 � Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 933 EVERGREEN PL Suite No Vicinity: Parcel Nunmber: 42252112 Applicant: BRUNNING, MIKE' = � �.-,=�;--�. � Address: 2740 E CHAPMAN. � � / . ORANGE,CA, ', " ' Owner:� MAHONEY, JOHN Address 933 EVERGREEN PL PLUMBING PERMIT Status: ISSUED Applied: 05/O6/2002 Issued: OS/06/2002 ISSUED BY: j Phone: 714997-7374 ;^ - , � . . '-� `� Zip: 92860 _ : " - . , .. . . ._ _ . _ � . .. � � , � � , Phone: , � '' COSTA MESA, CA Zip: 92627 � 'Contractor: ORANGE PARK POOL SUPPL�INC' Address: 2740 E CHABMAN � " - ' � _ .. � . � � � Phone: 714-997-7374 � ORANGE, CA Zip: 92860 � License: 544037 Arch / Eng:' � Address: Phone: Zip: Licenset -' - ' - - � _ - . i � ' � r . ' � , _ _ - , �� ;, ; � G �_ • � � SCOPE OF PERMIT ' ' ! �". .` � INSTALL FIBERGLASS SWIMMING POOL, ICBO #ER-3753. 250 S:F. � � � �� i, / :� FEE SUMMARY �, , � �, � AMT�� QTY � AMT �'� QTY = j, � � �AMT QTY ISSUE FEE � �� ' $23.50� _; �- -�, ">� ' Laundry Tub / Washer .'� > $0.00 � -�0=<i �' =`. �"Sump"Pump � " �� ) $0.00 0 Backflow irrigation $0.00 � 0 , landscape Ivigation $0.00 0 - Swimming Pool ;$6075 1 Backflow Preventer � .',$0.00 �0 -� P-Trap ' $0.00 0 ��-Trap Pniner . �� , � � $0.00 0 Bathtub ' ' -$0.00 �_ 0 �� Pressure Regulator ' $0:00 � 0 - �' UnnaL ` <-�"/ ! % � $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) �$0.00 0 Receptors '� $0.00 0� Vacuum Brkr Bkflow(5+) $0.00 0 Dental Uni45 $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 Venl System $0.00 0 Drain, Rainwater $0.00� �� 0.�� - Sewer Privale Line $0.00 � 0 ' ', Wafer Closet (Toilet) $0.00 0 Drain,Roof $0.00 0-. � Shower $0.00 0 „'��WaterHeater/vent $0.00 0 Drinking Founlain $0.00 0 �,' 'Sink, bar $0.00 ��.0, �_ � Water Piping Qnst 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 oullets) $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: E84.25 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access raquirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authorized under this permit to be consitlered legal, such work must comply with all applicable codes, and all requlred Inapections and final approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this pertnit. FOR INSPECTIONS CALL: (714) 754-5626 2aaaas (�voo) WORKERS'COMPENSAnON DECLARAnON: — � " I hereby attirm untler penalty of perjury one oi the following tleclaretions: ❑ I have and will maintain e certificate of consent to self-Insure for workers' compensation, es provitletl for 6y section 3700 of ihe Labor Code, lor Ihe pertortnance ot the � work tor which this permit is issuetl. � . 've and will WOfKBf3 G i, as requirad by seaion 3700 of the Lebor Code, for the perfortnanca of the work for which this pertnit is issued: number ere: � Policy Numberl one hundred dollars ($100) or less.) ❑ I ceM1ify ihat in the pedormance of the work for which Ihis permit is issued, I shall not employ eny person in any manner so es to 6ecome sublect to ihe workers' wmpensaiion laws ot Califomia, and rea Iha� If I should become fubjec� �o t�e workers' compensation pmvisions of Section 3700 of �he Lebor Code, I shall }orihwlih comply with these pW� ion �/� ✓_� 'D � Applicam SignaN'b�� Date: �:7 WARNINO: FNLURE TO S CURE WOiiKERS' COMPENSATION COVERAGE IS UNIAWFUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AN� CIVIL FINES UP TOONE HUNDRED TMOUSAND OOLIARE (8100.000). IN ADDITION TO THE COST OP CQNPENSATION, DAMAGES AS PROVIDED FOR IN SECTIIXJ 3]O60F TNE LABOq CADE, INTEREST, AND ATTORNE`fS FEES. LICENSED CONTRACTORS DECLARATON: I hereby aflirm that I am licensed untler provisic farce and etted. Lic. k Con�teCl0f5 S19n2t� 9(commencing with Section 7000) of Division 3 oi the Business and Professions Cotla, and my license is in tull � Cless # ( � —/�q Date: v �li�=�t�c CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm that there is a consfmction lending agency tor the pedormance of the work tor which this permit is issued. (Sec. 3097, Civil Code). Lentlers Name: Lender's Address: SignaNre: � Date: OWNER-BUILDER DECLARA710NS: I hereby aNirm that under penalry ot perjury Ihat I am E%EMP7 FROM 7ME CONTRAC70RS LICENSE LAW for ihe following reeson (Sec. 7031.5, Business end Professions Cotle: Any ciry or counry which requires a permit to construct, alter, impmve, tlemolish, or repair any strucWre, pnor to its issuance, also requires the applicant for such pertnit to tile e signed sWiemen� that he or she is licensed pursuant to Ihe pmvisions of the Comractors License Law (Cheptar 9(commendng with Seaion 7000) oi Division 3 of Ihe Business and Professions CoOe) or that he or she is exem0� lherefrom and the besis for the elleged exemption. Any violation oi Section 7037.5 by any applicent for a pertnit subjects ihe applicant lo e civil penalry of not more Ihan tive hundred tlollars ($500).): ❑ I, as owner of Ihe property, or my employees with wages as their sole wmpensetion, WILL DO THE WORK, antl the structure is not intended or oNered tor sala (Sec. 7044, Business and Professions Code: The Contractors License Law dces not apply to an owner of propeny who builds or improves thereon, and who does such work himself or hersetl or thmugh his or her own employees, providetl that such improvements are not intentletl or oNered tor sale. If, however, the building or impmvement is soltl within one year of completioq the owner-builder will have Ihe burden of proving that he or she did not build or improve tor purpose of sale.). ❑ I, as owner of Ihe property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRAC70R5 to construct the project (Sec. 7044, Business antl Profeuions Code: The contractors License Law tloes not apply Io en owner of proparty who builds or improves Ihereon, entl who conlrects for such prolact with e contractor(s) license pursuant to iha Contractors License Laws.). ❑ I am exempt under sec. Business and Protessions Code for this reason: Signaiure: Date: Owner ID verified by tlrivels license. ❑ Yes ❑ No Driver's License No. Expires: Venticetion of Ownership by (type of tlocument, i.e. - pwperty tax bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity tha� no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work euthonzed by ihis permit, antl that no building sWdure, scaftolding, falsework, or demoli�ion or dismantling Iheraot, will be more than thirty-six (36) faet hig�. (Chap. 32, Grp 2, Art 2, Sec. 341, 71t1e e, California Adminisiretive Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit irom Ihe Division ot Indusirial Safery, es notetl e6ove, unless such person hes e permit ta do such work fmm tha tlivision. Signawre: Date: DivLsion of Industnal Safety Permit Number: CEHTIFlCATE OF COMPLIANCE AND AUTHOR2ATON OF ENTRY: I cenify under penalry of perjury thai I have read Ihis application and state that ihe inlortnation given is cortect I agrea to comDly with all s;ate laws and ciry ordinances relating to building construction, and authonze representa�ives of t�e Ciry of Costa Mesa to enter upon Ihe abova-described pmperty lor inspection purpases. I agree not to occupy or allow wcupancy of any building authorized by this partnit until finel inspection. J, Sign� Of Le O� /1 ��/ '`� te � l0 V nd/ uthorized Appliwnt � Date COUE �. INSPECTIONTYVE 7616 Fi:ed System Final Fire Prevention 1266 Pool Spa Final 200 Finel Re-Root 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition Q�j� ��5 �fp�d INSPECTIONTYPE 206 Final Mec�anical 20B 210 212 220 Final Plumbing Final Electrical Final Fire Prevention Final Planning Approval 222 Final Site 250 Final BuildinglOaupancy �g �� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT JobAddress: 933 EVERGREEN PL Suite No Vicinity: Parcel Number: 42252112 Applicant: BRUNNING, MIKE�,-:-_� =� � � . Address: 2740 E CHAPMAN': � ��- ' �`;;-� � , -- � Phone: 714-997-7374 ORP.NGE,-CA ' - - ' ' Zip: Ownec /MAHONEY, JOHN_ Address:' �933 EVERGREEN PL - � / ,� . .� ' . . , Phone: � - COSTA MESA; CA Zip: / /�' . Contractoc �% ORANGE PARK POOL SUPPLY INC ,' Address: 2740 E CHAPMAN , .. . ORANGE,CA . � ` 92860 92627 ISSUED BY: Status: ISSUED Applied: OS/06/2002 Issued: 05/O6/2002 �-'Phone: 714-997-7374 , , . ~Zip: 92860 License: 544037 . � � . -i,." �<"` , ' ._ SCOPE OF PERMIT ' � INSTALL FIBERGLASS SWIMMING POOL, ICBO #ER-3753. 250 S.F. � �i . , � ; _r. _, _� �._,� � � _� _ _ . �� ',-,) �� -n � � '.. ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair / Alt Cooling/Heat Inst/�Rep. Recess Wall Htr Re6ig Sys <700 k BTU , Refng Sys >700 k BTU Gas Piping � Factory'Fireplace Hood w/Mech Exhaust VAV Box `�' `. Vent Fan % Single Duct, � Appliance �� Fire Dampers � . Smoke Dampers. � Inst or Relocate Appl Vent Air Handlers < 10000cfm � Air Handlers > 10000cfm Floor Furnace Floor or Suspend Heater Quantity $23.50 . $0.00' 0 _ - � $0.00. 0 �---�- ---- $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 `�� $0.00 0 �V��;.`$000_:� 0:: � .. . � �$0.00 0 ` � � ' �$0.00=; 0 . ' , $0.00 = .0 , - $0.00 0 $0.00 0 $0.00 0 , $0.00 , 0 $0.00 0 Repair / Alt Absorbtion Unit Repeir / Alt Refngeration Unit - Ventillation System - � Evaporative Cooler � Commercial I ncinerator . Domestic Incinerator � � Compressors / Absorption Systems . Upto3hp/100kBTU -' 3 To 15 hp / 500 k BTU ��" � n,'. 15To30hp/1,OOOkBTU �.i=: 30 To 50�hp'/ 1,750 k BTU '�� ,_ �� Over 50 hp LOve�;�,750��BTU "�,-�' , , Boilers ' ' , - Upto3hp 3To15hp ' � � �!��, :15 to 30 hp - ' � . � . � � 30 l0 50 hp � . , � - ' Over 50 hp - . - Other Mechanical Fee , ' Investigation Fee ' PlanCheck.Fee -� , Reinspection Fee _ � .. : ' TOTAL�CALCULATED FEES COMMENTS / SPECIAL CONDITIONS _ '/ Quantity �,� ;.$0.00'� 0 , �„$0.00"` 0/ ""$0.00 0� � � .��;�.$0.00 0� , . �.'- $0.00 0 � �' ; $0.00 �0 - .� $0.00 � 0 u r' � $27.15' r1'. ' $0.00 , 0 � � $0.00.' '0� �� $0.00"�`�:0 $0.00� 0 �',$0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $50.65 NOTICE: The work authorizad by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) � EXPIRATION: 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 requiratl inapectlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 .'..�='.�-`C1:1] WORKERS'COMPENSAnON DECLARATON: � . , I �ereby eHirtn untler penalry of perjury one of the following tleclarations: � � �� ❑ 1 heve end will mainiain a certificata of consent to selt-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, br the padormance ot ihe work lar which this pertnit is issued. , ❑ I have and will maintain workers' compensation insurance, as requiretl by section 3700 of ihe Labor Code, for the pedortnance of the work for whiU this pertnit is issued. My workers' compensation Insurence carrier and policy number are: . Cerrier: Policy Numher: (This sec(ion need not be � mp/eted i! fhe Oertnif is valued at one hunOretl dollars ($100) or less.) ❑ I certity that in ihe peAortnance of �he work for which this pertnit is issueQ I shall not employ any person in any manner so es to become subiect to ihe workere' compensation laws of Califomla, and egrea at if I shoultl become subject to Ihe workers' compensation pmvisions of Section 3700 ot the Lebor Code, I shall totlhwith wmply wiih these provisions. �% �� \ � Appliwnt Signature: �i� ` � �� / Date: WARNIN�: FAILUflE TO SECURE WORKERS' COMPENSATION COVERAGE IS IINLAWPUL AND SHALL SUBJECT AN EMP�OVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAIJD OOLLARE (5100,000), IN ADDITION TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED FOF IN SECTION 3]O60F THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm ihat I am licensetl under pr visions of Chapter 9(commencing with Section 7000) of Division 3 oi �he Businass and Professions Code, antl my license is in full torce antl effecL Lic. a ` Class 8 Coniractor's SignaN : Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aflirm ihat ihere is a construction lending agency for the pedormance ot the work for which this pertnit is issued. (Sec. 3097, Civil Code). Lendefs Name: Lentler's Atldress: Signature: � Date: OWNER-BUILDER DECLARA710NS: I hereby ettirm Ihat untler penalry ot perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reeson (Sec. 7031.5, Business end Professions Code: Any ciry or counry which requires a permit to construct, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires ihe applicant for such pertnit to file a signetl stetement that he or she Is Ilcensed pursuant to the provisions of the Contractors Licensa Lew (Chapier 9(commencing with Section 7000) ot Division 3 of ihe Business entl Professions Code) or that he or she is exempt theretrom and tha basis for t�e allege0 exemptioa Any violation of Section 7031.5 Dy any epplicent for e permit subjects the appliwnt to e civil penalry of nat more Ihen five hundred dollars (5500).): ❑ I, es owner ot the property, or my employees with wages es Iheir sole compensation, WILL DO THE WORK, antl the strucNre is not intended or ofleretl for sale (Sec. 7044, Business end Professions Code: The Contractors License Law does not apply �o an owner of propeM �'ho builds or improves ihereon, and who tloes such work himself or herself or Ihrough his or her own employees, providetl that such improvements are noi intended or ottered for sale. If, however, ihe builtling or improvement is sold wit�in one year ot completion, the owner-builder will have ihe burtlen ot proving ihat he or she did not build or improve tor purpose of sale.). ❑ I, as owner of tha propany, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct tha project (Sec. 7044, Business antl Profeuions Code: The contrectors License Law does not appty to an owner ot pmperty who builds or improves lhereon, and who contrects tor such prolect with e coniractor(5) license pursuant to ihe Contrectors License Lews.). ❑ I am exempt untler sec. Business and Professions Code for this reason: Signature: Date: Owner ID veniietl by drivefs liCenSe. ❑ Yes ❑ No Driver's License No. Expires: Veritiwtion oi Ownership by (rype of document, i.e. - property tax bill or tleetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby cerlify t�at no excevation fiva (5) or more Feet in depth into which a person is required to descend, will be made in connection wlth work euthorizetl by Ihis pertnii, and Ihat no building siructure, scallolding, falsework, or tlemolition or tlismantling Ihereot, will be more fhan thirty-six (36) feet hig�. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle 8, Calitornia Adminisira�ive Code). ❑ As owner-Duiltler, I will not employ anyone to do work which would require a Dermit irom ihe Division ot Indusirial Satery, as noted ehove, unless such person has e pertnit ta do such work from the division. Signawre: Date: Division ot Intlustrial Satery Permit Number: CERTIFlCATE OF COMPLJANCE AND AUfHORVJITON OF ENTRY: I certity under penelry of peryury that I have read this epplication and state that the information given is conect. I agree to compty with all s;ate laws and ciry ortlinances relating to DuilGing construction, antl authonze represeNatives of the Ciry oi Costa Mesa ro enter upon t�e above-described property for inspection purpo . I egree not to occupy or allow occupancy of any buildinq euthorized by Ihis permit until final inspaction. i ure e w r(s) Date And/ rAuthonzetl Applicant Data COOE I, INSPECTIONTViE 1616 Fized System Final Fire Prevenfion 126fi Paol Spa Final 200 Finel RB-Root 207 Final BIocWRetaining Wall 202 . Final Factory Fira Place 203 Final Sign 204 Final Demolition . . _ � 7S�RIIII/15�7 COOEI INSPECTIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Siie 250 Final Building/Occupency. � � � � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: 933 EVERGREEN PL 42252112 App�icane BRUNNING, MIKE Address: 2740 E CHAPMAN - . � _ � � � ISSUED BY: ; .� `" ' Phone: 714-997-7374 ` ' � -� ORANGE; CA"= � ; � , Zip: 92860 � f � + � �`' �/ i � , , ,� i � � i',- - �_, �' �. _ . . , , _ owner: � MAHONEY,�JOHN ` - � � � �� Address' ' 933 EVERGREEN PL `" ' ` - � � � � . ' , - - � � , , i . , � ' , . . . Phone: � , _ . COSTA MESA, CA Zip: 92627 � ' , - - ' " ' `��"" \ , , �� '' Contractor:. , OR,4NGE PARK POOL SUPPL•Y INC : Address: 2740 E CHAPMAN� -� " ' - ' " �� - � . . . _ -;� _ � ., :Phone: 714-997-7374 � .. , . ��y,, . - �� . ',ORANGE, CA � " � Zip: "92860 . : - , , ,�� '„� . - . , ., - License: 544037 ' - , ��_�. -" .� �''y ,, � . , . � . __ �:, . � , . A � � �. .... . Status: ISSUED Applied: OS/O6/2002 Issued: OS/O6/2002 � � . - .- -� SCOPE OF P�ERMIT ,_, . � ; ',,� � � - ✓ �. - INSTALL FIBERGLASS SWIMMING POOL',;ICBO #ER-3753. 250 S_F: ��" �' � �� . - � • , � i • ISSUE FEE � Temp service test � Res. a/c package New Res (1-2 units) � New Res (3+units) Pool / Spa Lighting Fixts - Recept OuUets , Switches�. �-`-, Non Res Appl , ', " Res Appl ` ` l� Service to 200a �. , Service to 1000a � � Service over 1000a � � Motors l0 7 hp � Motors to 10hp Motors to SOhp Motors to 100hp Motors over �OOhp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole FEESUMMARY' ; � Quantity , _ � _ � _ � "t r ` - �, Quantity .' �; �' ' -- $23.50 - � � Temp Dist System / Lighting ' $0.00 0 � $0.00 Busway /100 ft � � $0.00 0 ,1 �� - $0.00 . Standing Section � ,$0.00 0 ' ; - � ' $0.00 0 Misc Eleclrical Equipment $0.00 0' '�,� ,-, $0.00 0 Transformers up to 1 kva/kw $0.00 � 0.' " - $49.50 1 �_-.; _,�' �'.....::ti:.......up to 10 kva/kw $0.00 ,0, %� � . . $0.00 0 ' ` ' � � ..........:....:.up to 50 kva/kw $0.00 � �- 0 ._ � � , . -��$0.00 0 ' � " .............:...up to 700 kva/kw $0.00 �/� � 0 � � " � $0.00 � .. 0 ., - - �• . . .. :..:...........over 100 kva/kw;� : _ , $0.00' �' 0 � , ' ' $0.00 `0; � - � ". "LowVoltageEquipment � �-� -$0.00 0 -� �� i -$0.00 � �. � ` 0 - , " . - " Low Volt Wiring System / Ckt �- '- $0.00 : , � 0 � ' : r � � $0:00 - ;�,; c�Q , Misc. Conduit . - �-'$0.00 '; � 0 �', j� $0.00 � 0 � Misa Conductor ' " $0.00 � , 0 $0.00 o Circus ( gen or ride) � - � $0.00 , 0 , � �� $0.00 0 Circus (mech nde or lights) � � � $0.00 0 � ' $0.00 � 0 , Christmas Tree Stand � ' $0.00 , � �, 0�� . �-$0.00 � �� -0 - Fireworks Stand -- $0.00 �� '0 $0.00, .. 0 �. � � Other Electrical Fee � , - $0.00 -' $0.00 . 0 � ��. � , � . $0.00 ' � - 0 � Investigatlon Fee _ . " �' ��" $0.00 $0.00 � -0 --. , Plan Check Fee ' ' , � � $0.00 $0.00 0 - Reinspection Fee � $0.00 50.00 0 $0.00 0 TOTAL CALCULATED FEES $73.00 50.00 0 COMMENTS / SPECIAL CONDITIONS NO710E: 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 1 BO days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS� In order for ihe work authorized under this permi� �o be considered legal, such work must comply with all applicable codes, and all requlred Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiretion of this parmit. FOR INSPECTIONS CALL: (714) 754-5626 �<•, _.�:nau:n� WORKERS' COMPENSATION DECLARA710N: � I hereby aflirm under penalty of perjury one of the following declarations: � . ❑� I have ana will maimein a certificata ol consent to seli-Insure tor workers' compensation, as provitletl tor by section 3700 of ihe Lebor Code, tor the pertormance of ihe � work tor which this permit is issued. � . wiil maintain workers' compensation insurance, as required by section 3700 of Ihe Labor Code, tor the perfortnance of the work for which Ihis pertnit is issuetl. s' compensation Insuranca carrier antl policy number are: Carner. Policy Number. (This section nee0 no( be comp/efed i/ the permit is velue0 af one hundred tlallars ($700) or less.) ❑�I certiry that in Ihe pertormance of the work for which this pertnit is issued, I shall not employ any person in eny manner so as to become subject to ihe workers' compensatlon laws oi Calitomia, antl egree t it I uld 6ecome sublect to the workers' compensation provisions of Section 3700 oi the Lebor Code, I shall iorthwith comply with these pra �n/s.//� � ��'� � Applicant Signeture: �� A!�-�_�( Date: WARNING. FAILURE TO SECUFE WORKERS' COMPENSATIqJ COVERAGE IS U� WFUL PND SHPLL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND QVIL FlNES UP TOONE HUNORED THOUSAND DOLLAFE (E100,000), IN ADDITION TO THE COST OF COMPENSATION, OAMAGES AS PiiOVIOED FOR IN SECiION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm Ihat I am licensetl under provis' s of Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business and Professions Cotle, and my licansa is in tull force and ettect. Lic. N 7T ��/7 �,F Class q �/� ConiractofsSignaWrB��/N � '+� / Date: l� _/ i 7� .i 46��i CONS7RUCTION LENDING AGENCY: ❑ I hereby aHirm that there is a wnsWction lending agency for the pedormance of lhe work tor which ihis permit is issued. (Sec. 3097, Civil Code). li Lender's Name: Lendefs Address: 'i SignaNre: � Date: OWNER-BUILDER DECLARATIONS: I hereby aHirtn Ihai under penalry of perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for �he tollowing reeson (Sec. 7031.5, Business end Protessions Cotle: Any ciry or counry which requires e permit to construct, elter, improve, demolish, or repair eny structure, pnor to its issuance, elso requires ihe eDD�icent for such pertnit m lile a signed statement that he or she is licensed pursuant to ihe provisions of ihe Contractors license Lew (Chapter 9(commenGng with Sedion 7000) of Division 3 of ihe Business and Protessions Code) or that he or she is exempt therefrom and t�e 6asis for the allegetl exemption. Any violation of Section 7031.5 by eny applicant for e pertnit subjects the applicant to a civil penalry of not more than five huntlred tlollars ($500).): ❑ I, as owner ot Ihe property, or my employees with wages es their sole compensalion, WILL DO THE WORK, and lhe structure is not intendetl or oHeretl tor sale (Sec. 7044, Business antl Professions Code: The Contractors License Law dces not apply �o an owner of properry who builds or improves thereon, antl who tloes such work himself or herseli or through his or her own employees, provided ihat such improvements are not intended or ottered lor sale. If, however, �he building or improvement is soltl within one year of completion, the owner-builder will have �he burden of proving ihat he or she did not build or improve for purposa of sale.). ❑ I, as owner of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consimct ihe project (Sec. 7044, Business entl Profession5 Cotle: The contractors License Law does not appty to an owner ot pmparty who builtls or Improves thereon, and who coNrects for such project with e coMractor(s) license pursuant to ihe Contractors License Laws.). ❑ I am exempt under sea Business and Professions Code for this reason: SignaNre: Date: Owner ID veniied by tlnvafs license. ❑ Yes ❑ No Dnvefs License No. Venfication ot Ownership Dy (type of tlwument, i.e. - pwperty tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: Expires: ❑ I hereby cehify ihat no excavation five (5) or more feet in tlepih into which a person is required to descend, will be matle in connection with work euthonze0 by thls pertnit, and ihat no building structure, scalloltling, falsework, or tlemolition or tlismantling �hereoi, will be more than t�irry-six (36) teet high. (Chap. 32, Gry 2, Ar12, Sec. 347, Titla 8, Califomia AOministrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require e permit irom the Division ot Indusiriel Satery, as noted a6ove, unless such pereon hes e pertnit to do such work irom Ihe diNsion. SignaNre: Date: Division of Industnal Safery Pertnit Number: CERTiFlCATE OF COMPLIANCE AN� AUiHORVJ1T10N OF ENTRY: I certify under penalry of perjury that I have reatl this application antl state thet the intortnation given is wrrect. I agree to comply with all s;ate laws and ciry orCinances relating to building construction, and aulhonze representalives of the Ciry of Caste Mesa to enter upon the above-descnbed property for inspection purposes. I agree not to occupy or allow occupancy of any building authorizetl by this permit until final insDection. —_ g{al�ye Of L I r(s) \ �� J /� � /�y�i� �� l0 An Or uthonzed Applicant �— Date cooe �. n+srecnoNrrve 1616 Fixetl System Final Fire Preven[ion 1266 Pool Spa Final 200 Finel RB-Roo� 201 Final Blwk/Retaining Well 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition . � . �� INi1T1ALS $�QOja INSPECTIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final Eleciricel 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Oaupancy PSIE II�dLS (714) 754-5273 • Fax (714) 754-4056 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 933 EVERGREEN PL Suite: Vicinity: Parcel Number: 42252112 Zoning: Applicant BRUNNING, MIKE Address: 2740 E CHAPMAN � � � � � � � " . - �Phone: 714-997-7374 ISSUED BY: � . ORANGE, CA'. -. ; ' ' , � . - , � Zip: 92860 � � owner. MAHONEY, JOHN � Address ,933 EVERGREEN PL - - � - � � ` . ." . � - - Phone: � .. � i" , -'COSTA MESA, CA � . Zip: 92627 Coniraoror: 'OR,4NGE'PARK POOL SUPPLY INC � Address: 2740 E�CHAP�v1AN Status: ISSUED Applied: OS/06/2002 Issued: 05/O6/2002 �_ � \ _ ' ' . ... . �•� � .� - .. � .�� ; .� �/ j . . ' , � Phone:. 774-997-7374 �' \. , " � , � _ � _ ORANGE; CA ' � �` � � � � � ., Zip: � 92860 � „ ' License:', 544037 � . ._ � � ` � � ,i,� � i � Arch, : � ; !'% � � � ,� ...-'�':. Address: . "' � '' `�,:" . � ��' - , � � ; ,-` • � � ;, ,,.. Phone: � , y' � , ��Zip: � . / � . / Llcense: ' � - . ._ �r:-�st ,7 G' �� 22' LONG X 12' WIDE FIBERGLASS POOL, ICBO # � Plan Check: - '�$145.11 � � Permit: $223.25 SMIP Res: $1.30 SMIP Com: $0.00 Other: � $0.00 Jnspection: $0.00 � '� TotaL• � $369:66 �� ,�_�� ' SETBACKS . MAINSTRUCTURE Front 0-0 ACCESSORY Front 0- 0 PARKING Existin': � 0: NOTES: 1Y �:.�- . � ' �� , ��Rear _ 0-0 . . � E�g: ,. ; ��.-� -'� �.'��t .. �� A�\ _ Address: � � �,� �, � �' � �� `. - �� i �� V Phone� , �, _ �,,. �._ i , - - ��,� i - �� `License: . _ , � �VPE OF PERMIT _ .. " i ' � �753..�,�---- -�...�..��._; �. FEE SUMMARY � - � � � Calc Valuation: �� _ $�a,000.00 , ;; , A - � : � Claim Valuation: �- t" . _� $i3,000,00� ,� � _ ,,;", � � :� . , . >i, � � �� , , �., �� - - �, _ , � . � �,,,.:�,._z -j�, � '/ �PLANNING & ZONING � �� : ` � ,',; � � � i�, /� Left 0- 0 Right , �.0- 0 - � � , � � Rear 0- 0 Lek 0- 0 Right ��0- 0 " i . . . .. '-'/" , Re uired: ' 0 Proposed: 0 ' NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: 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 requlred inspeetlona and tinal epproval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit. POR INSPECTIONS CALL: (714) 7545628 r�..r+.�+(:LS91 WORKERS'COMPENSAnON DECLARAnON: . . . . � I hereby attirm under penalry oi perjury one of the following declarations: � � � � ❑ I heve end will maiptein a certificaie of consent to selt-Insure for worker5' compensation, es provided tor by seclion 3700 of lhe Lebor Code, lor ihe pedortnence ol lhe work for which Ihis�permit is issuetl. ave flnd will maintain workers' compensation insurence, as required by section 3700 of the Labor Code, br the peAortnance of the work for which Ihls pertnit is issued. My workers' compensation Insurence carrier antl policy number ere: � �� r .� Carnec Policy Number: (Th/s section need no! be camp/efed i! fhe permif is velued et one hundretl dollars ($100) or less.) ❑ I cenity that in the peAormance of ihe work for which this pertnit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensatlon laws ot Califomia, antl agree that' h d become subject to the workers' compensation provisions of Sectio 3700 oi ihe Lebor Code, I shell torthwith comply with these provisions � ��/ _ ' � � Applicant Signature: Date: U WAqNINp: FAIWRE TO SECURE WOPKEFS' COMPENSATION COVERAGE IS UNLAWFUL D SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDFED TFIOUSAND OOLLARE (5100,000�, IN ADDRION TO THE COST OF COMPENSATIIXJ, DAMAG AS PROVIDED FOR IN SECTIIXJ 31060F THE LABOR CODE, IMEREST, AND AiTORNEV'S FEES. LICENSED CON7RACTORS DECLARATION: I hereby aflirm that I am licensed untler provisions oi Chapter 9(commencing with Section 7000) of Division 3 of the Business antl Pmfessions Code, end my license Is In tull farce and ettect. Lic. n Cless # � Contracmrs Signaimer Date: � � CONSTRUCTION LENDING AGENCV: � I hereby aMirtn that ihere is a construciion lending agency for the performance ot the work for which this permit is issued. (Sec. 3097, Civil Cotle). Lender's Neme: Lenders Address: Signature: OWNER-BUILDER DECLARATIONS: Date: I hereby attirtn Ihat under penalry of perjury thal I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe following reason (SecJ031.5, Business antl Professions Cotle: Any ciry or county which requires a permit b construct, alter, improve, demolish, or repair any sWcture, prior to its issuance, also requires the applicant for such pertnit to file e signed s�etement that he or she is licensed pursuent to the pmvisions of the Contraciors license Lew (Chapter 9(commencing with Section 7000) oi Division 3 of the Business end Professions Code) or that he or she is exempt theretrom and the basis tor Ihe ellaged exemption. Any violation ot Section 7031.5 Dy any epplicent for a pertnit su6jects the applicem to a civil penalry of not more than five hundred dollers (5500).): ❑ I, as owner ot the pmperry, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intentled or oHeretl tor sale (Sec. 7044, Business and Protessions Cotle: The Coniractors License Law dces not apply to an owner of propeny who builds or improves Ihereon, and who does such work himselt or hersetl or through his or her own employees, provitled that such improvemeNs are not iNentled or oNered for sale. If, howevar, ihe building or improvement is sold within one year oi completion, the owner-builder will have ihe Durtlen of proving ihat he or she did not build or improve tor purpose ot sale.). ❑ I, as owner ot ihe property, am EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to construcl the project (Sec. 7044, Business and Professions Code: The contractors License Law does not eppty to an owner of property who 6uilds or improves Ihereon, antl who con�racls for such pmject with a contractor(s) license pursuaN to ihe Contractors Licanse Laws.). ❑ I em exempt untler sec. eusiness antl Professions Code for this reason: Signeture: Date: Owner ID verifiad by tlrivefs license. ❑ Yes ❑ No Drivers License No. Venficatian of Ownership by (type of tlocument, i.a. - pwperty tax bill or tleed): Eapires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenify that no excavation five (5) or more feet in depth into which e person is required lo descend, will be matle in connection with work euthorizatl by �his pertnit, and ihat no building strudure, scaMolding, falsework, or demolition or dismantling ihereof, will be more than thirty-six (36) feet hig�. (Chep. 32, Grp 2, Art 2, Sec. 341, Trtie 8, Califomia Atlminisirative Code). ❑ As owner6uilder, I will not employ anyone to do work which would require e permit from the Division of Industrial Sefery, as noted ebove, unless such person has a pertnit to do such work irom the divisian. Signature: Date: Division oi IntlusMal Safery Permit Number. CERTIFlCATE OF COMPLIANCE AND AUTHORIZATON OF EMRY: I certity under penalty of perjury that I have read this applicetion and stata Ihat the intortnalion given is correct I agree to comply with all state laws antl ciry ordinances relating to building construction, antl au�honze representatives ot Ihe Clry of Costa Mesa to enter upon the above-described properry for inspection puryoses. I agree not to occupy or ellow occupancy of eny building authorized by Ihis permit until (inel inspection. COOE I• INSPECTIONTYPE 1616 Fixetl System Final Fire Prevention 1268 Pool Spa Final 200 Fin01 F8-Roat 201 Final Blxk/Retaining Wall 2p2 Final FaIXOry Fire Place 203 Finel Sign 204 Final Demoli�ion . �jF INTff1AL5 �]2Zti1 � S I/— _ O�ate «� Date COpE I INSPECTION TYPE 206 Final Mec�aniwl 20B Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site � 250 Final Building/Occupancy ��oww�eNimw 933 EVERGREEN PL OMJERSNWEIiqqWN: HOGART, BRAD KENT woxEss BOGART, MEGAN MOTE 933 EVERGREEN PL OSTA MESA CA 92627650-7395 �rx.■uuw�noxess: �AME ��T CITY OF COSTA MESA — HUILDING PERMIT PERM NO; E 071578 PERMIT NO: E 071578 PLAN CHECK NO: N GOVT; N SUPP; N CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE; ADD u�cxnECTox�aw�x: JAMES GARTNEFt ARCH uc,ra.: C17450 41CI1 ON ENO.'S ADDRE55: N IA UNT: � N/A CA 90000 curtx�crars "•K. cam�croRs �uiwc /iWflES4 uc. xo: uxr: 110EN5ED COMRACTORS DECL,�i1GT10N: 1 Iwroby � m ��a pnnNy ol pe�jury pW I em licenaed uMx pwlelme d C�eqm 9 (oommerwinp wilh Seclion )000) W Oimion 3 d Ihe BusreU end PMeaabre Code. arM mY licenaa w in lull face eM afletl. cm uc. No.: uc. cuss: uc. xo.: EXP ; o�e: � comrea«: OWNEN BUILDEfl DECLRPATION: I hareby alfirm uMx pB�Y d perNrY �� I am examq imm iM Contretlas Lirome law ta iM Idbwip reawn (�� ]�1.5 &roi�a eM Adamims C�: p�Y cry a mumy xfiich mpuiree a pe�mil b mmVucY. Mm.'unprova. �u�� ;'lmann. «,ev� �v a�Naure. c�« w i�s oweMe. el.o rea��ree �ne roWi�am �ar wcn v�u �o Rk e vpnad.w�amem �mm �e «sne l%;�'�en„e w�� o �n, ro.n.o� d m. comrmo�. �o� �w IcnaW� s(o�ma�� ..nn sm� �000) d oH:� a d in. s�"+,�"��ine� eM VMesaions Code� or tlul he w ehe ia ezemq �haehom end Ihe besie ta IM elbpeE axemqion. My videton M Sepion ��r031.5 Ey any eppliranl for e permil wbjem iM eppl'ranl lo e civil penelly d not more Ihen Ma hundred dollen �5500��. . g] I.avownerdlMpropenYamY�DbYes+wahwegasa+IMiadecompenae�bn.willEOlMv.wk.eMiMatrucluree�wlinleMeA «dle�ed la seb (SecUon ]odd.6�nea eM Prdessbna Code: The Comreuaa L'aense lewdoea mt eGPNto en owrer d properry W�IO bll�! IX�IIP�a I�IBIB011. BII� M�1040G8 9Uf�1 Mdy. �1NI8G� M �1B9B�i IX 1�1fp9h �16 Of �Mf OWII B111pp�BBB. plpVbpd �� 9UCh ' pwemama are rot imaMed a atlaeE ta eeb. tl, howewr. iM Witli�q a'vnpavemam ia edtl wnhin ma yeer d compblion, �M1e owner-Witlar will Mva iM WNan d pravi�q M a she d'M nd buiW w imD� la iM W�e d eele). � I. ea ovmer M the prapaM. �%�dusiveH �nireqin0 �h liceneed conVeMae to constriw the qajea (Sed'on ]OI4. Bueirme arM Pea/auiona Code:The Contreaon Lieense Lew doen M epOMto en ownerotpapeny who buiWa a imqwml�erson aM who coMrecle M wM P�Weds wLh a wmrepor(e) licensed Wnuem io �ha CaNretlare Limme law). • fl I em uem Mx B. 8 P.G.. tar N' m+m: �� /�= '� '. ,�,: 9� �... I Ao hereEy ceMiry ihel I em ewere W eM uMenlend iha rea4irameMs o/ C omie VbMh eM Salety Co Seqiona 25505. R5533, end 25534, end ihm I a eny Mure Wildinp oaupent vnll / wdl�w( (orcla are) naeE b compty wYh seiJ tlele ea end �M rayuimmanb lar eDermil lamnevuction a modiRWionhomlMAi�enepeman� Dolritl. Paeidentiel mMrutlun eppFa�'vmue e�emq from Uws Dma: AppliuM: ' WOFKEN'S CONPFHS�TION pECL�HATION: I Mreby elfi�m under yenelly d psjury me d the Idlawirp dedera!oeu: ❑ IheveaMwilmeiMenacerlilicatadomeenllosetlin9�relawarken'wmperreYian.mpwkeE/aby5etlian3)OOd�helnbn coae. t« ma oartm�ce d ma xak �« w:di mb oa^^^ a��°�^a. ❑ � neve ena wi� meimen woMeis� cano�� ,renca. m r.a��e M swim a�oo a u,e �.e« coao. b, me w�wmerwe a m. wark la whid� Mia permn u iaueE. MY ��' �PA^��°^ ir�vurenca umx ud pdiry n�mber ere: c�.�: Pd'cy Number: �rnrs seaiar neee m' ae comd�ee r� w�e o ro. are n��d�ed ediers /siwl or bs,.� Ibf I mnN � in tM paAmnvx.a d �he work la whch �hia peemn is imuetl. I ehell rial empby erry penm m eiry menner ao o to �t� Daeome eubjeet b iha xoekere' eompemetion lewe d Celilomie. enE eprw thm il I slwuW beame wbjxt b � xwken' compenution pmvnbna ol Setlion 9J00 d iM Lebor Goda, I I twthvAh comD ' h Ih ae piqi ' ns. {ome: ��,�9 � j�nwi�m�. Wem/n0� FaNun ro secun woMsn' compsiu�tlon covwPW h unMwNl, ntlllWl iuUJect M Mipl to [IlMivl qMMN eM e�w n�.. w ro o�. n�a�.e mou,.�e ewdn ls�oo,000A �n .eeiwn ro m. oo.� or �omo.�wnon e+m.w. u o.o.lwe ror m Sxtlon JN6 0l Ms laDo� Cotb, Infwss4 aM ettomeyY Isu. �CONSTFUCTION LENDINO R�ENCY: I Mreby elfirm wder penelry ol perjvry Ihm thare ie e mnbmdion bMinp epenry br tM 'aan«m� w ma won� i« .n�� mm re�+ �. m.�ad (sma� aaei. cw. q. LENOEX'S NMIE: LENUEN'3 ADDNE55: I ceniy ihet I heve road Nis eppl'rsibn eM 9ete Ihet IM ebo+e intormnion is coneq. I eprae �o mmply wilh ell dry eM wunry wdiiwime end etete lexv reletng io buikinp ronatrutlion eM hareby e�n�orrze repreaentmivas d Ihie dry b enter upon tM ebova-menlioned pmperry r°`�°�°�`"�°"`P�"g MEGAN HOGART (5151d6.WP) W�ile-Buildiq 8 Seleiy: OrearrFle: Cerery-AppFant: Pink-Hwanue: GdEmro�bseawr JOB DESCRIPTION ; ADD 4465F LIV ROOM, 598SF GARAGE TO EXIS SQ FT; CLAIM VALUE: CALC—C�ALUE: GROUP OCC; R-3 /M-1 COMMENTS: RES:B-70249 if+t***rat**ar**x�it****+tirar**�t*�r�t**et**�3tit�r*****it*it*�t****+�********at*atr*****�t**atat*�*+�rtar Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT; FT IN RGHT; FT IN LEFT; FT , IN RGHT; FT IN PARRING REQ• PROV: PARCEL: 42252112 ZNE: REF NO: PLANNING N6T'ES> i 1F if If if ff fk iE 1f if if 1F M 1E 1f 1f if if 1! 1f if if 3E 1E jt K it aE �f N if if ak iE±f %�f if �f 3f ik iF 1f iF if aF af if if if if If if iF if 1E if �E iE if 1f If 1E 1E if M 1f M iF �f �1(� dE f(� 1f 1f iE aF if 1E aF 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 HY DATE: HUILDING APPROVED BY ; APPLICATION ISSUED HY: ��**�*��***��**�,«*�� LEGALIZATION:N � F E E S U M M A R Y HLDG PMT PLUMBING ELECTRIC MECHANIC PERMZT 18.50 508 PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECFC TOTALS----> 18,50 15.00 0.00 REVENUE DIVISION TOTALS--> COLLECTED• BLDG PMT PLUMBING ELECTRIC MECAANIC 33,50 DATE; DATE; �� *.*�****��***�.�*�� STRUCTURAL SEGMENT;N FIRE SMIP/RES GRADING SMIP/NON—RES TOTAL FAID DUE 33.50 33.50 ,00 33,50 OVER/SHORT: ,00 FIRE SMIP/TOT GRADING PLAN—CHECK M fF if 1f 1f iF k fF if if 1f if k M iF if if 1f it iF �E 1f it M 1E M if if 1f iF if iF 1f 1f 1F if 1f iF if 1f 1! iF iF if M if �F if M if 1M 1F 7f if 1f ff iF if �F i! if iF if �k i! if iF it if iF if 1E 1k 1F 1F Y iE if 1k I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 SEAVICES BELOW 600 V 6 BELOW 201 AMP 18,50 18,50 END OF FEES Ot Qov&Soe-0o173506 TC37 j3i1i; �kT�: paiZ2lS� TFf1E; 1�a�4 „� CONSTRUCTION AND PLANNING �'• ' POOI _ �PA �, Date Inspector Date Inspector � APPROVALS Permii # APPROVALS Permit # 1 7. Temporary Electrica� Service or Pole 52. Pool & Equipment Location,� 2. Soil Pipe-Undrgmd. 53. Steel Reinforcement ' � . �- 3..Electrical.,Conduit U2��V-Undrgrnd. 54. Forms � .r '��4; ElectricaPCooduit-Undrgmd. - � 55. Electrical Bonding . ',. :5. Steel Reinfo.rcement �� • 56. Rough Plumbing & Pressure Test ' �' �� Electricai�ffFER Gmd. 57. APPROVAL TO COVER-GUNITE �� -• '� `�2, �Footingsz; 58. Electrical Conduit�.Undrgmd. : � $. Foundation 59. Gas Pipe, � Undrgrnd., Test - ...F,9; Water Pipe-Undrgmd. �� i 60. Backwash 4fnes, RTrap, �'Undrgrnd. � 10. Stiucturai Floor System �61. APPROVA� TO DECK -' it. Properry Sewer Line & House Connection 62. Backwash & Receptor-Final • � 12. Sewer Cap 63. Heater & Vent-Finai 73. Roof Drains r �64. Plumbing SYstem � Pinal 74. Rough Plum�ing •:� , t.65. Electrical-Pinal �� 75. Rough Electrical-Condutt � � 66. Solar SYstem-Final ' 16. Rough Electric Wiring �' 67. Fencing & Access Approval � � � � � 17. ftough Wiring Sign '68. APPROVED FOR PIASTERING 78. Rough Electrical-T Bar Ceiling ' ��69. P.00GSPA SYSTER1S FINAL 19. Rough Heating & Air Conditioning FIRE DEPT; REQUIREMENT 20. �Rough F,actoiy Fireplace ,�;,? " - � APPROVA'L$: �_, Pe"rmit # � " 27. Ducts, in:StrULture � � •• •� + � _ - _ ' 70.`Undefground Hydro '' 22..Ducts, Ventilati�g`;; ' - � � � �;; .: 71. ProductPipinc� O�Gas ❑Oil . - . .: ,. 23. 'Gas Pipe-Rough & Test � _ � . •'� � •-� 72, Underground Flush � 24. �Roof� Framing� L� -�- " .' _= 73. Undergmd. Sto`rage Tank � Gas ❑ Oil 25. Roof.Sheathing c� � _ . ��; � 7q. Overhead Nvdro � 26. T-8ar Ceiling �Strucfurall & Svlonocoat � �� -� �;,� � 75�. Dry Chemical _,�-' `' ' 27. Frameand Flashing� -�� : r - -- •� . � 7�6. DryStandpipe-•i F � � ; 28. Lathing'& Siding ; ' � �, � "�, 77. FIXED SYSTEM,FINAL . ;,j 29. Insulation '_'� �• � � �• 78. FIRE PREV. F'INXaL � � ' 30. Drywall'Nailing ' i � ' �' �� ';:HEALTN_DEPT. REQUIR�EMENT � _ _ �.i � 37. Plaster B�own Coat �": i n+� � 1 �'�t n FINAL tNSPECTIOF� � :. 32. E�ectrica('Pov✓er Meter-Fina1 �l�� f F`� 8:�FOOD CERTIFICATE ISSUED, ' • 33.�FinaLElectric. , ; N� 6 Notes: 7b- _ ; _ �r•• . 34.'Final:Heatin �&AirConditionin9` - � ; ;� '� •' - -� •� + S `'7 9.. ..,, i . �,�_ 35.•,Final Gas Pipe�Test . .'" .: � . " . _ � � n�„' : 36.�HoodorGanoPY - , ' ' ... � . � � i;� � . '. ..y�,. rn • v�. ��n . 37.��F.inal:Factory Pirepiace • • ,._ : � �° . , , , � 38. Fina��Plumbing �'% � " �'" , ' - i I. `, 39. 4Vater Service�Final . � . � � �` . '' ' ' . � �. � 40. Gas Service-Pinal � C�+' � � !• •- � ' - � [. ; ' � - 41. Solar OomesticFinal • ; .. ; � j ; j t;' y�:� , ., 42. Backtlow:Preventer- � ' : � �� .. r 43. Backflow Irrigation . �" '� -r. :� ., ' ' �O �44. Landscape Irrigation System�'�+i�'` • '�+ �` '" o� �: '�' � " -� �� 45. Sound Attenuation; "''.. '� ' . t; �" ��". �1 ; > �, ..� 46. HandicapRegulations ', � '•". _ �� , . 47. FINAL STRUCTUR,E & BUILDING ; � I I', � " ; , .. 48. FINAL PLANNING• ` ' 1 � ' ,�� , °� � • -^ 49. ElecFiic Release to Edison � ' � �� ' " , � • �� 50. Gas Release to Southem Califomia Gas Co � , � � �� - -� • :. *� • 51. CERTIFICATE OF OCCUPANCY _ . ' . -� - No. Date UNIT: OWNEfl'SNAME: �33 EVERGREEN PL aooaess:gpGAR'I'. BRAD KENT BOGAR'T, MEGAN MOTE 933 EVERGREEN PL COS'TA MESA.CA 9262 % ' AflCHIENGMEEH:6SO— I39S BEG.NO.: aoosess:JAMES GARTNER ARCH C1'�LAifiO N/A PEnMITTEE:NIA CA 90000 aooeess:lAEGAN BOGAR'T ( 714 ) 650-7395 r 933 EVERGREEN PL rn q 7 LICENSEO CONTHACI9A�WPATION: I hereby aHirm Ihai I am licensetl unQetytavisO��Cl�a�ter 9(commencing wi�h Section 7000� ol Division 3 0l �he Business and Professions Code, anA my license is in tull lorce an0 effec�. LITY LIL.: STPTE LIG.: LU155: EXP: oate. Signature: WOFKEflS' COMPENSRTION DECLAflA710N: I �ereby allirm Ihat I �ave a cenificare of consem to sel4insure or a certificate of Workers' Compensalion Insurance, or a cenilietl copY ��ereo� (Seciion 3800. LaO. C�. POLICY NO.: E%P. ORiE: COMPANY: _� Cenified capy is here6y fufni5he0. ❑ Cetlifie0 topY �5 filea wiih t�e ciry Building Division. oate: applicanC EAEMPTION FBOM WORREBS' COMYENSRTION OECLAflATION: (This sec�ian neea no� be compleled if Ihe permi� is far one hunared�$100) ar less). I cetlily Iha� in the Dar�ormance ol �he work �or w�ich this Dermit is i55ue0, I 5 II nol employ a person in any m ner so a5 io 6ecome suti �o � r ers' C mpe ation Laws of Cali�ornia. �' aie'. 9 SignaNre'. IOTICE: Ii. alter making �his Oeclara�ion, you shoultl �ecom subject �o Ihe Workers' C pensa�ion pwvisions ofthe Lahor Cotle. you must lonhwith comply with such pmvisions or t permit shall be Aeemetl voke0. ` CONSTHUCTIDN LEN�INC AGENCY: I hereby allirm Iha� Ihere is a cons�mction lending agency tor �he pedormance oi Ihe work for which �his permit is issuetl (Section 3097. Civ, C�. �- �� LENOEN: aooaess: OWNEB BUILOEP OECIABNTION: 1 here�y a��irm �ha� I am exemp� Imm Ihe Con�mctors' State License Law for ihe followinA �eason (Seqion 7031.5 Business antl Prolessional Code: Any city o� counry which requires a permit Io con5lrucL al�ef. improve. demolis�, or repair any s�mc�ure, prior �o i�s issuance, also requires �he aDPlicant �or such permii lo lile a signe0 statement I�at he/she is IicenseJ pursuam la ihe pmvisions ol ihe Comrac�ors' Sla�e License law (Chapter 9(commencing with Seciion 7000) oi Division 3 0l lhe Business antl Pmfessions Coae) or Ihat he/she is exempl Ihere�mm and Ihe basis lor �he alleBed exemp�ion. Fny violation o� Sec�ian 7031.5 6y any apPlicant for a Dermit sublecis ihe aDPlicanl to a civil penalty of not more Ihan live �undretl tlollars ($500). � I, as awner of ihe vrooehy or my employees with wages as iheir sole compensation, will Oo the work, antl ihe nmmure is not intended or ollere0 for sale (Seaion 7044, Business antl Professional Coae: The Conimctors' State License Law does na� apply lo an owner a� a pmpetly who 6uilas or improves thereon, and who does such work himselAhersel� or ��rough �is or �er own employees, provitletl tha� such impmvemenis are not intendetl or ofteretl lor sale. Ii, however the huilding or impwvemeni is soltl within one year ol completion. �Ae owner will �ave lhe bur0en of pmving he/she tlitl noi builtl or impmve lor ihe purpose ol sale). I, as awner o� ��e pmpeny, am exclusivel9 conirading wi�h licensetl contractaB �o canstmc� Ihe pmjec� (Sec�ion 70d4, Business ❑ antl Pmiessions Cade: The Coniracmrs' Stale License law does not apPly to an owneroi pmperly who builOs or improves ihereon ana who conlracis for sucn prole��s wilh a contractorls)license Dursuan(lo ihe Coniractors' State License Law),I am aware ihat pmol o� �heir Worker'S Cnmpensalion insurance should 6e pmvided Io me. � I am exempl untler Seclion'. B. 8 P. C. i IhiS red5 n: oate� �x /�� Owner �' tlo �ereDy ceNty Iha1 I am aware o� antl underslane Ihe reQuiremenis of Caltlor Health and Sa�ery C Seciions 25505, 25533, antl 25534 antl Ihat I or any Iuiure buil0ing occupanl willlwill no� (circle one) need �o mply with saitl state es antl �he requiremen�s for a permit lor consimction or modification �mm I�e Nu Ouah�y Managemenl DisVic . Hesidential con5imc ion applications are exem0� ��om Ihese pmvisions. �aie'. NpplicanP. I here�y certify Ihal I �ave reatl ihis application and stale ��at ��e above in�armation is wrrecC I agree �o a��inancesands�atelawsrelatingloUuilOingconslruc�ionantlherebyam�orizere0�esemaiivesotthis lo pmperly for m pepion purpo es. /�, ✓ t; � %"/�� Slgnalure' �Orivei's Lirense or Sociai Securi�y x: with all ciry antl cowty Dn �pe above�menli0ned 16aL46 White—Buildmq�, Green—Gotle Enbrcemenl', Canary—Appllcanl; Pmk—Revenue�, Goltlenrod—Assessor CI'PY OF COS'TA MESA — BUILDLNG PERMI'T PERM NO: E 070435 PERMIT NO: E 070435 PLAN CHECK 1�0: N GOVT: N SUPP: N CONSTRUCTION 'PYPE: PERMIT TYPE: ELE PURPOSE: ADD JOB DESCRIPTION : ADD 4465F LIV ROOM. 598SF GARAGE TO EXIS SQ F'T: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: REF: B-70249 iE # if )f If iF if'lf iE af aE'lf if aE if af if'� �f if iE af if iE 7E �f iE 7f iF If iE if lf if'lf if'Jf if �f if iF iF af jE "if If af af IE lf if if'lf if iF if 7f iF'� iF if if if �f iE'If af if if af iE �f If'1E if lf'� if lf Z O N I N G R E(,� U I R E M E N T S S E T B A C K 5 ------------ MAIN BUILDING --------- --------- ACCESSORY BUILDING ---------- FRN'T: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEF'T: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REp: PROV: PARCEL: 42252112 2NE: REF NO: PLANNING NO'TES> > * if if if � aEif if * if if if if iEif iEaf af if iE if if if � 3E iEif � if if if'� *iEif iEiEiE � if iE � aEiEif iE � if if *af iE* if if iEif if ef'� if �* iEif iE� if iEif if iEif *if if if iEif 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 'LONING APPROVED BY _____ DATE: _ BUILDING APPROVED BY : /� DATE: APPLICA'TION ISSUF..D BY: �/ � ➢ATE: �!/ � iE iE iE iE iE iE iE �E jf if 3E iE �f �lE if if iE iE �f iE iE if'if �iE�FiF�F'iF3F 3F'3F 3F'iE$aF'39JF3F3F'3FiF3FiE iFiF3FaF�FiF3E�3F�F3FiE iE iE-lE jE 3f 1E -lE 3f 3f �F'�F" **� iEifififiEiEiEifiEiEiEififjEjEjE3f�E�EiEiEiE•IEiE�%ifiEjElEiEiEiEiEiE�E�E1EiEiEiEiEiEiE�EiEifiEiEiEifiEifiElfif'7EiEjEiflEiEifiElEifiEififiEiE iEiE�kjfiE�EifiE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL EGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE TOTALS----> 42.65 15.00 42.65 5�% 15.00 PLAN—CHECK �. �� SMIP/NON—RES TOTAL PATD DUE 57.65 57.65 .00 REVENUE DIVISION TOTALS--> COLLECTED: �5`/.65 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADiNG PLAN—CHECK 57.65 �� iE if iE if if iEif *if'x iFif if if if if if *** if iE �*if iEif iEaf if if if iEif if iEif if iE *iEif * �f jf if *if if �if if if iEiE*if if if if if if iE iE * if *iE"� iF "�af iEiEiEiE iEiE I N D I V I D U A L F E E B R E A K D O W N TYPE (�'PY D E S C R I P T I O N UNIT COST TOTAL COST ELE 13 FIX'fURES. LIGHTING 1 ST 20 EA. .75 9."/S ELE 12 RECEPT/OUTLE'T 1 ST 20 EA. .75 9.00 ELE 12 RECEPT/OUTLET ADDITIONAL EA, .45 5.90 ELE 1 SERVICES BELOW 600 V& HELOW 201 AMP 18.50 18.50 END OF FEES ! D? ?01738`?—QQ1736`7 Tf C�T 57.5E� DATE: ;2/19l9d iI!7E� 14.04 CONSTRt1CTION AND PLANNING POOL ,. �PA � ` .APPROVALS Permit# Date Inspector p�ppROVALS Pe�mit?k Date Inspector • 1. Temporary Electrical Service or Pole 52. Pooi & Equipment Location 2. ,Soil Fipe�Undr,grnd. 53. Steel Reinforceme�2 3: ElectFica�Conduit Utifity-Undrgmd. 54. Forms 4._�lectrical Conduit-Undrgmd. 55. Electrical Bonding 5. Steel�Rein4orcemenc 56. Rough Plum6ing & Pressure Test 6. ��lec{rica� UFEFt'Grnd. 57. APPflOVAL TO COVER�GUNITE 7. Footing5 -� 58. Electrical Conduit�Undrgrnd. 8: FoundaTi�n � 59. Gas Pipe, O Undrgrnd„ Test " 9.' W.ater PIpe:Undrgrnd. 60. Backwash Lines, P-Trap. �7 Undrgrnd. 70. Structural Floor System 67. APPROVAL TO D"eCK • 11. Property Sewer Line & House Connec.ion 62. Backwash & Retep:er�Fina� 1 Z. Sewe� CaP ._ 63. Heater & Vent-Finai 13. Roof Drains r � ' 64. Plumbiny System � Final t4. Rough Plumbfng- fi5.� Etectrical-Final . � 15. Rough Electrical^Condurt � 66. Solar System-Final 16. Rough Elecvic Wirinq (� ��`��O G 67. Fencing & Access APP�oval (dKC 77. Rough W�ring Siyn 68. APPROVED FOR P�ASTERING 18. Rough Electrical-T Bar Ceiling o9. POOUSPA SYSTE ;4S FINAI 19. Rough Neating & Air Conditioning FIRE DE?T. REQUIREMENT_ ; i �� 20. Rough Factory:Firepiace � � . � _ � ��' APPROVAIS: ��,Permit� _ �'� �..;�� 2i. Ducts; in Siructure •• ' ' : � - `-'�� '70. URdergrdiind,HYdro � -� i, n; . 22. Ducts�,.Ventilaying�:a ''� � - r;;� �7. Producti?ipingG'�Gas, ❑OiI 23. Gas PiPe�Rough & Test ?:. , � �= '. -72. Undergrou�d FIuSh i � •,� .,_ 24. Roof Frarriing ': ' ' ,' � � 73. Underyrnd. Storaye Tank C� Gas ❑ Oii `"' 25. Roo` Sheathing . . -. •�i:: � � �7q, ,Overhead Hvdro � • 26. T-Bai Ce�Iin9 (Struct�uraq & Nlonocoat - � _ � ' 75, .�pry Chemical _ , , , " �,� ��'=', I 27. fiame and Hashing, : -. � . . � K> � 76. Dry StandPipe, �c; �. �. . . � ' . 28. Lathing&�Siding . . - - � ': ...;� 77..-fIXEDSY5TEb1�F�NAL'., . � �, 29. Insulation. - .. •• � � �= 78..FIftE PREV. FINAL'" - �� - 30. Drywall Nailing ' � ` _ HEA'�.TH DEPT. REQUiRE11��iJ_F' 31. Plaster Drom�n,Goat 4 .. J9, FINAL WSRECTION � .- � � - � 32. Electrical Pow`e� MeterFinai -� /�� . FOOD CERTIFICt'lTE ISSUED ,. <- � _ � ,, i. x 33. Final"Electiic- � -,; f� /{�.�5 Notes:.. . --� � � �� - 34. Finai'H¢atin9 & Air Eonditioning 1- � N � . . • ' � �1 - ... - .� � : +t , c,? . . _ 35. FinalGas�Pipe,Test ti°'' ,' ' � � ' ' :j�, ' ' •_ 36. Hood�or CanoPY " -. - . � . > : , . .'_ ' i !" :7 , r. ..Ctl. _ 37. Final� Factory Fireplace . � . x . . -,- ' '".;. ' � 38. Final Plumbing .- .. . .� , � :- .. ^ . _ --- � 39. Water Ser'vice�Final M � " . �"` -: - . . � � � , _ - 40. Gas Service-Final . - -.- - ,, ; � � � � :��t� :r,: � �. � �- 41, Solar pomestirFinal ' ' - "' � ' .., � . 42. Backflow,Qreventer . �. . . -• -i � 43. Backflow Irrigation - :� , ' „� �'' "` U .. '-, � ' K� - , - 44. l.andscave irsigation System � �;.�.�. - � -, - �� . ;�� , , . 45. Sound Attenuation"' �'��` - � -' +'�' ' - ', `' . „ , . . � r� - F t 46. Handicap Regulations . . .' � . �. • _ . . � a7. FINAL STRUGTURE & BUILOING ' ":� � `' •'= �• 46. FINA�LPLANNING! . `��_ K J � � � ;,� -� �, i. 49. Electric Release to Edison � � �- � • � �- ' 50. Gas Release to Southem Ca6fornia Gas Co ' . _ �� ' � . c� . _ - � � � - 51. CERTIpiCATE OF OCCUPANCY > ; i , . . - . . - No. Date PHOJECT ADOflESS: 9 3 3 EVERGAEEN P L ' • uNir: OWNEH'S,�PME: nooeess:BOGAR'T. BRAD KENT ` BOGART, M�GAN MOTE 933 EVERGREEN PL COSTA MESA.CA 92627 650-7395 FflCHIENGINEEfl:JAMES GARTNtiR ARCH AEG.NO.:CS%�TSO ADOflE55: N� A U I. PEPMITTEE:MEGAN BOGART CA 9000014 ) 650-7395 p00NESS: fj33 EVF.RGREEN PL C.M. CA 92627 LICENSE� CONTflACTOP OECLAHATION: I here0y allirm �hat I am Iicen5e0 un0er provisions o� ChaO�er 9(commencing with Seclion 7000� of Oivision 3 of Ihe Business antl Pmiessions Cotle. ana my license is in full torce an0 efiect. CITY LIC.: STATE LIC.: CUSS: E.XP ; �ate SignaWre'. WOFREflS' COMPENSRTION DECLABATION: I hereby a��irm that I have a cerlilicaie oi consenl �o selt-insure or a certilicate ot Workers' Compensaiion Insurance. or a certilied coDY �hereoi (Section 3800. Lab. C). POLICY NO.: EXP. DFTE: COMPRNV: ❑ Certified capy is hereby fumishetl. ❑ Certilietl copY is �iletl with Ihe ci�y BuilOing �ivision. Oate: NpO�icanP. E%EMPTIONFBOMWONNEXS'COMVENSATIONOECUPRTION: �Thi55eclionneednot�ecompleteOillhepermitisfaronehunOre0�5100�orless�. I ce�ily Ihal in ihe peAormance ol �he work for whic� Ihis permii is i55ue0, I shall no� employ any pe�n in any manne� as to become sublea� � he Worke s' Co pensa bn Laws of Calilomia. . �ate'. � SignaNre: NOTICE: II, afler making Ihis tleclara�ion, you should become s lec� �o �he Workers' Com sa�ion pmvisions of Ihe Lahof Coee. you musl fatlhwith comply with such pwvisians or this mi� shall be tleeme0 re d. CONSTBUCTION LENUING RGENLV: I hereby aifirm that t�ere is a wn5lmction lending age cy for the petlormance o� the work for whith this permil is i=suetl �Seciion 3097. Crv. C�. . LENOEH: AOOflE55: CI'fY OF COSTA MESA — BUILDING PER1dIT PERM NO: P 07043- PERMIT NO: P 0%043"1 PLAN CHECK NO: N GOVT: N SUPP: N CONSTROCTION TYPE: PERMIT TYPE: PLU PURPOSE: ADD JOB DESCRIPTION ; ADD 4465F LIV ROOM, 598SF GARAGE TO EXIS SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: REF: B—"/0249 ADD 2 HOSE BIBS �****��***iE***�**�*�*�**�******x***�**�****��****��**��rx��*�*�****�*�-�*��*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; F'l IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGH'T: FT IN PARKING REQ: PROV: PARCEL: 42252112 ZNE: Rk:F NO: PLANNING NOTES> � jE iE �lE lE �3E iE iE iE iE �lf iE if �IE iE iE 1E iE iE � if if iE iE if if iE jF iE iE if if iE iE if iE iE iE iE iE iF iE iE iE �lE jE 3E dE jE �E iE jE iE iE iE iE �lE jE �lf iE iE #�)f )E jEiE �lE �� jE �E iE �lE iE �lf iE �� lE iE iE iE D E V E L O P M E N T 5 E R V I C E S" R E Q U I R E M E N T S ZONING APPROVED BY � DATE: BUILDING APFROVED BY : . DATE: APPLICATION ISSUED BY: �� ---- DATE: /[ �� P� F i F 9 i I �EiEiF*iEiEiEiE�7EiEiEiE�1E�EiE9EiF3E�lEjEIE�lE7F�F'��'3F��f�'iF ��FiF�'iFiE��F�F'iFiEiEif�fiFiFiEiEjF�P}if�� iEiE iEiEif7EiE'��lEiE-IEiE1EiE�lf�lE�lEiE-lE1FiEiE�lE�lfiEiE�7f�lfiEifiEiE�lEjEiE�lf-0fifiEiE�7f�lfiEiEiEiEiEifiEif�lfiEiEifiEifif�lEif#�IfifiE�lEiEififiElfif�EiEifif if�lE�1EiE�%-lE LEGALIZATION:N F E E 5 U�M M A R Y STRUC'TURAL SEGP9ENT:N OWNEFBOILOEflOECLAHPTION: Iherebya�firmlAa�lamexempllrom��eContractor5'StateLicenSeLawiarthefollowingreason BLDG P�'9'f PLUMBING EL$CTRIC MECHANIC FIRE $MIP/R$$ GRADING (Seclian 7031.5 Business and Pmlessional CoOe: Any city o� counry which requires a permi� �o cons�mct, al�er, impmve, demoli5h, or p ERMI T 4 0. 00 . � repair any Slruc�ure. pnor �o i�s is5uance. also requires lhe aOPlicani for such permrt �o hle a signeJ slaiement IAai he/she is licensetl 2 5% � � SMI P/ NON—RES pursuant �o �he pmvisions ol i�e Conlraclors' State License Law (Chapter 9(commencing with Seclion 7000) of �ivision 3 of the Business and Pmlessions Catle) or Ihai he/s�e is exemp� �here�mm anOlhe basis for Ihe allegetl exemp�ian. Any viola�ion ol Sec�ion 7031.5 Uy PLAN ' any applicani �or a permi� su�lecls Ihe applican� ta a civil penal�y ol no� more �han �ive huntlred dollars ($500�. I e�+$UE F`EE 2 �. � 0 ��t I, as owner of ine pmpeny or my employees wim wages as their sole compensalion, win Uo the work, antl me BUILDING—DIV—> PERMIZ' IS$UE FLAN—CHECK .y s�mclure is nol intentlea or olferetl tar sale (seclion 7044, 6usiness ana Pmtessional Code: 7he ConVac�ors' Sta�e License Law TOTA LS --- — i 4 0. � � 2 �. 00 �. �� tloes nol aDPly to an awner ol a pmpetly wAo Uuiltls or impwves �herean,,-ntl who does such work �imseli/herself or Nroug� ', Ais or her own employees. pmvidetl �ha� such impmvemen�s are no� ime6�tl or o�fereJ lor saie. I�. however lhe builtling or impmvemem is so�a within one year ot camvleiioa �he owner wi�� have the bumen o� pmving he/she aia not 6ui�0 or impmve R EV ENUE D I V I S I ON TOTA LS -- � COLLECTED :, mrmePurPoseo�sa�el. BLDG PMT PLUMBING ELECTRIC MECHANIC i as owner oi ine PmPeny am excwsi�ei contracting witn iicensea comracmrs m constmct ine proiect (Section 7oaa eusiness ' 6 �. 00 � -- TOTAL PAID DUE ` 60.00 60.00 .00 / 60.00 OVER/SHORT: 00 FIRE SMIP/TOT GRADING FI.Atd—CHECR ❑ antl Prolessions Code: TAe Con�mclors' Slale License Law does nol appty to an owner oi propehy who builOs or improues �hereon � antlwhocantrac�s�arsuchprolectswiihaconlracbr�s)Iicense0ursuant�o�heContracmrs'S�ateLicenseLaw).lamaware �..��..�*.�*.X..�.�.�**.�***.�.�.K..�.�.�.�.x..�.�.1E.7E.1E.1E.�.1f.IE�.1f.1f.If.lEiE.lE.1f.1f.1f.lE.lf.lf.lf.lEk�4.1Ejf.x.jEj4.1f.1F.�.IE.IE.lE.IE*.If*.If.If.lE.iE.lf*�f.1fjE.�.1E.lf.IE ihat pmo� of their Worker'S Compensa�ian insurance should 6e DmviUetl �o me. � I am exempt untlei Seclion'. B. 8 P. C. � lor Inis reaso - n/�); `/ tar_'. �'�l�%/—�T Owne. � .0 � I Do here�y cenily I�ai I am aware ol antl un0er5tan01�e requiremenis of Calilor Healih and Safety Co e eclions 25505, 25533, and 25534 an0 Iha� lor any�uture �uiltling occupan�will/willnol (circle one) neetl�o mply w�ih sai0 state c d and the requirementsfor a permit for cansimc�ion or moddica�ion �mm �he Nir Ouahty Managemen� Oisiri . ReSideniial consimc�ian apPlica�ions are exemp� tmm ihese pmvisions. Oa�e: qpplicanl'. I here6y certilythat I have reatl��is applica�ion and stale�ha� Ihe above inlormaiion is correcl. I agreeta campty wiih all ci�y and coun�y or4inancesantl5la�elaw5relatingloOuiltlingconstmclionandherebyauthoritere0��$enia�ivesolthisp�y�o¢nteruponlheabove-mentionetl pmpeny br inspgction purpa5e5. i � f// // `/ � Signalure: _ oriver s Lmense or Sociai Securi�y a: t6at�a6 WM1ne—Builtling-, Green—Cotle Entorcemenl', Goltlenratl—Assessor I N D I V I D U A L F E E - B R E A K D O W N TYPE OTY D E S C R I P T I O N - ,.� UNIT COST TOTAL COST PLU 1 LAUNDRY TUB OR WASHER 7.00 "7,00 PLU 1 WATER HEATER AND/OR'VENT 7.00 7.00 PLU 1 GAS PIPING SYS OF 1 TO 4�OOTLETS 5.00 5.00 PLU 2 FIXTl7RE SET/TRAP W/PIPING &;BACRFLOW 7.00 14.00 PLO 1 REFAIR/ALTER DRAINAGE/VENT PIFIidG l.00 7.00 END OF' FEES. ' 01 �D1�3b`5-�QI?3b:-8 'i'O T bC.�C1 DRTc: �2ii9/44 i'I�IE: 14:Qfl r. ^.�ONSTRUCTION AND PLANNWG POOL'& SPA I `• APVROVALS Permit �`r Date Inspector pppROVAIS Permit �k Date Inspector I � '�. TemporarY Electrirai Service or Pole 52. Pool & Eqoipment Location 2. Soi) Pipe-Undrgrnd. � 53. Steei Reiniorcement r 3.�ElectricafCond6h tlUlity-Undrgrnd. 54. Forms � 4�EI2ct`rical Conduif-Undrgrnd. 55. Electrical Bonding .5. S[ee��Reinforcemenc 56. Rough Plumbing & Pressure Test 6'=;TStecFncaiZJFER.•67nd. 57. APPROVA�TOCQVER-GUNITE ; I -. . , . =:7. Fbotings � � 58. Electrical Cor.duit•Undrgrnd. , '8_ �:oUndation ' 59. Gas Pipe, C Un�rgrnd., Tesc ' _9 � Water Pipe�Undrgrr�d. ! 2_Zz 53 _,!�// 60. Backwash Lir,es, P-Trap, � Undrgmd. l l ' �Y! 10. Strucwral Floor System 61. APPROVALTO DECK ? 7. Propeity Sew� �ine & House Connectio� 62. Backwash & Re.�`eptor-Final 12. Sewer Cap . 63. Heater & Vent-Final 73. Roof Drains ' , �� -� 64. Plumbing Sys2em � Final 74. Rough Plumbing� � � �� .�5 65. Electrical-Fira� � 15. Rough Electriral=Conduit 66. Solar System-Final � 76. Rough Electric,Wiring � 67. Fencing & Access Approval 77. Rough Wiring Sign 68. APPROVED FOR P�ASTERING 78. Rough Elsctricai•T Bar Ceiling 69. POOUSPA SYSTEPAS FINAL 79. Rough Heating & Air Conditioning � _FIRE DEPT. FiEQUIREMEN7 �, :_ _, � 20..Rough FactoiY Firep!ace ,`r' �� ; ` - '.,� ' 'APPRQVALS1,��Qermit� " � y- �'�-, 21. Oucts,in.Struttu�e��; �� ^ � - ' ��> "'70. Urider9rSund'Hy�I�,o . - 22. Ducts, Ventileting:� f - _ , . `'.' ;;.77. Product;Pi�iqg G Gas ❑}Oil 23. �Gas PiPe:Rough & Tes2 ��7.' �• � lY. �� 72. Undergroti�ld FlUsli �' r- 24. Roof Framin , ' `• ' � , _ .. .� _ .. 9� ;t�, � .73..�Underymd.Storage.�ankCGas ❑Oif� � � 25. RoofSheithing � - � .• .- • -. _ ' jq.`-Overhead Hvdro ' i 26. �T�Bar Ceiling (Structurap & Monocoat ' '�� ' ' 75.,Dry Chemicai " � _� , � 27.iF.rameand Flashin : + ;. �.'" � y F�" ., ' 9 � �� - » • 76. Dr Stand :pe �'�- � 28. Laihing $ Siding - ^ " - . - � '. " ' 77..`�FIXED SY$TEM�2N'AL�, .. '_ -.'.. 29. Insuiation _ . � � �� '� ~ 78.:.F1RE PREV. FINAL' � � - � �30. Drywali Nailing '� , � i '� ' ' HEAITH�DEPT'f�EQUtREf'v1ENT��. 31. Plasrer Brown Coar,. • � ' : . 79. FINAL INSPECTION �� - , .�r -32. Electrical Po�9er Meter�Final �'� , " SO.�FOOD CERTIFI�ATE lSSUED � A '- 33. �Fina! E�eCiric , � _ . �. '�,:, Note's: ' _ - ': :. �� • .-. z -� .��u=�� `-Vi-1�t��L�_4JJ4iF'J _ -� :34. �Pinal.He�ting & Air.Conditioniny:.; • � �• •* C ' ` " � � ' _ _ . , rr ' '� �• > �,�! � ��?�C�iL� [. 35. �F�inal"Gas P�Pe-Test w , ,; ' , , � � ;, 4 �'_ � , ' - . ��=�=��dL&�s�2.�G�- 36. Hood.or CanoPY . `� �- � � • ' �' - ' ' �� ' ' -�l � � -�GG»..i2.�-L, � � • i - L' - '-. .;� e -. � ._ : � 37. F�inal Factory Fireplace .: . ;,,� � .. . � I�Z �"� �t�cz�� 38. Final Plumbing - � � ' =" r• �. - - 39. Water Seivice-Final . - ' . � -. .°,�� " - ' r : �. . 40. Gas Service-Final . .. r^- -� �. . , '. %)v � ; -41. Solar pomesticFinal `" � " = � ' '^�`_' � `' � �. f r �42. BackfiowPreventer-.� � � � �. ,; ; r. � 43. BacRflow Irrigatiort"� -, • =,'�' • - . ;• - . r: �:� , . _. .,,t:.:: . � . .- - - A4. Landscape Ircigation System-�r7�,� r ,;r. . 7�. ; �� r; �� r� �- .-, 45. Sound Atfenuation "'r,"' ' ' -_ -' � .` " " . `. '= = - � -� �- -� � • • •46. �Handicap Regulations '" � M' c - _ _ ' . 47. FINAL STRUCTURE & BUILDING �- "' � ^� -� � - . �_, w . �� v 48. F.INAL PLANNING _ • - a,; , :'- ;*; - - ,- 49. �Electric Release to Edison ' = . � „ r � 50, Gas Release m Soutfiem Califomia,Gas Co = i`, .;. :- . ' w • �. `51. CERTIFICATE OF OCCUPANCV ;�: :" � . - : . _ -' No. Dare � �� li� PBOJECi PDOflESS: 9 3 3 EVERGR E EN ' PL OWNEP'S NAME: HOGART, HRAD KENT aoonEss: HOGART, MEGAN MOTE a 933 EVERGREEN PL � COSTA MESA,CA 92627 650-7395 NflCN/ENGINEEFl: p00flES5: XEG.NO.: UNIT: UNIT: eexminee: MEGAN BOGART ( 719 ) 650-7395 PODflESS: 933 EVERGREEN C,M, CA 92627 LICENSEU CONTFACTOH UECLl�NpTION: I �ereby aifirm Iha� I am licensed untler pmvisions o� Chap�er 9(commencing wiih Sec�ion 7000) oi Division 3 oi �he Business antl Pro�essions Code, antl my license is in lull �orce antl e�tect. . CITV LIC.: STRTE LIC.: CIASS: oate: signaWre: WOBREflS' COMPENSRTION DECIAflFTION: I �ereby al�irm �hat I have a cetlilica�e of consenl b selbinsure or a ceni�ica�e o� Workers' Compensation Insurance, or a cetlihetl copy �hereof (Seciion 3804 Lab. C). POLICY NO.: EXP. OATE: COMPPNY: � Certifietl copy is hereby �umished. ❑ Cerlihea copy is tiled with Ihe ciry BuilOing Oivision. Oa�e: NPDlicanl: EXEMPTIONFPOMWONREBS'COMPENSPTIONOECUMTION: (Thi55ec1ionneeAnolOecom01e�e0illhepermiti5laronehuntlretl�5100�or1e55�. I cetlity Ihai in �he pedormance o� Ihe work �or wAich �his permi� is issued. IShali not employ� person in any manner so as �o become subleclto Ihe Work ' Co ensation Laws ol Califomia. Da�e: Signa�ure: NOTICE: Ii, after maling 1� 5 Oeclaraiion. you should �eco su0lect Io Ihe Workers' om0ensa�ion provi5ions o� the Lahor Cotle. you musl forl�with comply wiih such pmvision5 or is permii s�all be Dee revakea. COKSTfluC7lON LENOING AGENCY: I here6y aflirm Ihat �nere is a consiNqion lenai g gency lor the Dedormance of ihe work for w�ic� this permit is issued (Sectian 3W7, Ci¢ C) LENDEN: AOOPE55: OWNEfl BUILOEN OECIAPATION: I hereby afiirm �ha� I am ezemp� imm Ihe Contraclors' State License Law tor the tollowing reason (Secimn 7031.5 Business antl Pmlessional Cotle: Any ci�y of county whic� requires a permi� m constmc�, al�er, impmve, demolish, or repair any s�mcNre. pnor to i�s issuance. also requires ihe applican� tor such Dermit �o file a signed slaiemen� �ha� �elshe is licensetl pursuam to the pmvisions ol the Coniractors' Slate License Law �Chap�er 9(commencing wM Sec�ion 7000) o� �ivision 3 o� �he Business an0 Pm�essions Cotle) or ��al he/she is exempt therelrom antl the basis �ar I�e aliegetl eKemption. Any violalion ol Seclion 7031.5 by any applicanl �ar a permit su�le��s the applicant to a civil penalry o� no� more Ihan five hunOretl Oollars (55011�. I, as owner of Ihe pmpetly or my emplayees with wages as iheir sole compensation, will Oo Ihe work, antl the ❑ slrucWre is nol in�entletl or o�fered for sale (Sec�ion 704A, Business an0 Professional Code: The Con�rac�ors' State License Law tloes n�� apply lo an owner of a DroDetly who builtls orimpmves �hereon, and who tloes such work �imSelVhersell orlhrough �is or her own employees, pmvideA iha� such improvemems are n0i imentled or oflereU for sale. If. however �he OuilUing or ImOrovement is soltl within one year o� completion. Ihe owne� vnll �ave the �urEen ol pmving helshe Oi0 no� build or improve lor Ihe purpose o� sale�. I. as owner of the pmperty, am erclusively contracling with licensea coniractors to consiruct the prolect (Sec�ion 7044, Business � antl Pratessians Code'. The Comractors' State License Law tloes no� apply lo an owner ol Dmpehy who Uuiltls or improves ��ereon antl wha comrans lor such pmjects with a conlracmr(s) license Dursuam to the ConVacmrs' S�ale License Law�. I am aware I�ai proo� o� Iheir Worker's Compensalion insurance 5�ou10 he DmviUetl to me. � I am exempl untler Section: B. 8 P. C. lor ihis reaso�� '/ �! �ate: /'✓1��F- Owne I tlo nereby renity that I am aware of and un0er�ents ol Caiilomi ealih ana Salety Code Se �ons 25505. 25539, ana 2553C ana ��al I ar any �uture �uilding occupanl will/will nal (circle one) need to ply wi�� saitl s�a�e cotles a �he requiremenls for a permil lor constmc�ion or modilicalion irom ��e Nu Ouali�y Management Disirict. Resitlential cons�mction a¢a�ions are exempl imm Ihese pmvisians. Oa�e: NpO�icanl: Ihereby cerlitytha� I have reaa Ihis applicalion antl sta�eihal Ihe a�ovein�orma�ionis correct. I agree to comply wiih all city antl ordmances antl state laws relaling lo builamg constmction antl �erehy authorize reD�esentatives ol this ciry to enter upon ihe abq+e�me pmperiy lor Inspec�ion rpo es. �711. Date: Signa�ure: V oriver's License ar Social Security v: 16a1-a6 While—Butltling', Green—Gotle Enforcemenl', Cdnary—Appllcant', Pink—Revenue; GOItlBnmd—FSsessor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: B 067023 PLAN CHECK NO: N CONSTRUCTION TYPE: PERMIT TYPE: STR JOB DESCRIPTION : T/OFF REROOF W/COMP SHINGLES PERM NO: B 06702 GOVT: N SUPP: N PURPOSE: OTH SQ FT: 1,500 CLAIM VALUE: 1,500.00 CALC—VRLUE: 1,500.00 GROUP OCC: R-3 /M-1 COMMENTS: REROOF 1200SF RESID W/COMP, SMOKE DETCTORS RRp�7RSO��ER1LriD�T/'�� iEiElEiEfE�lEfEiF1F1E�1ElEiEff?fiEffiEiFlfifiEiFiEiEifif-iEiEikiEiEiE1EiE�fi[-iEif-lfiEiEiFiE9fifiEiElE3tiFiE7lifj��d�I�Ej�jAjt[�1t�i�'�'`E k�v✓ � Z O N I N GS ERTEBQAUCIKRSE M E N T S REQUIRED ------------ MAIN BUILDING ---------- --------- ACCESS[�RY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT; FT IN RGHT: FT IN LEFT: FT IN RGI-IT; FT IN PARKING REQ: PROV: PARCEL: 42252112 ZNE; REF NO; PLANNING NOTES> ;.� .>, *****x�**�*�**�****�**+�**x�*�r�*****************+�*�**�***�r**�r**��********�t�***��c+� 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; � HUILDING APPHOVED HY ; DATE; APPLICATION ISSUED BY: � DATE: � '�(�l 9E1fiE�MicjFiF3ciEiEiFifiFitiFlE3E�EiFiE#iFF��F��F�3F��F�{��F�F7F$F�F�3F�F�"$F�F3F TF�i�iFifiF�TF3FiEiEiFiEiEiEiFiEjE9E jEiM iE iE if iE iE if iP iE 3f iE iE iF iF ic %iF iF if i: iE 3F 3E iE 9E if iE i:9F iF iE iF iE iE if it if if iE iE 3: �f if iE iE 1E if if iF 3F * 9F 1E 1E 1E if iE i?� iE %if if * if 3E iE iF if if iE iE if iE aE �E �E iE iF if iE LEGALIZATION;N F E E S U M M A R Y STRUCTIIRAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 35,00 ,50 SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 35.50 0.00 0.00 35,50 35,50 ,00 REVENUE DIC�ISION TOTALS--> COLLECTED: 35.50 OVER/SFIORT: ,00 BLAG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIF/TOT GRADING PLAN—CHECK 35.00 .50 if if iE if iE iF iF it iF 1E iE if 9f if iE iE jE iE if iE iE iE� �E iE jE iF if if iE iE if iE iE iE iE iE �)h jE iE iE 3E if iE iE iE iE iE * iE it iF iE iE if if iF iFlE 1E �IR IF if iE iE iE 3f iE iE �F iF iE iE 3E iE if if iF if iF 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 1500 REROOF BY VALUE RESZDENTIAL NOZONE 1.00 1,500.00 END OF FEES 01 OO1S98E9-00159E9D TU T 35.50 DATE: �5/02l94 TIttE: �5:00 -� CONS�RUCTION AND PLA(JNtNG POOL .. aPA APPROVALS Perm�t sr Date Inspectqr AppROVALS Permit � Date Inspector 1, Temporary Electricai Service or Pole _� 52. .Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement � � 3. Electrical Conduit Un�ity-Undrgmd. 54. Forms 4. Eiectricat Conduit-Undrgrnd. � � 55. Electrical Bonding 5. Stee� Reinfarcement � 56. Rough Plumbing & Pressure Test 6. Efectica:UFERGrnd. � 57. APPROVALTOCOVER�GUNITE 7. Fooungs -„� 58. Electrical Cqnduit�Undrgrnd. $. FoundaUon 59. Gas Pipe, 0 U�drgrnd., Test 9. Water Pipe-Undrgrnd. � 60. Backwash �ines, P-Trap,'��. Undrgrnd. 10. Structu�al Ftoor Sysrem 61. �APPROVAL TQ DECK 11. Property Sr.vder Line & House Connection � 62. Backwash & Receptor�Final 12. Se�ti•ei Cap � -- 63. Heater & VenFFinal ' 73, floof Drains ' 64. Plumbing System - Final 14. Rough Plumbmg - 65. Electrical-Final 75 Rough Electrica!-Conduit 66. Soiar System�Final � 16. Rough Electric Wiring 67. Fencing & AcceSs ApP�oval � 17. Rough 1Vrt�ng Sign 68. APPROVED FOR PLASTEF WG 18. Rough Electrical-T 68� Ceiling 69. POOLlSPA SYS7EMS FINAL 79. Rough Haating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rouyh Facmry Firep�ace � APPRQVAIS Permit # 2t..Duc[s, ir Structure 70. Underground Hydro 22. DuctS, Ventilating 71. Product Piping O Gas Q Oil 23. Gas Pipe-Rough & T¢st � 72. Underground Fiush 24. Roof Freming� . 73. Undergrnd.Storage-Tank OGas C�OiI 25. Roof Sheathing S 3� rG � wG4 74. Overhead Hydro - -i 26. T-Ba� Celling (Structura�l & iv5onocoat 75. Dry Chemicai 27. Frame and Flashin9 76. Ory Standpipe � 28. Lath�r.g & 5ding ' � • • 77. FIXE� SYSTEM FINAL 29. Insulation :. � 78. FIRE PREV. FINAL � 30. O�ywall h'aihng HEALTH DEPT. REQt11REPo7EN7 .�31. Plaster Brown Coat � � � 79. FINAL INSPECTION ' 32. "ciectrical Po�ver M=terFinai - SD. FOOD CERTIFICATE iSSUED 33. firal Electric ' Notes: 34. Final Heating & Air Gonditioning i � 35. rinai Gas Pipe•Teu ' 36. Hood or Canopy _ ' � 37. Final FaCtory FirepigCe _ 38. Finai.P�umbing ' � � 39. Warer Service�Final ' ' � 40. Gas Service�Final - � 47. Solar Oomestic-Pinal " 42.8ackflowPrevente;.:� .. 43. Backf�ow Irrigatio� ' ' , 44. Landscape Irriqat/��Sy°"�..�m . .. . 45. Sound Attenuation � ' � - 46. Handicap Regulac� , � �_i 4J. fINALSTRUCFI:nc:�3UIl0ING S•�.Gl'C� ��f� - rt'' �-'s' 48. FINAL PLANNIPt � . •�+ � 49. Electric Release t�'dison. 50. Gas Retease to Sv�em Califomia Gas Co . � 51. CERTIFICATE OF pCCUPANCY No. Date , �� I� � � PPOJECT AUGHE55: OWNEH'S NFME: nooness: ROOflESS: 933 EVEP.GREEN PL BOGART, BP.AD KENT bOGAP,T, MEGAN M]OTE 933 E`.'ERGREEN FL COSTA MESA,CA 92627 GSQ-7395 JAPIES GARTNER AP,CH N/A UNIT: XEG.NO.: �1idSO UNIT: a n W PENMITTEE: MEGAN BOGAP.T ea O�U014)650-7395 nooeess: 933 EVERGREEN PL C,M. CA 92627 �LICENSEO CONTHACTOP OECIAflFTIUN: I hereby a��irm Iha� I am licensed untler pmvisions o� Chapter 9(commencing with Seciion 7000) ol �rvision J ol �he Business antl Prolessions Cotle. antl my license is in �ull �orce antl eflecC . GITY LIt.: STRTE LIC.: CLASS: EXP : Oate: Signamre: WOBREBS' COMPENSATION OECLARRTION: I �ereby allirm �hat I have a certiticate ot conSenl to seli-insure ar a certdicate o� Workers' Campensalion �nsurance. ot a cetldiea copY Ihereof (Sedion 3800. Lab. C). POIICY NO.: E%P. OATE: COMPANY: � Cehi�ietl cOpY �5 here0y lumished. ❑ Certiliea copy is �ilea with lhe ciry Building �ivision. Date: ADPliianC E%EMPTIONFflOMWOPREBS'COMPENSpTIONDECIAflATION> �i�isseclwnnee0no�becomple�eail�hepermitistaronehunare0�S100�orlew�. I cetlily ihai in Ihe Oedormance ol ��e work lo;which I�is Oermit is issuetl. I s�all not employ any person i any manner so as to became sublet� �o ihe�°� ers' Compensalion Laws ol Califomia. Da�e: �"7% ��/�% Signamre� NOTICE: II. after making lhis aeclaration, you�shoul becom su6lect to ihe Wor' rs' Compensation pmvisions of Ihe Labor Cotle. y�u musl Iori�with comDly wit� suc� pmvisions or is Dermil shall be tl etl revoked. CONSTPULTION IENDING PGENCY: I hereUy xlfirm t�a� ther is a constmciion len ing agency for Ihe pedormance o� Ihe work �or w�ich this permit is issuetl (Seclion 3097. Civ: C�. � LENOEP: � aooness: OWNEB BOILOEP OECLpflFTION: I hereby afiirm Ihal I am exempt imm the CanVactors' Slaie License Law fo� �he following reason (Sec�ion 7031.5 Business and Pmlessional Cotle: Any ciry of coun�y which requires a permi� �o cons�mct, alter, impmve, demolish, o� repair any simclure, prior Io i�s issuance, also requires Ihe applicant �ar such permi� to file a signed s�a�emen� �ha� he/she is licensetl pursuani Io Ihe pmvisians a� Ihe Camracmrs' Sla�e License Law (Chapier 9(commencing wi�h Sec�ion 7000) of Oivision 3 of �he Business and Pwiessions Cotle) or Iha� he/s�e is exemp� ��ere�mm antl ��e basis tor �he alleged exemption. Any viola�ion of Sec�ion 7031.5 by any app6cantfor a permit subjecis the applican� �o a civil penafly of not more �han �ive huntlreJ dollars ($500). I, as owner ol I�e properiy or my employees wi�h wages as �heir sole compensa�ion, will Oo �he work, and ihe � s�mcWre is noi imentled or offeretl lor sale (Section 7044, Business and Pmiessional CoOe: The Coniractors' State License Law tloes nol apDly Io an owner of a Oroperty who builds or improves thereon, an0 who does such work �imseli/hersel� or ��mugh his or her awn employees. pmvided Ihai such impmvemen�s are nat iniended or oHereO fo� sale. If, however Ihe builtling ar impmvemem is saltl wit�in one year o� comple�ioq t�e owner will have �he hurJen o� pmving Ae/she Oitl nol builtl or impmve �ar ihe purpose o� sale�. I, as owner of ihe D�opehy, am exclusively contracting wilh licensed coniractors to consimct the proiec� (Section 7044, Business ❑ an0 Pmfessions COUe: The Conimclors' State License Law aoes not appry to an owner ot propetly who builds or impmves ihereon antl who coniracls lor such pmjec�s with a coniracbqs)license pursuan� to Ihe ConVactors' S�ale License Law),I am aware Ihal pmo� oi Iheir Worker'S Compensalion insurance shoultl be pmvitletl to me. � I am exempl under Section'. B. 8 P. C. lui IhiS i/ep son' ,/ Date: /2/ 7��" Owner: � I eo here�y cenify �hat I am aware of ane untlers�ana tne requiremenls o1 Cabfomia eal�n an0 Satery Cotle tions 25505, 25533, antl 2553a antl Ihal I or any Imure Euilaing occu0am will/will no� (drele one) need m comply wi�h said s�a�e codf /n0 �he repuirements for a permil �or conslmction or modilicalion �mm Ihe Air Oualiry Management DisVici. Fesitlen�iai constmc�ion Qplicaiions a�e exemp� Imm ihese orovisions. Oale: Applicant: I �ereby cer�ily ��al I have reatl Ihis application ana 5�aie ��at �he above inlorma�ion is correcL I agree �o compty with all ciiy anA counry ortlinances antl stale laws relaiing Io builAing consimction and hereby authonze reDresematives a� �his ciry �o enter upon the a0ove�meniione4 pmpetly foi insp)eqion Ow�p/ases. -�/ ,/�/� �y�� (/'i) Date'. �Zl �l�Y Signature: � A / �WL� �'\/� .. // Oriver's License or Sociai Security a: 164La6 Wtine—BUAOing: Green—Cotle En�arcemem, Canary—Applicant; Pink—Pevenue; Goltlenrod—Assessor CITY OF COSTA MESA - BUILDIP]G PERAIIT PEfll1 NO: H 0?OZA� PEP,f9IT A1G: B 070249 PLAP7 CHECK NO: 04278-94 L GOGT: N SUPY: N CONSTRUCTION TYPE: PEP.MIT TYPE: STR PURPUSE: AL'D JOB DESCRIPTION ; ADD 446SF LSV ROOM, 598SF GARAGE TU EX.IS SQ'FT: 2,544 CLAIM VP.LUE: SO,OU4,00 CALC-VALUE: 95,626,80 GROUP OCC: R-3 fM-1 COMMEPITS: UEMOLISH EX.ISTIP7G OA]E CAP. GARe1GE, REMODEL KITCHEN AREA iEx.u3F-�c�cncac**;p*�c+f+t+i++ c.ac+raci��f-x-�*if?Fac,;x��F�c9c*-�c�7E�r-jc�fat�-ic3t+FiF�F�IE+'�+«x+Fitxac-i�.*.�..v..K-u.k.acu�car.a..u.s+c+Ejcrtac.cac+c?car-.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 --- — --- — ----- --- ACCESSOF.Y EUILDING --------- FAh7T; 20 FT Ih] AEAF.; 17 Fi IN FP.P!T; FT Ird REP.R: FT IN LEFT: $ FT IP! RGHT: i 3 FT 9 IN LEFT: FT IN P,GiiT; F'F SP] PARKING REp• PP.OV; PARCEL: 92252112 2NE• fl? P,EF D10; PLANAIIA]G N6TE5> r1DD 446 SQ FT, F7 LIC'ING ROOM E NEid 598 SF, 2-CAR GAP.AGE, > DEMC E}�:. 1-CAR GAP,AGE, 139 SF REAP. YD COVEP. PROP; 538 ,SF OK i�-a�+F�lfifiFiE+fiF+=+f?�f�tiFirx��tjkiE#iFififififl(-a=iFif�tt-iEft�NaFaciF+EiFifftif?E+Er�iE�%xrrbir�M�iFiE#ujtiFit�{t{6+tisacriF�-iEri:M�-?�ifiE9c3:aF D E l7 E L O P M E'�7 T S E R V I C E S R E Q U I P, E M E N T S ZONING APPROVED BY ' W l C9Ls DATE:. _Z � I � HUILDING APPP.OVED BY : DATE: APPLICATION ISSUEC� BY: �' l�p� DATE: `_ � l-1 �tE �if iR jE ih if if� i� Y-i(- �Y �v- iF 1E-�E ii iE Y-a� it+E af af �1( �ft� �lE it �:- ii� it fc-1- 3E iF �c #-�f -�-%� ac ar +t ic � i�- x�k w.� ic iE iF �R ft -u x aF iG?e it if af u+:-IR>.( iF At. .F a4 � ac.f -lF tt ic r� i! tr v�+E s i�� tc iF+f x iF it if +f iF ip r jt it iF iE }.y. iF?E iF �F it-+<�+c;.-1P ir-u- �IE it Y� iE �lE i! at �?F Y iE #- rF iE ia ic iR;t -:+c-Y� iF it+E it x ap+f k� ac iF iF x'f�.r. IF :F ar. i�� - ��4 iF a�-�,. LEGALIZP.TION:A] P E � S U A9 M A�R Y i:`�,• S'PFtUCTC7FA'L SEGMENT:: HLDG PP•IT PLUMBING ELECTRIC D7ECHANIC: 'J FI•RE SMIP/RE.S GRP.DIC7G PERMIT 388,SQ � . � ' �9,55 ' , • $A7ZP/NON-P.ES PLAPI 252.53 . . ' ISSUE FEE ' � bUILDTNG-DIV-> F'ERMIT ISSUE FLAPd-CHECk TOTAL Pt?ID DIIE TOTALS----> 393,06 Q.OQ ;.252,5,3 �^ 695,59, 695.55 ,00 � �i REVEtJUE LaIVISIOAJ TOTP.LS--> CGLLECTED: , '393,�.6 /OV£R/S�ORT': ,GO HLDG PMT PLUMBTNG ELECTRIC MECHANIC., FIRE 5MI-F?/�TOT -6�tALING PLAN-CHECK 388.50 . . ' t9.56 . �� , �. . . 1E if V Y if if �4 �1F if� iF #�)f 1E iF')F iF aE 1F 1F i41F j(- 1f if iF iE iE if 1h if !E jE if iE,-1F �/f �lE df af if a(' iE �IE if iE �K 3f 1F jE i!� iF i41f #�1(� if �E iE Y i�� 1F if ?F <iR af 1f'N� iF 1F iF �Y �X- if �K # Y:t if I N D I�? I B L A�L ' F' E E B R E�. A Y,. D�. O. i^I N. Y: TYFE QTY D E S C 4 I F T I"O N, •� , , UDIITiCOST TC�TAL CUST • / f.. SFk 496 DWE-TYPE V-410GD FP.AME - �-GOOD ' � 74.00 33,044,00 SFP. Sy8 RES-GAP,P.GES TYFE V. . ,, �.28.60 11,?22.80 SFP. 15Q0 ALTER BY t'ALUE P,ESIDENTIAL �NOZ�ONE,, r�. 1.0^ 1,500.QO END OF FEES ' . • ". . � i V i . . r •. , i+: �1 70173Qi4-�Di7T�24 Til T 3Y3.�6 . � ' � DFTE: 1'L/67l4= ?IFtE: 21:5� t '� : _ . CONST�UCTIt9N AND PLANNING POOL SPA APPROVALS Permit# Date I�spector AppROVALS Permit# Date Inspecto� 1. TemVorary Electrical Service or Pole 52. Pooi & Equipment Location 2, Soil pipe-Undrgmd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgmd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55.' Electrical Bonding 5. Steel Reinforcement 56. flou9h Ptum6ing & Pressure Tzst 6. Electr�cal UFER Grnd, lZ�t�l� 57. APPROVAL TO COVER�GUNITE 7. Footings �L/y�pfl � 58. Electricai ConduirUndrgmd. 8. Foundation , 59. Gas Pipe. O Undrgrnd., Test 9. Water Pipe-Undrgmd. 60. Backwash Lines, P�Trap, O Undrgmd. 10. Structural Floor Svstem 67. APPROVAL TO OECK 11. Property Sewer Line & House Connectio� 62. Backwash & Recepior�Final 12. Sewer Cap 63. Heater & VenFFinal , 73. Roof Drains � 64. Piumb�ng System � Finat i 14. Rough Plumbing 65. Electrical�Final 15. Rougti Electricai-Conduit 66. Solar System-Final 76. Rough Electric Wiring 67. Fencing & Access Approvat � 77. Rough Wiring Sig� 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceilin9 69. POOL/SPA $YSTER4S FINAL ( 19. Rough Heating & Air Canditioning FIRE DEPT. RE�UIREMENT 20. Rough factory Ficeptace . APPROVALS Permit # 21. Ducts,�n Structu:e 70. Underground Hydro 22. Ducts, Ventilating 77. Product Piping � Gas ❑ Oil 23. Gas Pipe�Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergmd.Srora9eTank OGas ❑Oil 25. Rooi Sheathing L q. I. fi-� 74, pverhead Hydro L- 26. T�Bar Ceiling (Siructuraq & Monocoat . 75. Dry Chemical 27. Fram Flashing �/ 76. Dry Standpipe 28. athinr ,� Siding 3 2i �/ 77, pIXEO SYSTEM FINAL 29. Insulation 3 Zj 9'��- 7g, FIRE PREV. FINAL 30. Drywa�i Nailing HEALTH DEPT. REQUIREMENT 31. Plaste� Browm Coat 79. PINAL INSPECTION 32. Electncal Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes:(Z-2Z -�9 /.'ZS -i /: yy �J,s� Ou/+�./� 34. Final HeSting & Air Conditioning i/ ro�/.� .H. ��:SeiM .9oa s,ie y��J� �i� 3�0�-'-�., 35. Finai Gas Pipe-Test , - i i �'rG } � �%r �C� � �tlo! co.YrO�i �si�Y/' 36. Hood or Canopy /J / ' ---v , y�I"o%%�l G.... �a� l�..�. ,(/e I�li��.,.. ' � 37. Final Factory Fireplace . � /�' //� 38.FinalPlumbin9 � l2-L7-$'y �G_ .�/o/C'a.n/��i��Oy - 39. Water Service-Final � J-G' 1 SGA� G�� /�4 C�B� 0 40. Gas Service�Final 2�� A�-C� � �tk l 41. Solar pomestic-Final /J / � / A�^�Rr �_ 42. Backflow Preventer 3o�9r �� p�� 43. BackStow lrrigation 44. land5cape Irrigation SYs,em �� Y i Cr�i.f . 45. Sound Attenuation f/2 9,� N� � �, �� ,/ � �/�% CW�. �ofii�L 46. Handicap Regulations 47. FINAL S7RUCTURE & BUILDING 1�-/l-y� I 48. P�NAI. PLANNING 49. Electric Release to Edison . �-' 50. Gas Release to Southem Califomia Gas Co �- '� .� 51. CER7IFICATE OF OGCUPANCY No. Dace -. PNOJECT RDOflES$: 9 3 3 EVER GR EEN Pli �,. uNiT: owNr^�Name:gpGART. BRAD RENT *"aooness:BOGART. MEGAN t30TE 933 EVERGIFEEN PL COSTA [dESA.CA 92627 650-7395 pNCHIENGINEEfl:JAMES GARTNER ARCH REc.xo.:C17450 aoosess: N/ A uxir: N/A CA 90000 PEHMITTEE:MEGAN BOGART ( "/14 ) 650-7395 anoRess: 933 EVERGREEN PL C.M. CA 92627 LICENSEO CONTBPCioF oECLANATIaN: I here�Y aflirm that I am Iicense0 untler provisions of Chapter 9(commencing with Sec�ian 7000� of DiNsian 3 of ihe Business and Pmfessions Catle, and my license is in full �orce ana etfect. CITY LIC.: STFTE LIC.: CUSS: EXP L Da1e. Signature: WOPNEflS' COMPENSpTION oECLABATION: I nereGy aflirm that I have a certilicate ot consent to sefl-insure or a certificate of woBers' Compensaiion Insurance, or a cerlilieU copy ihereol (Semion 3800. Lab. C). POLICY NO.: EXP. DATE: COMPANY: ❑ Certihetl copy is hereby �umisheJ. ❑ Cehilietl topy is tileE wii� �he ciry Building Oivisi0n. Date: Applicant: E%EMPTIUN FBOM WONNEBS' COMPENSRTION OECIANpTION: (This section nee0 no� be camDle�eO if �he permi� is lor ane hunared ($700) or less). I cerli�y Ihai in ��e pedormance ol �he work for wAich t�is permi� is issued. I sh I no� employ an rson in any manner so as Io hecome sublec o Ihe Work� 5' Con pensati Laws o� Calilornia. , at � C� Signaiure: ' NOTICE: Ii. al�er making Ihi declara�ion, you 5hou10 eco e ble�� o lhe Workers' o ensa�ion provisions ot the Labor Code. you muSl tatlhwith camplV wi�h such Dmvisions or ihi permi� shall he Oeem oked. CONSTflUCTION LENDING AGENCY: I her y-a1Yrm Ihat Ihere is a con5lNc�ion lentling agency for IAe petlofmance of Ihe work br � which �his permit is issuetl (Sec�io Civ. C�. LENDEP: ROOPESS: OWNEN BUILUEB OECLAflRTION: I here6y aflirm Ihal I am exemp� imm ��e Contraclors' Sia�e license Law �or Ne following reason (Sectian 7037.5 Business and Pmlessional Code: Any city of rounty whicn reauires a permil to constmct, alter. improve, tlemolish, or reDair any stmcture. prior ro i�s issuance. also requires ��e apD�icani lor such permi� �a lile a signetl s�aiemenl Ihat helshe is licensetl pursuam m �he pmvi5ion5 of Ihe Comrac�ori S�aie License Law (Chap�er 9(commencing with Sec�ion 7000) of Division 3 of Ihe Business antl Prolessions Cotle) or Ihat he/she is exempt there�mm an0 �he basis for Ihe allege0 exemption. Any viola�ion o� Section 7031.5 Dy any applican� �or a permit sublecis ��e applicani �o a civil Denalry oi no� more ihan live �wdretl dollars ($500). I, as owner of the pmperty or my employees wi�h wages as �heir sole compensa�ion, will Ao Ihe work. antl lhe � s�mc�ure is noi intentled or oftereA for sale (Seciion 7044, Business antl Pmtessional COAe: The Coniractors' State License Law does nol apply to an owner o� a pmperty who huil�s or improves �hereon, an0 who tloes such work himself/hersell o� lhrough i �is or �er own employees. pmvitletl Ihat suc� imD�ovemenis are not in�entletl or oflered �or sale. i�, however Ihe builaing or improvemenl is soltl wi�hm one year of completion. Ihe owner will have the bur0en o� pmving �e/she Oid no� build or impwve for ihe purpose ot sale�. I, as owner ol IAe pmpeny, am exclusively conlrac�ing wiih licensed contractors to cons�mci Ihe D�ole�� (Sec�ion 7044, Business ❑ antl Pmlessions Cade: The Coniracrors' State License Law Ooes nol apDty ro an ovmer of Omperry who Uuilds or im0�oves ihereon ana w�o conVacls tar such pmjetls wit� a coniraclor�s) license pursuant lo Ihe Coniractors' State �icense Law�. I am aware ihai pmoi ol �heir Worker'S Compensation insurance 5hoW4 be pmvi4e0 �o me. � I am exempi un0er Section�, B. 8 P. C. � �� aie. I tlo Aereby ceNly iha� I am a 25534 antl ihal I or any fuiure p¢rmit �or ConsimClian ar mc Ihese pmvisions. LOwner ✓'v`� an0 unaersland ihe reQuiremenis af Caii�omi� eall� an0 $a�ery Code Se ons 25505, 25533. antl g occupantwill/will not (circle one) neeDio c ply wi�h saitl s�ate cotles tl the requiremenis�ar a m Irom the Air Ouali�y Management OisVict. e5i0en�ial consimc�ion applications are exempt trom Dme: AOOlicanl: I here0y wrtily iha� I �ave reatl @i5 aOPlica�ian and slale Iha� �he a�ave inbrmation is correcL 1 agree Io compty wilh all ciry and counry ordinancesanOslalelawsrelaungtobuiltlingcons�mclionantlherebyauihorirerepresen�ati so��iscirylq.eq�erupon��eabave�men�ionetl �r u nspecl' n pur oses. '/ � Z � Signamre: oriver's License or Socia� Seariiy 164696 Whne—Butlding�. Green—Code Enior<ement: Canary—AppllcanC Pink—Revenue; GoltlenroG—Assessor CI'TY OF COSTA MESA — BUILDIP]G PERMIT PERM NO: td 070936 PERMIT NO: M 070436 PLAN CHECK NO; N GOVT: N SUPP: N CONSTRUCTIOAI TYPE: PERMIT 'TYPE: MEC PURPOSE: ADD JOB DESCRIP'TION : ADD 446SF LIV ROOM. 598SF GARAGE TO EXIS SQ FT: CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /M-1 COMMENTS: RtiF: H-%0249 **�******�*��**i�**�**�E***��*��**i�**�E�E**�E*****�Ei��E**�f�*******�-�**i�i��Ei�*�E***�E*** Z O N I N G R E Q U I R E M E N T S S E T H A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- IFRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT: FT IN LEFT: }'T IN RGRT: FT IN PARKING REQ: PROV; PARCEL: 42252112 ZNE: REF NO: PLANNING NOTES> i x�*�***�***�**��****��**�**��*�*�*�*�r**��*******��**��**��x*�*��*�*��*�**-��**� 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; APPL'ICATION ISSUED BY: ��;Fi � DATE: �(�/r[� �FiEiEiE*iE*iE*�E��E-%iE�lEiEiEiE�IE*�IEiE�'3�".� Fi�iF'iF'iF'iFiE"iE�FiE'�F'iF3F3F�lEiEiE�E-1E�1E-lEiEif�lE �*�(iEiEif/*1 iEiEiElEiEjf'iEifiEiE�f'lEiEififiEifiEiEiEif�EiEiEjEiEiEiEiEiF�EifiEifiEiEiEiE�fifiEiEiEiEiEiEifiEiEiE#iEiEiE�lEjEiEiE�f�EiE��'�jf�fiE-0EiE3f�E iEif iEiEiEiE LEGALIZATION:N F E E S U M•M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELEC'TRIC MECHANIC FZRE SMIP/RES GRADING PERMIT "� 6.50 25% SMIP/NON—RES PLAN �- ISSUE FEE BUILDiNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS----> 6.50 . 15.00 0.00 REVENUE DIVISION TOTALS--> COLLECTED: BLDG PMT FLUMBING ELECTRIC MECHANIC �� 2�.5� -. 15.�� TOTAL PAID DUE 21.50 21.50 .00 V 21.50 OVER/SHORT: ,00 FIRE SMIP/TOT GRADING PLAi9—CHECK iE'7E jE iE 1E iE iE iE jE iE iE iE iE iE iE if if iE �F iE iE jE iE iE iE iE if iE iF iE iE iE iE if if iE iE iE-0E jE if jE �lf iE iE jf if �M iE if iE if if if if if iE if iE �E iE iE if iE iE if if �lf �lf jf if �lf jf if iE iE �� if jE I N D I V I D U A L F E E B R E A K D O W N TYPE pTY D E S C R I P T I O N UNIT COST TOTAL COST MEC 1 FACTORY FIREPLACE 1 6.50 6.50 END OF,FEES . ' _ /• / / . v oi ocf�,^as�-c:ai��E T�.�T 21.5II 'oar�= za�is�q4 �r!"E: 14:�0 �•�;ONSTRUCTION AND PLANNING POOL & SPA , � 'yAPPR04ALS Permit # Date Inspector APPqOVALS Pe�mit ak Date Inspecmr !'. Tempo�ary Electrical Service or Pole 52. Pool & Equtpme�c Locacion 2. Soil pipe�Undcgmd., 53. Steel Reinforcement � • 3. Etectdtdf Canduit� Utility-Undrgmd. 54. Forms - 4. Elecirical Conduit�-Undrgrnd. 55. Electricaf Bonding , 5. SteetAei�forcement 56. Raugh Plum6ing & Pressure Test - , , - �6. rlectrical UFEP'Grnd. 57. APPROVRL TO COVER�GUNITE ;� �, -7. Footings� 58. Electricai Conduit-Undrgrnd. � i '8. �!�oundation -• 59. Gas Pipe, t� Undrgmd., Test ' I - g, �Water Pipe�Undrgr,nd. 60. Backwash Lines, P�Trap, O Undrgmd. 10. Structu�al Floor SYsiem 67. APPROVAL TO DECK .t t. PropertY Sewer Line & House Connection 62. Backwash & Raceptor�Final - - , � 12. Sewer Cap � 63. Heater & Vent-Finai 73. Roof Drains , ' �. � 64. Plumbing System - Final 14. Rough Plumbing �� 65. Electrical�Final � 15. Rough Etectrical-Conduft 66. Solar SYstem-Final - 16. Rou9h �lectriclNiring 67. Pencing & Access Approval 77. Rough Wiring Sign 68. APPROVEO FOR PLASTERING 78. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEhiS FINAL 19. Rough Heating & Air Conditioning . f/_ 5 i� ., R�R,E DEPT. REQUIREMENT � . � , r: ' f'iJr � :+ Ci 20.:Rongh Pactory 'riieplace ' ' ' � „ APPROV �,5�,�.Permit #-t- -l� `�s 21: Ouecs, �n Stcucturp� ' �� •• •-'.': = '� "' � � '70. Underg ourid Hydro ' � ' ' V F'� �: K 1 22, Oucfs, Ventjating' ~n ' �:. �� 77, Produca;Pi'ping OGas ❑Oil 23. Gas Pipe-Roogh & Test - � �" ,72, Undergro�d FIVYh' " 24-Roof Ftamin§ :;i;" .'" ' � ,� � �� - , ; '.73�,Undergrnd.Storage•Tank�`OGas ❑Oil 25. Roof 5heathing - � v � � � _ ^ r��. �- 74,��Overhead Hydro: � - � 26. T�Bar Ceiling (StructuraVl &=M"opdcoat ' .,�, - �:j`' , 75.,-Dry Chemical . � � � 27. �Frame and Flashing "' . � - � 76. ,Dry Standpipe � '�' - - , - 28. Lathing & Siding ; '� '`;� ' -- ' " 77:� FIXED SYS'TEM FINAL�` ._ ,� 29. Insulation � - �. �x� 7&=FIRE PflEV. FINA�L � -- � �30. Dry�va�l Nailing � �K' -' `NEALTH DEP7.. R'EQOIREMENT �31. Plaster Brown Coat� . ,-^� , � .. •�79 �FINAL INSP_ECTION � � - ��"32;� Eiectrioal Power Metei•�Fjnal - '� ^'• 'SO�FOOD CERTIFICATE ISSUED_, m, 1 ' M � `f� ? '` A: 33.� Final Elec:rtc ,� � �c; � � ,q: x �Notes: ^n . -, : '� 34:- Fina� Neating & Air Conditioning: -. w -. •k - -� + - • r�.•=' � •' - . :� ,t�• z3: !� � CvYli2rzz� �� 35:�.Fina1 Gas Pi'pe-Test� .: , . i. : ` � _ � . ; ,_ -. �� . . � - 36. .HoLd Or_CanoPY .. r"' .. ; . ' . �.. �. � �- , . ;-' ' '.+ ^' � �` -�/S � ^ -G•`Lt�--�z.�_ 37. Finel Factory Fireplace . ; �: . ;,' °� �- ;, ' z _. _ . i'z . 88. Final Plumbing V � '-' ' " ' ,v- . �39. Water Service�Final � " � ��"� '' ;��'' � � � N 40. Gas Service-Final . p; r.�� ; � ., r.i ' • . �c_ . 4 . 1 41. SolarpomesticFinal ' ^ ' ' ,. �` ' `T ' -n . � -y. . , , � J ; 42, Backflow Preventer,. • . .>- .+ ?[ • . �- - 43. Backflpw Irrigatiori - r ;_ �- `. .. � . rc r. . r: � 44. Landscape Irrigation System.r7� � - � �'� � _� x .- :' ;7 `�i • ^ ..,... _ _ � n,Y 45.-Sound Qttenuation ""� � �- ';' r� "' ' "; -' `� ; �T "� r,n rl�..,� o t• � �.-: . ' 46. HanditaP Regulations � � � . ' t. �� r� jo . -� . 47. FINA4 STRUCTURE & BUILDING ' `* ' � � •� c � - • 'k . . F- 48: FINAL PLANNING � �. � � , . •* -i = 49. Electric Release to Edison � - �' n - • 50. Gas Re�ease to Southem California Gas Co - ' - - • c' r. • C �; n 51. CERTIFICATE OF OCCUPANCY • . � i?� � • � � No. Date ,� �oowEssoremiowc: 933 EVERGREEN i�L. � uxr. 0{YNEASN.IMEIFplOWN: HOGART, BRAD KENT " � _e '.00xess: BOGART, MEGAT� MOTE �' 933 EVEk6REE2v PL =OSTA MESA,CA 92627650-7395 MPL. YNIING �WNE54 ARLXAECTONFNfalFFA: J�]ES GARTNER ARCH m,xonu+cs�ooxess: N/A N/A CdlIpACTpf3NWE CONfH�CT0A5MY11NG /i0DHE55: UC.NO.: CL%�ISO UM: CA 90000 11C. NO.: UNT: LICENSED COHfRRCTOPS DECLANRTION� � TereEy eflim uMer pereYy oi pe�jury thet I am licer�d undx prm+eiona d Clieplm 9 (oomme�wrq wi�h Saction )000) d Diviaion 9 M �he Buainea eM PMeevona Code, eM my licen» ia in hll iwce vM eNed. cm uc. No.: uc. cuss: uc. No.: Ey{P ; oda: cd,vaa«: OWNEN BUILOEH UECLAFATION: I Mrtby e/firm uMer pandy al perN�Y �� I em szamq Imm �ha Contrepas Licenee lew /a Me c ;�IMmp �ae�on (�ion 1031.5 Buaiwa eM Proleeaiwn Cade: AnY c'ry a cauny wt�iM rpuirea e pemin �o mruvun. Mx. impwe. ?:�:.nol6h, a npeir any souclura, p'ar b Na ps�eMe. ebu requirea tM epplicent br euc� peimil to fib e sgiroE Netement ihm he a ehe %"�4'licenaeE Ou�suent lo Ihe poviaiona d tM ��as Liceme lew �Cheqm B(cammemiip wilh Setlion )�00) d D'vopn J d ihe S� vrusineae enE Proleeaona Cde] or ihel M ar ehe ia exemq iheraimm anE the beaie /a iM dleped uamqion. My videtbn W Setlun ]03t.5 b/ eny epplifent lor a parmil wbpde �� aPPIceM �o a civil panelry d nM more ihan liva hundred dollen �550p�). � I, m ovmer W the propaely or my empbyeae v.ih wepea m �hei eole eompenae�ion, xill do iM xwk, erid Na etrueluro e nd inlanEeE m MereA br aeb (Seciion ]OOi. Busirroea end PMessima Code: The ConlreUon Licenae lawEoeS rot epplyto en oxnard propery who Wids a inpeovea iMrean. end xM daee eudi xak MmaeM w Mnetl m Ihrwph ha «her own empbyeas, proviCed ihet euch impovamema are nd imeMed a allered la vele. M, howe`er, the buiNi'p m'vnpwemem b edd wnhin wr yw d mmpb�ion, tM ow�wr-0uitler �+ill heve tM W Nm d p�'i�p he w ahe d'd M WiIE or impvn la Ihe purpoae d aeb). ❑ �. e. o.,w a i�» wwero. � a.eunMr ��e�o wnn foeiwe wn�redon �o canm�a �ne o�= Iswion �ou, ani�en.m PMeswna Coda: The Cam�eeon liM��e lew Eom na eCPN to en owror d poPeM wM buiMa or unpw'ea Iheieon erM who mnveem 1« wM P�q�s xitn e aoMexlale) IieemeE WnuaM to Ihe Cont�eaae Li�wiae Lewl, y� a I em aaemp uMer Section: B. d P.C.. Iw Mia ramon: . Dale: ��' I do Mreby carliy Ihat I em ewere d vM urdamm�d the requiremanre of Cellomie HaeXh end Sefety Gode Sedione 25505, 25533, uM 2553C, end the� I or eny Mure buikinp oocupeM vnll / will nM (drcb one) need to camDh'uilh eeid ateta cadee anE iM req�iromenb M WOPKEN'SCOMVENSATONOECLAXATON:Iherebyelf urderpyeM1ydprjuryanadiM ' Eatlereiiom: � Iheveudr.ilmeinlanecMifkeled��tosWimurelurwakbncanperomian.o IabySsqion3)OOd�Mlabar coae. �« ine ron«�a d� w� �a �n ms v�a o��d. ❑ i neYe e�e �� meimew wonen ca�c��^^ �^•��. ��a��e M s.aon a�oo a me i.n« c�. b. me wdwm.�c. a mo WOfI[ Ip WM1ICM1 �M16 P��mll 1919fIME. MY Wtt1{B9 WIIIpp1148�M11111911I8MB GfflBf Bfld VdkY IIYIIItBf azB: carre.: Pdicy Numbec (This sMion neeE iwt 6e canplNeE I the pl�rt is lw are hundred ddlen (Sf00J w Iw.) � I cerlty Ihet in Iha pe�amenu d Ihe wark 1« which ihb pertnn ia inuad, I ehell M empby any panm in eiry menner eo m to beeama vubjea ta ihe warFera' eanpe�+e�ion lexe d Cdilomie. arW epree thm il I elwk beeana wbpa �o tM xvekan' rnmpense�ion pwisions ol5epbn 9]DO o/ iM lebor CoAe. I Mell lathxnh comqy wilh Ihme povieime. ome: nod�v: W�mlip: F�llun b ucuro wollren'ro��tlon eovereps l� unlewlul, antl NWI au6/�ct an rplayw ro eMMiul pwuMu enC clvll llros tq ro om Mnerotl fMuuM EWan ff10QP00A ��Itlan ro N� tolt o/ roTpaueWnl demep� u poHOM ror In SxHon 9105 a1 tlis La6ar Code, lnHnsf, end attomeyi /su. CONSTFUCTION LENUING AGENCY: I M�eM eHrm unEer penelry W per'ryry Ihm then e a canatruaion bMiip epency /w iM pan«mence d me w«k ror wnim me w�+ �• nwea (seaon aas], ca. q. , LENDEH'S NAME: LENDEH'S RDONE94: � cenly �nm � neve reaa �ne epd�an ene Aai. mm �ne ebove m�ammlon 1. wnea. � eoree m mmWv wun d� ary ene coumy okirences end n�ele kwe eelelin0 �o builEvnB con�ruaiM entl Mreby aWMrixe rapraaen�Porvea d Ihis tiry Io anlx upo� IM ebove�mentoned qoperry la impedpn Wrpasas. (5151-�l.W I oma: 3 . q�. While-Buikiq 8 Sd�eiy: OraemFle; Cenery-AppFceni; Pink-qevenue; Gokanmd-Maemr CITY OF COSTA MESA — HUILDING PEAMIT �IFER'l ; PERMIT NO; P 071445 PLAN CHECK NO; N �G�C�'T-�SIIP"P;�— CONSTRUCTION.TYPE; PERMIT TYPE; PLU PURPOSE: ADD JOB DESCRIPTION ; ADD 4465F LIV ROOM, 598SF GARAGE TO EXIS SQ FT; CLAIM VALUE; CALC—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: REF: B-70299 RELOCATE PLUMBING FIXTUAES, RE:#P70437 f(� ff �lk 1F 1E �t if iF �1F 1F if if ff' if iF 1f if if �1F it if If 1E 1f If *'1P iF if M iFlE 1f M if iE iF If Ih if �IF M if if if 1f iF if if 3E 7f 1F if df %if ff if if 1f iE If if If iF iF ft M M M af if if 1F af ff if IF 1F � Z O N I N G R E Q U I R E M E N T S 5 E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR; FT IN FANT: FT IN REAR: FT IN LEFT; FT IN RGHT; FT ZN LEFT: FT IN RGHT; FT IN PARKING REQ: PROV; PARCEL; 42252112 ZNE: REF NO: PLANNING NOTES> i �k M M 1F if if if 1f if 4!F if 1flk fF jf 1F 1f 7t M 7t 1k'k it 1F'k 1f i! 1f if 7f if k�lf it if !f 1f %!f 7f iF if� iF df %1f.iE iF 1E it iFff ff M�If ii'If 1f if if it if i41f if'k M i! If 1f ff if iF'M if �f �E if . D E V E L O P M E N T S E R V I C E S.^ R E Q U I R E M E N T S ZONING APPROVED BY ��" DATE: BUILDING APPROVED BY ; DATE; I+.PPLZCATION ISSUED HY; ,i DATE: I�� 1fif1ffFlhlkMMlkitlFiFifMifYlfMlFMifiF 1f1fM1EffiFaflfMM �k1f 1f ft M M 1F fl� jf if 1t ik 1f 1F M if M ff fFlF 1t �lf M!k'M 1f �f'1F'll' M ik it M ih iFlF 1f if'7(�'If if iF 1E M 1t ff M it M at If M 1f fk if M if 1f iE M 1E k if M if 11� if 1F ft M�k M%1F 1L 11� iE 1E 1k iE 1E LEGALIZATZON;N F E E S U M M A R Y STRUCTURAL SEGMENT;N HLDG PMT PLUMBING ELECTRSC MECHANIC FIRE SMIP/RES GRADING PERMIT 19,00 " 252 '' SMIP/NON—RES PLAN ` ,. ISSUE FEE 10.00 � - HUILDING—DIV—> PERMIT ISSUE PLAN-.CHECK ' TOTAL PAZD DUE TOTALS----> 19,00 10,00 �; 0,00 24.00 24,00 ,00 f REVENUE DIVISION TOTALS--> COLLECTED; 24,00 OVER/SHORT; .00 HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 24.�0 . .. .. �F'k!h'k 1t M iF M iF 1Flf jh iE 1f k 11� ik 1F if 1f'1F'If if iF iF 1f 1F ff 1f 1f 1f'k 1F iF iF dF 1f 4 ff iF'It M'M ih i! 1f 1f if if'1F k M il� M�If 1f 1f 1f if 141E iE 1E iF 7f 1t 41!'It iF �F ik 1F 4%�F if 1f if I N D I V I D U A L � F;E E-.H A E A K D O W N TYPE QTY D E S C R I P T I O N�� -' UNIT COST TOTAL COST PLU " 1 WASH BASIN •�� 7,00 7,00 PLU 1 WATER CLOSET (TOILET) �.i �'"' 7,00 7,00 END OF• FEES I V j;'/ J , �. ` .^„ Ji CCl?7?9°?-CQi?�999 T[aT GkTE: C�3i 13r'rg Ttf!F.: iQ%?5 ''' 24.�0 � � POG _ .. SPA ,y:ONSTRUCTiON AND PIANNING '� :APPROVALS Permit # Date I�spector qppROVALS Permit # Date Inspector t. Temporary E�ectrica� Service or Pole 52. Pooi & Equipment Location .� ' 2: Sojl Pipe-Undrgrnd. 53. SieCi Reinforcement '�3i.�Electrical�Conduit U2ility-Undrgmd. 54. Forims � �j;4i,Electricafionduit�Undrgrnd. 55. Etectricat Bonding �''� ; �, �.��;$teel Reinforcement 56. Rough Plumbing & Pressure Test �- '�"G��Iectrical�f3�ERGrnd. 57. APPROVALTOCOVER-GUNITE ❑: r u. � .�_.�, =�7��ootings : 58. Electrical Conduit-Undrgrnd. ... .. "8.� Foundation 59. Gas Pipe, O Undrgrnd., Test ^r� .�.9. W'3ter Piae�Undrgmd. 60. BaCkwash Lines, P-Trap, CI Undryrnd. " 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 - Finat _, 74. Rough PIum6'r'ng p; . �_J� �r-/� �a�j,j 65. Electrical�Final . 15. Rough Electrical-Conduit _ . 66. Solar System�Final � 76. Rough Electric Wiring 6F. Pencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 78. Rough Electrica6T Bar Ceiling - 63. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning � �� FIRE DEPT, REQUIREMENT .-� o. r� �' t� T�-� Ul c., U7 . i'. ,r C^ 20: Riii�9h�FacEpry��ePlace i°;�� ;,� 7 J �' i F� S[ APPftiQV S;�' Pe mit #' :" �'�� til �� ` F• t -�--:-- 23, Diicts,�n SiYucture i�^ •- ,�' � %�� 70.`Unded§�aL,"�rd F(ydro i r� � , . . ~ �^ c 22. Dn�ts,rC/entilaci�� ; ;,-� y �� y� 77.Yprodustijipinc�`��YGas �Oil 23: Gas Pipe-RQugh &.Test j R�=, p: � `�. �. .- 7z, Underg�ro'�Lhd Fflish � :- � ` 24' Roof Fyami�tg �; } �`' `•" "�; '�' � �, �r 'r `- 7� Undergrlid. Sto«`t��e Tank G� Gas d-bii' i.. •.i ...,... .: . - c 25. Roof Slieathing ��. v v�� .-� vl � r 7eP Overhead HYdi_o" - 26: T'Bar Ceiling (StrBciural) &�f��'�ocoat � � `L' r ; ' 73, Dry Chemical �.,_j � �� ` °'y .} .. .. .. i � _...., , ` _ . -. �. � ._ . • :. n. .., r 22; Frame.�nd Flas�n9 �c; � r. t; 76. 4ry Staridpipe.-�s-� r :r.,n _ � E; 28. Lathin"g&Sidin"gr �' h�;� � ..� .� •..h � 77_ FIXED��KSTE,42f1JV,4�,y �1 ':�� '� 29. �nsu�aiion ��• �.� ", . ... •• . I I� ' 78:'-FIRE`PREV. FiNAI `' � �-+U ' 30. Oryw§I�I'Nailing'-�} H �iy ; H I � j* . ,�,.��; ��H'EALTH DEPT'REQUIREMENT Qa � i r � �c.,«, v , � . . �� -j 31. P�aster�srown Goat �' ': � y i f' ., ,. 79: FINAL fNSF'ECTciON r -. �: :. , .�, . ; 32: Electriql P"ower�Met2�,;F�n�l � �} � � �t ;' S� POOD CEFTIFJCATE tiSS�UED G : � r � x I �' '1 l � �` �: �' - s -� - 33� Fii;ai Elect jc � . �� IVotes: - > ; �; ; �;- .; 34. FiFial FJeati &�Air Conditioni Cl � � '* , . � w -,"i;i: . ,_L � ' �!9 �J 4: �� t n• � a p t-j 'f �.� . f-�C� ��/ G •-, ' � ]4 7 . "• , � . . `�. ... , ' / ,*. 35; F nal G�s �,�je-'T��s,i `n •• a r-. � i � �- '�2.�i:! .G.,+,j<� 7?� z; ` i;� ��,. i.�.. � 36: Hood or Canopy' � :�"' •- i � ' � G - ` - " A � i r.f �� rl 1 ' oa (, � 7 - / � , a�_ G't77: j, •'j /�"• ' Rt " '.; � 1 _`.'[�' 1 x ::1 - . } _ .: . 3T.: Fir�al Factory Fr,aplace• � ;..,c.. �.� ; : � �� _ �� :. . .. - • � �s�£c�.�T • 38. F"rd31 P�umbing�C ` �^: � . - � ; ' ` "' + . - H h' " lti .-1 Q: Y+ � J � + i ..� � ' i , � I. [ ; :.1.�1 , 39. Wafer Sqrvice•Ft}jdl � � ,-r I _ *�. , 40. Gas Sei'vlce-Finst�• �y 4r-tn S a t�? { �s - 0.-. on; t 0. � . ' r 4 .�. �' - 41. Solar pomestio-Fi a�' � �` " * ��• � � � ' ' �' n _ s4� ,�' � � �: i �:• •;�. M . , '� �� 47. Backflow Preventer � ^; + ^ ; I �* • c.^, � >F- : C7 .= _ a. , s •t. y C q• .. .-. O.' y � _ :.'`• .. �" 43. Backflow I�Yigatioj� �, : �. , i .. ,� . . ; 44. Landseape�trrigation Systea7� iC? tr- , � 7 O� r�. tn :u 7iC) � o; or., , � ..a : � c: . '_ • 4�r� Sound;�Attenuation `.:"f , [� ' � i �� f t� ry t� . c. ^ Y r ; 46: Handicap Regulations � y�� . cr, c't� �' f I �, rr� s 47'r FtkJAL STf�UCTI(FtE & BtIiLDING ; ` � ! �' � ' �� - ' ' r � ' � r�• s �. 48:� FIIVAL PLANNING �.--F� t:- � � �[', tn r; ` - 49�." Electric Release to� Edison � ` 4 � � �;� �: , � � � i i i ' • i ,. ' _ ... _ 50. Gar Release-to Southern Califor.eia Gas Co �= i � ��t �� a�.', vi • t', •� -<• . • r� ;i� � � 51. CERTIFICATE OF OCCUPANCY � r :' : • -- -. • �--� N0. Date „ OWNER SOLORAY� A. � JOB ADDRESS333 Ever�r ♦ p” �, 117-4 j� IA_ �CTION$ Q so�� cas WATER ROUGH PLUMBING PROP. SWR.LINE TEMPORARY SERVI UNpERGR0UN0 � ftOUGM WIRING �yR.z.sa-yky�asi AI.IUK uwner tsiar. -11 LOT TRACT Si nmi HOUSE CON. � VIR CONOITIONING OR POLE POWER � IS � STEEL REINF. � 'EEL REINFORCE I� SNEATHING FRAME AND FLASHING LATHING - IN n S' 'URAL, FINAL HG. .NG. VENT.. REFRIG. AND ILOING, F DATE �-1( (4 BUILDING PERMIi N0. hlKt LUNt VALUE $cvv. TYPE GROUP SUBCONTRACTOR _ Z . W W a U F- Z Za O v~i am J � J � Q W QI J • f11 J Q U N Z a W � d W WZ J 0 m Z J � W W 0 ZH W � N � � � H z Q U J a a Q 0 H � z � H U � � H � z �8294 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely y9UIlDING DA`2 L . _ n __ _ .. �i OWNER H •• /� MAIL ADORESS CITV CON5TRUCTION IENDEF BFANCH ADDRESS ADDRESS CONTRACTOR ADDRESS GTV STATE LIC. NO. 512E OF LOT USE OF EXISTING BLDG. 51ZE OF TJEW BIDG. EXTE:iIOR WALL GOVERING USE 09AUI LDI ND NO.OF ROOM� ROOF TEL. TEL. NO. CITV LIQ NO. INO.O LBF� NOW ON LOT v�io 4°r 17-74c:s.Q(1 664;> ..::,t;:::5.50 / o APP CATION FOR BUILDING PERMIT. ' R C I BV DATE RECEIVED DA E {ISSUED ��'11�' �� A.P. NO. PEJC�� BUILDING � f' � �� ADDRESS C TRACT (� LO BLOCK W ADD A P owNEa 11. �lOLC7VQ! FIRE ZONE APPROVED ) � NO.OF PLANS VARDSAPPROVED MAIN BUILDING ROM C/L ST,REET) � L. SIDE O REAR � �( DISTANCE BET. MAIN BLDGS. VAR. # C.U.P.ak �GROUP � ^ DATE "'/ � USE OF N W . BUILDING - VAROSC PROVED BET. MAIN & ACCESS. BLa DATE �jp¢�yl�Cl.�i�l�je�1 a( 7�e�h�� i n antl state .,� v ffiet e above information is cor ct r e co ply wlth all laws regulating builtling construction, and 1 � 1�' ,��( any person in violation of the workman's com �il��s"f)f ffie Stare of Calitornia. / m b 1 hereby certify that I am properly licensetl as a contractor untler SQ. FT, o the S[ate of California Business and Professions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR � Chapter 9, and that such licenses are in full forc¢ and effect, or I- THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: Q am exempt from tl:e provisions ot the State ot California Business VALUATION and Protessions Cn e, Divi i9n 3, Chapter 9. °� PERMIT FEE $ � � � SiB�ature t ./ m Permktee $ �D PLAN CHECK $ E � `o Authorized Aqent LL TOTAL FEE y^ ORANGE COUNTY BUILDING DEPARTMENT -� � . 636 North Broadway . , SANTA ANA, CALIFORNIA '" FOR APPLICANT TO FILL IN BUILOING ADDRE55 933-Evergreen Place scr+oo� oisr. CO6t2 M29& OR TOWN NEAREST �Ross ST. Monrov7.a OWNER (!hinnnk HnmPs Ino no RE55 9:i63 S411ehire Blvd. =�ry Beverly Hills No`.�CR 54361 ARCHITECT OR _ __ __ , LIG. ADDRE55 AOORE55 (ATTACH METES & BOUNOSI SIZE OF LOT 73 R ZLV I NOW ON LOT O USE OF NO. OF NO. OF EXISTING BLDG. FnNi�iea I RO CENTERKOFISTREETM�rj� lt� SI�EYARDl�% � DESCRIPTION OF WORK MOV USE OF NEW BUILDING ROOF APPLICATION FOR PERMIT � ' "- - ��Y ' r� �_� _ ' FOR AFF.ICE USE.ONLY - 1 RECFIPT NO. PEftMIT NO.. � . �33i so ;:�� ,�BY / A"`%C"JS / T/ 5�� TOWN 1 ! A��Qx�_�/ /SL_ � . IAREST �%J � _ ' � '.055 ST. , J//AIYI�) �A7J a./1... �� -� NO.OP � TYP � GROUP� PLANS �-_ -- PROVE /�� DATE'/ —I•. � CORRECTIONS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS FOFMS, APPLICATION AND STATE THAT THE A80VE IS CORREGT UNDER-F AND AGREE TO COMPLV WITH ALL COUNTY ORDINANCES FRAME: FIRE BRAQNC AND STATE LAWS REGULATING BUILDING GONSTRUCTION. AUTHORIZED VALUATION S 4830�QQ PERMIT FEE $�� MA50� PLAN CHECK $ �` BONO FEEAL / /. 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