HomeMy WebLinkAbout2805 EUROPA DR - Building PermitsCITY OF COSTA MESA
��pMFSq BUILDIIIIG DIVIS/ON
>`�� 77 FAIR DRIVE. COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
� ° FOR INSPECTIONS CALI: (714) 754-5626
��"OR"jOfi PERMIT NUMBER: P11-00193
PERMIT TYPE PLUM
APN: 13940408
STATUS: ISSUED
DATE ISSUED: 'I'1/01/2011
ISSUED BY: MDM
JOB ADDRESS: 2805 EUROPA DR CM Suite/Unit:
viciniry:
SCOPE OF WORK: REPLACE 38 GALLON GAS WATER HEATER
OWNER: SOMERS ROBERT Address: 2805 EUROPA DR
PHONE: City/State2ip: COSTA MESA, CA
APPLICANT; ATANASOV, STOIL Address: .
PHONE: 866-692-5273 City/State/zZip:
CONTRAC70R: CALIFORNIA OELTA MECHANICAL !NC License No. 811114
Address: 1235 GRAND AVENUE PHONE: 800-898-0008
City/State: SPRING VALLEY, CA ZipCode: 91977 CELL: 666-692-5273
uv
ARCHITECT; litense No. PHONE:
ENGINEER: License No. PHONE:
:�
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE:
PERMIT FEE:
TOTAL FEES:
$0.00
$35.80
$35.80
n,.�_.
� -Lh..' 5..5
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Cali(omia statutes and relatetl
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMii EXPIRES 1B0 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with alt applicable codes, and all
required inspections and final approval musl be obtained. Failure to obtain inspeclions and fnal approval will result in the expiration of this permit.
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LOOE A. INSPECiIONTYPE DnTE INTITIALS COUE1 INSPECPONTYPE OnTE INiRIAL
1616 Fixed System Final Fire Prevention 206 Final Mechaniral
1266 Pool Spa Final 208 Final Plumbing '�_--�—✓—�-I �
200 Final Re-Roof 210 Final Elecfrical
207 Final 9�p�k/Retaining Wall 212 Final Fire Prevemion
202 Final Fac�ory Fire Place 220 Pinal Planning Approval
203 Final Sign 222 Finai Site '
204 Final Demolition 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARA710N:
I hereby aKrm untler penalty of perjury one of the following declarations:
❑ I have an0 will maintain a certificate of consent ro self-Insure (or v✓orkers'
compensation, as provided for by section 3700 ot the Labor Code, for Ihe
pertormance of the work tor vfiich Ihis permit is issued.
� I have and will maintain v.orkers' compensatbn insurance, as required by
sectbn 3700 of the Labor Cotle, (a the peAortnance of the work for which this
permit is issued. My workers' compensation Insurance carrier and policy
number are: 1 }/
Carrier: .�YQ 1� �%i1�'J
(rhrs seaibn need iro/l�0/e�m�m7pietee Aqme� 2peimrt a vahme at me hundied exars (5f 00) a ress )
Policy Number. � f7 –/ /�iC J
❑ I certify that in the peAormance of the work for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to the workers' compensation lavrs o( California, and agree that il I shoultl
become subject to the workers' compensation provisions of Section 3700 0!
the Labor Code all forth �th comply with Ihese provisions.
� � JI - 1-ll
ApO�icanfs Sgnawre Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSA710N COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARA710N:
I hereby aKrm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license is in (ull force and e%ect. /� /'
Lic. # Class # Ci �q
y,�' �l- l- Il
Canlratlor's Slgnalure Date
CONSTRUC710N LENDING AGENCY:
❑ I hereby aKrm Ihai Ihere is a constructbn lentling agency !or �he
peAormance of the v.ork for which this permit is issuetl. (Sec. 3097, Civil Code�.
Lender's Name:
Lender's Address:
Signawre
OWNER-BUILDER DECLARATIONS:
I hereby aKrm thal under penalty o( perjury that I am E%EMPT FROM 7HE
CONTRACTORS LICENSE LAW for Ihe following feason ($ec. 7031.5,
Business and Professions Code: Any city or counry which requires a permit to
construct, alter, improve, tlemolish, or repair any sWCWre, prior to its
issuance, also requires the applicaN tor such permit to file a signed statement
Ihat he or she is licensetl pursuant to the provisions of ihe Con�ractors
License Law (Chapter 9(commencing with Section 7000) ot Division 3 of the
Business and Pm(essions Code) or tha[ he or she is exempt therefrom and
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicaN to a civil penalty o( not more �han
(ive huntlred dollars (5500).):
❑ I, as ovmer of the property, or my employees with vrages as their sole
compensation, WILL DO THE WORK, and lhe stmcWre is not intended or
offered for sale (Sec. 7044, Business antl Professions Cotle: The Contractors
License Law does not appy to an ovmer o( property who builds or improves
thereon, and who does such work himsel( or herself or through his or her own
employees, provided that such improvements are not intended or oHered for
sale. If, however, the building or improvement is sold within one year of
complelion, the ovmer-builder will have the burden of proving that he or she
did not build or improve (or purpose ot sale.).
❑ I, as owner of the property, am EXCLUSIVEIV CONTRACTING WITH
LICENSED CONTRACTORS ro constmct Ihe project (Sec. 7044, Business and
Pmlessions Code: The cont2ciors License law dces not apply to an ovmer of
property wfio builtls or impmves thereon, and who conlracts (or such project wilh
a cant2da(s) license pursuant to Ihe Con�2ctors license Laws.).
❑ I am exempt under sec.
Business and Pmfessions Cotle for this reason:
� � � � � � �
SignaWre Da�e
J051�G6 �]/0))
�
Owner ID verifed by driv�. _ acense. ❑ Yes ❑ No
Driver's License No. Expires: -
Verifcation of Ownership by (type of tlocumen(, i.e. - propeny tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby cehify tha� no eacavation frve (5) or more (eet in depth in�o wfiich a
person is required ro descend, will 6e made in connectbn vrith work auttrorized
by �his permiC and that no builtling structure, scaf(dding, falsework, a demolition
or dismantling thereof, will be more than thihy-six (36) feet high. (Chap. 32, Grp
2, M 2, Sec. 341, Ttle 8, California Adminis(rative Code).
❑ As owner-builtler, I will not employ anyone to do work wtiic� woultl
require a permit (rom the Division of Industrial Salety, as noted above, unless
such person has a permit to tlo such work from the division.
nppiicanfs Sgwwre Date
Division of Intluslriai Safety Permil NumDer.
HAZARDOUS MATERIALS AND EM�SSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to file antl
certify a Business Plan for emergency response ro release or threatened
release of a hazardous matenal? ❑ Yes ❑ No
(Section 25505 of the California Heal�h and Safery Code requires, with some
exceptions, lhat a Business Plan be fletl vrith the Costa Mesa Fire
Department by every business which has at any one time during a reported
year a quan�ity of hazardous materials equal to or greater than a vreight of
500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperaWre and pressure).
2. Does or will Ihe applicant or present or future building occupaN need to file
a registration (orm for acutely hazartlous materials? ❑ Yes ❑ No
(Section 25533 0( Ihe California Healih and Sa(ety Cotle, wiih some
ezceptions. requires registralion vnN the Costa Mesa Fire Depatlment by
each business which at any one time has on hand a quantiry of aculely
hazardous ma�erials equai to or grea�er Ihan a weight o( 500 pountls, or a
volume o( 55 gallons, or 200 cubic feet o( compressed gas at standard
tempereture and pressure).
3. Does or will �he applicant or present or future building occupant need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazartlous materials�? ❑ Y�s ❑ No
(Section 25534 0( the California Heal[h antl Safety Code provides that the
Costa Mesa Fire Department may require the preparation, certifcation antl
filing vnth the Fire Department o( an RMPP by businesses which are required
to register acutely hazartlous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 0! the Calilornia
Health antl Safery Code been (ully complietl with? ❑ Ves ❑ No
5. Does or wiu the applicanl or presenl or fuWre building octupanl require for
lhe work which is ihe subject of this aOPlication a permit for such construction
or modifcation from the South Coast Air Ouality Management District or from
any other air pollution conVol tlisMct or agency? ❑ Yes ❑ No
(Section 658502 0l the Cali(omia Govemment Cotle requires Ihat the requested
information be fumished on applications fa non-residential building pertnits).
6. Will any pah of �he facility to De constmcted under this permit be within
7000 feel from the outer bountlaries of a school? ❑ Yes ❑ No
p( "yes", the faciliry must meet the requirement of Sections 25534 and 42303
of the Califomia Healfh and Safety Code�.
7. If a permit from the South Coast Air Qualiry Management Districl or other
air polWtion control dislrict or agency is required for Ihe work which is lhe
subject o( ihis application, have all of the disclosures prescribetl by Califomia
Healih and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. (If'yes", attach certifcate of compliance fmm the appmpnale air pollution
coNml offcer).
CERTIRCA7E OF COMPLIANCE: I certify that under penalty of perjury the
information given above is correcL I agree to comply with all state laws antl
ciry ordinances regardi Hazardous Materials and Emissions.
i(-� - II
Sig .a ure Dale
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certi(y under penalty of perjury that I have read this application and siate that
the information given is correcL I agree to comply with all state laws and ciry
ortlinances relating to building wnstruction, and authorize representatives ot
the City of Costa Mesa ro enter upon the above-described propeAy for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorizetl by this permit uNil �nal inspec[ion.
��SignaWr egal0 eqs� Da�e
',' — / — / /
Ad/orAu onzeGAp011cxnl Date
�
krescrlptive Certificate of Compllauce: Ftesidendsl Water k%eattng _ CF-lZ2-A.Z,T-R73 '
Slte Addreea: /�QS �r, rA,na I k' I Cllmata Zone: {� � Aete;
• T xiti$� thet thla Cutiflc4te of Camylie¢ae deeumrntatioa ia sccmate mmd aomplota� . � -
• Ismell�'htovndarDivtainn3afHaCalifemiaBv�aecseadPmfase3onaCadoroaaccptmaponeibllty:forrhaLu7dmgdeeigaldeati9edan
iLle Cartlfioete af Campliance
• I aati£y &etflu a¢etg7r faahuee md pacfntLmnw apmlfiaaliana for tha 6u11d'mg dwigu identified rm thie Crstificate of C�3ienne cosst�m
N the xequitcn�fa af Titla 2}, PPr� 1 end 6 o4tEa Call.tamis Coda o4Raguletlona. �
• Tha buildie8 deei� foatnzae [dmtti5ed an th4 Cu@ficeta ef'Compltaace ue eaarlatantvrlth the icfomaflan pmvldadto document tStle
trufldiag deelgn an the othet apylirahte aoaspllmce &�4 vror'nheeta. eekvlatipne, Pl�+e eud epaotfioationa auhmSNed to ffie e¢Yotmment
Itame: � /�
Compecy:Celifornis Delte Mech c�
A�6'°�o6e E. Basellna Rd., #165
Cieyr9merlZiq:Mesa, AZ 86206
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CITY OF COSTA MESA � �
�,O`'TpMFs,p BUILDIMG DIVISION
4
F� ,. ,. �p 77 FAIR D� IVE, CaSTA MESA, CA 92626 • p14) 754-5273 • Fax (714) 754-4856 • vn+w.ci.costa-mesa.ca.us
� ` g FOR INSPECTIONS CALL: (714) 754-5626
'`°���^°fi PERMIT NUMBER: B11-00246
PERMIT TYPE B_ROOF2
APN: 13940408
JOB ADDRESS: �2805 EUROPA�DR,'CM
Vicinity: RESIDENCE AND DETACHED G'ARAGE�
Squares: 2800
STATUS:
DATE ISSUED:
ISSUED BY:
SuitelUnit:
Valuation:
ISSUED
0811612011 '
KJB
$9,500.00 `
SCOPE OF WORK: TEAR OFF EXISTING ROOF. RE-SHEATH AND COVER WITH 30 YEAR COMP SHINGLES. ROOF PITCH IS 6:12.
APPROX 2800 SQ FT. INCLUDES DETACHED C�ARAGE. RESIDENCE AND DETACHED GARAGE TO BE DONE
CONCURRENTLY.
NOTE:RESIDENTIAL RE•ROOF: Final approval of permit shall not be granted until access to dwelling unit(s) is provided for
verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card
OWNER: SOMERS, NATALIE
PHONE:
Address: 2805 EUROPA DR
City/State/Zip: COSTA MESA, CA
Unit:
APPLICANT: WALKER, CHRISTY Address: 3857 BIRCH Unit: .:UNIT 472
PHONE: 714-425•5852 City/State/Zip: NEWPORT BEACH, CA ._ _
CONTRACTOR: CITY ROOFING AND MAINTENANCE INC License No. 944471 '
Address: 3857 BIRCHUnit: UNIT 472 PHONE: 714d25-5852
Ciry/StatelZip: NEWPORT BEACH, CA 92660 CELL:
ARCHITECT:
ENGINEER:
FEE SUMMARY
F2eroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
Bldg Std Admin Fund
TOTALFEES
$0.00
$181.25
$0.00
$�.00
License No.
License No.
PHONE:
PHONE:
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18I2010 - PER CMMC Sec. 13•279
Monday thru Friday - 7:00 am thrv 7:00 pm. Saturdays - 9:00 am thrv 6:00 pm. Prohibitied all hours - Sundays and the following Federal holidays
New Years Day, Memorial Day, Independence Dav, Labor Dav. Thanksoivino Dav and Christmas Dav
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California staWtes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be wnsidered legal, such work must wmply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit.
LOOE%. INSPEGTIONTYPE OAiE IN1111RL5 CO�EC INSPEClIONTYPE DAiE INiRIALS
1616 Fixed Syslem Final Fire Prevenlion 206 Final Mechanical
1266 Pool Spa Final � 208 Final Plumbing
200 Final Re-Roof I, �_ jV_ �� 210 Final Electrical
201 Final Block/Relaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Finai Building/Occupancy
WORKERS' COMPENSATIdN DECLM2ATION:
I hereby affirm untler penalty of perjury one of the following declarations:
❑ I have antl will maintain a cenifiwte of consent to sel4lnsure for vrorkers'
compensation, as provitletl for by seclion 3700 0( the Labor Code, for the
ance of the work (or whiCh this permit is issued.
I have and will maintain korkers' canpensation insurance, as required by
s ion 3700 of the Labor Cotle, fu the pedortnance o( the v.ork fw which this
permit is issued. My workers' compensation Insurance carrier and policy
number are/'�, —
Carrier. `�' /'�1 � �l/l l�
(�nk secrm neea /iro]t IceL mmperedAa�ne ce�a u valuea ar prc nundmd tloears (5�00) a less )
PolicyNumber: ��L�'1 � � V���� I
❑ I certily Ihat in the pertormance of ihe work lor which this permil is
is5ued, I shall noi employ any person in any manner so as lo become subjec�
to the workers' compensation laws of Calibmia, antl agree thal if I shoultl
bec e subject to the workers' compensation provi5ions oi Section 3700 of
th ode I s a �h/l%'�h mply vnth these provisions
(/ /� � /�../
AOW����'s Sig�uwre Da�e
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
(5100,000), IN ADDITION TO THE CAST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATfORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Professions Code, antl
my licen e is� i1n,fIull lorce and eRect. �p
Lic. # �l'T Class # 1..--
lG l/
m� tlor's Signalure Da _
CONSTRUCTION LENDING AGENCY:
❑ I hereby affcm that lhere is a consWction lending agency for lhe
peAoRnance o( the v.ork fV wfiich tltis pertnit is ssued. (Sec. 3097, Civil Cotle).
Lender's Name:
Lender's Address:
Daie
OWNER-BUILDER DECLARATIONS:
I hereby a(firm that under penalry of perjury Ihat I am EXEMPT FROM 7HE
CONTRACTORS LICENSE LAW for Ihe lollowing rea5on (SOt. 7031.5,
Business and Professions Code: Any city or wunty which requires a permit to
constroct, alter, improve, demolish, or repair any slrucWre, prior to its
issuance, also requires the applicant (or such permit to fle a signed stalement
lhal he or she is licensed pursuant to the provisions of Ihe Conlrectors
License Law (Chapter 9(commencing with Section 7000) o! Division J of the
Business and Professions Code) or that he or she is exempl theretrom antl
the basis (or the alleged exemption. Any violation o( Section 7031.5 Dy any
applicant for a permit subjects the appliwM to a civil penalty of not more than
five hundred dollars ($500).):
❑ I, as ovmer ol me property, or my employees with vrages as their sole
compensation, WILL DO THE WORK, antl lhe 5lructure is not intended or
ofleretl for sale (Sec. 7044. Business and Professions Code: The CoMractors
License Law does not apply to an ovmer of property who builds or improves
ihereon, and who tices such vmrk himself or herself or through his or her ovm
employees, providetl that such improvements are not intended or oflered for
sale. If, however, the building or improvement is sold within one year of
completion, lhe ovmer-builder will have the Durden of provinq that he or she
ditl not build or improve for purpose of sale.).
❑-I, as ovmer of Ihe property. am EXCLUSIVELY CONTRACTING WITH
LICENSED CON7RACTORS to construct the pmject (Sec. 7644, Business and
Pm(essions Code: The conlraclas License Law tices not apply to an owner of
property who builds or improves Ihereon, antl who coniracts fa such project with
a coniractor(s) license pursuant to Ihe Cont2ctors license la�w.�.
❑ I am exempt under sec.
Business and Professions Cotle (or this reason:
Signature Daie
JOS]Jfi (3/Ol)
Owner ID verifietl by drive� o iicense. ❑ Yes ❑ No
Driver's License No. Expires:
Verifcation of Ownership Dy (type of Oocument, i.e. - propeny tax bill or deed):
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION:
❑ I hereby ceriify thal no ezcavation five (5) or more leet in tlepth into which a
person is required to descend, will be matle in connection with wvrk auttqrized
by Ihis permit, antl that no builtling structure, scaf(dtling, false�wrk, or Oemoli�i0n
or dismantling thereol, vnll be more Ihan thiny-six (36) feet high. (Chap. 32, Gry
2, M 2, Sec. 341, Title 8, Califomia Atlminist2tive Code).
❑ As owner-builder, I will not employ anyone to do work which woultl
require a permit from the Division of Industrial Safety, as noted aDove, unless
such person has a permit to tlo such vrork from ihe tlivision.
ApplrC�nfs SignaWre
Division o( Industrial Safery Permit Number. _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or fWure building occupant need to !le and
certily a Business Plan br emergency response ro release or Ihreatened
release of a hazardous matenal? ❑ Yes ❑ No
(Section 25505 of the Cali(omia Health and Sa(ety Cotle requires, with some
exceptions. that a Business Plan be filetl with the Costa Mesa Fire
Depanment by every business which has al any one time tluring a reported
year a quantity of hazardous materials equal ro or greater than a weight ol
500 pounds, or a volume of 55 gallons. or 200 cu6ic feet ol compressed gas
al standard temperaWre antl pressure).
2. Does or will the applicant or present or future building occupant need to file
a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 0( the Cali(omia Health antl Safery Code. with some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hantl a quantiry of awtely
hazardous materials equal to or greater lhan a weight of 500 pountls, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
IemperaNre and pressure).
3. Does or will the applicant or present or future Duiltling occupant need to
prepare an RMPP (Risk Management and Prevention Program tor acutety
hazartlous materials�? ❑ Yes ❑ No
(Section 25534 of Ihe California Health and Safety Code provitles that the
Costa Mesa Fire Depariment may require Ihe preparation, certifwlion and
filing wilh the Fire Department o( an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
4. If an RMPP is pre5en�ly required, has Section 25534 0( Ihe Calilornia
Health antl Safety CoOe been (ully complietl with? ❑ Ves ❑ No
5. Does or vrill the applicam or presenc or future builtling occupaN require for
Ihe work which is the subject of this application a permit for such wnstruction
or modification from the South Coasl Air Quality Management Dislrict or from
any olher air pollmion coNml distncl or agency? O Yes ❑ No
(Sectbn 65850.2 of the Calilania Govemment Code requires thal Ne requestetl
in(ormalion he fumishetl on appliCations for nornresidential builtling permits�.
6. Will any part Oi the facility lo be conslructed under Ihis permil be within
1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
Qf "yes", the faciliry must meet the requirement of Sections 25534 and 42303
of Ihe California Healih and Salety Code�.
7. If a permit from the South Coast Air Ouality Manaqement Dislncl or olher
air pollution control distncl or agency is requiretl for the work which is the
subjecl of this application, have all of the disclosures prescribed by Califomia
Health and Safety Code Section 42303 been made? ❑ Ves ❑ No
8. Qf 'Yes', attach cetlificate of compliance from the appmpriate air pollution
Gontrol of(cer�.
CERTIFICATE OF COMPLIANCE: I certify that under penalry of perjury the
information given above is cortect. I agree to compy vrith all state laws and
city ordinances regarding Hazardous Materials and Emissions.
Signawre Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this application and state that
the information given is cortecL I agree to comply wit� all state laws and city
ordinances relating to buil0ing construction, antl authodze representatives of
ihe City of Cosla Mesa to enter upon the above-descriDetl property for
inspection purposes. I agree not to occupy or allow occupancy of any builtling
authorized by this permit until (nal inspection.
Wr � ga' slsl le
l�- �, �� l r.
PnG/or Au�nwizetl Apd�t�m Daie
�.ivc Certificate oi' Compliance: Resi[lential
u! Adtcralion,e
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te Zonc A
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� UpBCju� SllCfaL•C PBYAIIS Ror Ihe lurred pm�tioned otMass VVnlls see Turring Strips Construction 7'able belnw. �
r �n � � U C I D � � � F G H��� � �7� • �—�
Tag/ I AssemblyName I Meteria� I Spacing, � U- q
ID or Tyoe and Size or Othe� factor
accoun�ing fm� Cauinuous lnsulnliai R-value, see Page
]A4 Tabie I Cavit��4 I Insulation I Assembty
Numbei R-vaiue R Value Cell Velue
wnlfs use nc�
Proposed
1. Fa� Tng/ID indieaie tl�e idemiJicatia� name �hat mmches the building plans.
1. Indica�c ihe Assem6lv Name or rype R00%/Ceiling, Walls, Floots, Slabst Crawl Space, Doors and e�c...lndicaie lhe Frame rype and Size: Fa�
N�ooA, Metal, Metal Buildings, Mass, enter 2x4, 2x6, a' e�c... see JA4 (ar oiher possibic, fr•ame ryye assen�bl ies.
3. Erver !he Uviclmess.�or muss in inches or Spacing Letween framing members enier; 1 G"or 14 "OC; or Olher for al( odier assembi�� descripiimi
aucH as Cnncrete Sandwfclr Yanel, Spandrel Panel, Logs, Stram ➢ale Panel and e1c.... ,
4. Uased m� �he Clinmie Zone; enier fhe Siandm�A U facior fi•om Table I5J-D, C a� D Im� each dif(ereni assembly Nmne or rype.
5. Enier the Tablr number• lha� closel�� rea�ei»6les tl�e yroyosed assem6li�. �
G. Enrer llre R-vaJue dmi is Lerng ins•talled br 1he wal! covin' m' Letweerr tke fi�nnenrg; olhenvise, emer "0 ".
7. 6nicr the Coivinuous ]nsula�iar R-value (or lhe proposed assemblP; olhenvise, emer "0".
8'. Lnier Ihe rm+� and columtt o(tlte U-�acior' value bosed on Cnlmmr FTa61c Number and enier Ihe AsaemblP U-(uaa� in Column J
I. T/re f'roposed A.rser+rLf r U-fac+or, Colxnvr ./, arusi Le eqnral �o nr les.r fhan the Stanrlard U-/uclor in Colarmo G m conrph�. �
kegi.elruiimi Num6e+': Regi.vunliun llaie/Timc: HEI2S 1'rnviderc
2(IOd; Re,t�idenliul Compliance Fornu�� dugtt.sl 2(JOl
of Compli� , kesidential
Residentirtl .
1'rnjcc� Nnmc:
cr-ifz-a�T , .
(Nune 3 of S)
If I t! ot Smries
� f
ROOrING PRODUCTS (COOL ItUORS) §15l(p13
Wheu d�c nrerr q�rxlerinr mof arqfact m Le replaced ezc¢ads mnre Ilmn 50°'o nf Ihe ezixtittg rnnf nren, nr mnre du�n l,000 f, ��hicHever i�'
less, fhe nn.�u mnfing nren mudl meC/ q�e mafing prudtrc! "Cnn( Roof'requirements of,$152(6)IHi, 152(LJ/NIi, nr /SZ(bJlHiii.
Check npp/icaLln. nl�arnntiva ar rxwp�inn Le/aH� lj�hc roof aLeration i.e esemp� fi•om �he rnn�nt; pr•oduci "Cnn! Rnnf" requiremeius. No�c: /Jony
one oJrhr. ul�ernative.c or exceprinn Lr.low i.r checked, rhe dged So(m� 12e/lecmnec and Thennal Emivaner. requiremener jor roofing praducis in
§ll8(!J arG nn/ upplicahlc. Un nnl,JIII fpb(c he(ow.
�ol Roofs N�t Itequired in Climnt¢ Zones I-12, 14, end I G with n Low Sfoped. Less or 2: i2 pitch.
ol 1Lonfs NQt Required in Climnte Zones I lhrough 9 nntl IG with e Steep•Sloped koof�: (pitch grwier Ihan 2:12) and pmduci unii weight lesfi
on 516/ft .
Alternntives to p152(b)lHl nud a152(b)FIIi, Steep-slopc rnot' (/ii�ch %?:I2)
❑ lnsulntion with a thermnl resistance of ni IcaFt O.RS hr(t��"F/Btu or nt leaat n 3/4 inch air-spacr, is ndded tn Ihe roof deck
nvcr nn attir, or
❑ Existing ducts in Ihe n[tic nre insul¢ted nnd senled according «� § I S I(QIO�, ar
❑ In climnte zones 10, 12 nnd 13, with I ft2.nf Bee ventilation nren oi ntlic ven�ilntion far evcty l SO ft� nf ottic floor aren, and
whem at least )0 percenl of tlie (ree ventilation eren is within 2 feet venicel dismncc nf thc roof ridge, or
❑ Ruiiding has at least IL-3U cciling insulntion; or
❑ Building hes radiant bartier in the Attic meeting thc requiremen�c of $ I 51(�2; or
❑ Building has nu ducts in thc attic; or
O ln climate zones 10, I 1, l3 and 14, It-3 or greuter mof deck insulation above vented nttic.
Gxception [n §'.52(b)ltliii, Lnw-slape roat (pitd� <2:12,�
❑ Auilding has no ducts in the attic,
Other Gzceptions
❑ Roofing areu covered by building integrated; ohotovoltaic oanels and solar thecmal panels are exempl fmm the helow Cool Iioof criteria.
❑ Roof constructions that have thermal m¢ss over the roof inembrane with at least 25 Ib/ft is exemnt trom thc belnw Cool Roof criteria.
Note: If no CR1iC-I laoel is available, Ihis compliance method cannot oe used, use the Pcrformance Aoproach to show comoliance, otherwise,
Check the aoplicable box below if Exemnt from the Roofin¢ Produccs "Cooi Roof' Requiremena
I Roof Slope I Product Weight I Pmduct I Aged 5olar Thertnal I
CRRC Produci ID Num6cr� <?:12 > 2:12 < 516lft1 > SIbIR� Type� Retlectance� ° Emittance SRIS
❑ � i7 � � ❑ ❑" �
`i�QO_�
■ ■ ��_�
� � � �_�
��00_�
The CR/tC'Yroduci /U Nurnber cmi Ge o4minedJrom Ihe Cool Raof Haling CounciPs Ita�edYrnduci Uirecroq� al ww�v.cnnlrnoLs.ore/nrndirc(s/.rearch.phn
bidicaie lhe lype oJprodncl ix bcing uaeG (rn� tlie roof rop, i.e. single-ply raaf, asphafl mof, meml rnof, e(c.
/f Uee Aged Re/lecmnce is imi availaGle in.ihe Coof Roof Raiing Cow¢il'.r Rared Produc� Direciar7� Iherr use Ihe Inilial HeJlectouce vafuc fram d�c same
direr.�nr�� m�d uae Ihe equmiou (0.2+0.7(�������„�— 0.2J ro a6iairr n calcu(ated aged value. Where p is �he Inllial Solar Refleciance.
Check bas iflhe Aged ReQec�mice is n eqfc�da�ed vafue using ihc eguatian a6nve.
CalciJaie !he SRl valuc 6,r using Ihe SRh Workrhee! a( hlln�//�vonv erterrv ca envhi�le24/and emer �he resuliing value in Uie SR/ Cofurmi o6ove and anach acopp af
�he SR6 fVnrlcsheer m tl�e CFI R.
a apply Liquid rield Applied Cuatings, the coating must be epplied across the entire roof surf¢ce and meet the dry mil thickness or coverage
�,commended by the coatings manufacturer and meet minimum performenee requirements listed in § I I B(i�. Select the applicable coating:
Aluminum-Pigmented Asphah Rqof Coating
Cement-Based Roof Coating
Gther
Regisrrmion Nimi6er: Regi.rirarian Daie/fime: FIE2SProvider:
2008 Resideniial Compfiance Farms �
Augus� 2009
]'rescriPiivr CerYificate o1' Cumpliancc: I2esidenti�l
Residentin/ Alternlinia.e
Prujecl IVumc: ;
Cr-1 l2-ALT
(Pa�,r. � �( �)
I il uf Staries
.E1�R5 Y�R1F1 CAT10f� SUM714AR�' The enla'cemen� ngent7'shmdd pm� syeciul unemion to �hr HB7tS h9easnre.�� speciJierl nr rhis
checlrlisi belrnr. d canpleied und sienedCF-4J( Form 1�+' all �he meaa�in�e.c ay�ecilicd.rh<JI Lc e�ubmived m iBe buildinZ inspccior Lefm�r%innl
UllC( 50rillll�e d 7'estine HLltu YL'!'1fIGOI101111' )'L(�1fU'GLI /OI' Ilil.\ 111L'(ISill'C. '
❑�'�S ❑ NO YCS�.In Climuie Zones ° Tntl 9-1 G, if more theu 40 lineor feei qf"ne�r m� replatemeni ducix sve insialled in uncondi�ioned
� space, thc duc�s m�e to be sealed yer {152(b)lUii LOd IIIC I1GN�I1' II151IIIIC[I dI1C15 OiC l0 bL' IIISUINIC(I )]LI 4151(1)10.
❑ EXCL7PT101t': Lzisting duct spstenis tlmi ar'c extended, ivhicli nrc cmistructed, ina�ul:ucd er� xeuled �vith as�est�s.
❑ Y�S ❑ NU 1'ES: ]n Clima�e "Lones 2 and 9-1G, i1' die existinE� space-conditioning spstem (NVAC equipmeni and ducting� is repluced, the
� ducts vm to bc sea)ed per O 52(b)1Di. �
❑ YES � NO ]'�S:ln Climate Zones ^_ and 9-1G, if [he existing HVAC equipmeni is ropluced (including the replaceroenl of�t6c air hnndler,
' omdoor condensing uni� o( ti splii system, cooliug m� heating coil, or the furnece heei exchanger) tlit ducts are to he
sealed per §152(b)IE.
❑�7:C�PT10n: Duct s,ystems tl�st are ilucumented tu have been previoualp se�led eonfirmed tl�ruugii Ft�RS
_ � veritication iu �ccurdoncc witL prucedures in the Reference Residentinl Appendix P.A3.
� �� O��J:C�PTIO�: Duct svstems with less than 4Uiinear feet in unconditionetl spuce. . .
❑ P.XCi�:PTiO�': i:xistin� �uct s��stems wnstructed, insulated orsenled wltli asbestos.
Refrigerant Charge - Split Sl'stem HERS veriJicaliai is reguired,fm'lhi.r measm'c.
❑ I'ES ❑ NO YLS: In Climete Zones 2 and F-15, w1�en ihe existing HVAC equipmenf is replaced (includin� the replacemen� of the air
haudler, outdoor condensing unii of a spli� system A/C or heat pump, cooling or heuting coil; or the fumaee heat
Central Fan Inteorated (CFI) Venfilation System and Fan �'att Dra��
The vencilaeion renuirements of F1501o) do not a�oh� m existine residential homes.
Ducted Split Systems - Air Conditioners and Heat Pumps: AirfloH� HERS verif�caiion is reguired,/a- thia n,easure.
[) YLS O NO 1'L+S: ]n Climate Zones ) U Ihrotigh 15, wl�en tl�e existing space-condiuoning system (HVAC equipment and dueting) is
replaced. [h: airiloe� and ian watt draw shall be verified per § 152(bll Ci to meet the requirements of § I� I(fi7B.
5tatement
• I certife thaf
�-c� � P� t�Y�—�._._
��-►�c� � M�►:Lr .
'I t�l a�+ � � 4 � �—
�
� I � � /zo t�
o ca�, o, ❑
� �ir.
- r'iU0 3
Respnusi6le Iluildine Desinner's Leclaratim; St.rtement ,
e 1 um eligiblr. under Divisimi 3 of U�c Califomia Busines � uncl 1'rofessions Code lu uccepi respunsibilily for Ihe building design identified on
thls CertiScate of Compliancc.
• 1 ecrtify lhai tlu energy lemw�er und perlormancc specificalion:: Inr ihe buildin�, dehigu idenuLed on lhls Cerlificiue ol' Complitmce conform
tu lhc requiremenL; ofTiqe 24, P;n'ls 1 eind L of We Culiiurnci Code of Ite@nlu�iuns.
• The building desigu fenture;, IdentiGed on lhic Cerliilca�e oi'Cuntplitmee tire consistent viilh lhe iidumimiun pruvided tu dueumeni this
buildin;; design on the other npplic�i6le cmnpli�uce funnc. wnrl;sheets, culculationz, I)Ii111S pI1lI 5�)CCI�ICi111U11:'. 5UI)111111L'(I lU Llll CITIUfCL'I➢Clll
aeencv for appruval with this building Permii .ipplicution.
iJ.irnc Si�nuturc: .
Addrest:
Uate:
License:
Pbone:
Tnr u.cri.rtrurce or r/+re.slinn.c regr�rrling the Enerdi' S'tru+d�rrd.s, cm�tac� Ihe Lne�•b r I-Jntfinr «t: )-h'!Jll-� i2- �30G.
�,....:..i...�,�,..� LL.�,.l,n,..
!<e;,�isirmiun Gaie/Time:
FJEP,:; Lrm�icier:
(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:
2805 EUROPA DR
13940408
npp�icant: REEVES, RICHARD R
Address: 2605 EUROPA DR
COSTA MESA, CA
Owner: REEVES, RICHARD R
Address 2805 EUROPA DR
COSTA MESA, CA
ContractOr.
Address:
ISSUE FEE
Temp service test
Res. a/c package
New Res (7-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 7000a
Service over 7000a
Motors to 1 hp
Motors to 10hp
Motors to 50hp
Motors to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
ISSUED BY:
Phone:
Zip: 92626
Phone:
Zip: 92626
Phone:
Zip:
License:
Status: ISSUED
Applied: 06/04/2001
Jssued: O6/04/2001
SCOPE OF PERMIT
ELECTRICAL TO INCLUDE: 10 LIGHT FIXTURES, 6 OUTLETS, 3 SWITCHES. SOME ELECTRICAL
WORK IS IN DETACHED GARAGE AND SOME IN RESIDENCE.
$23.50
50.00
$0.00
50.00
$0.00
$0.00
$11.00
$6.60
$3.30
$0.00
$0.00
$0.00
so.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Duantity
0
0
0
10
6
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY
Temp Dist System / Lighting
Busway I700 ft -
Standing Section
Misc Electriwl Equipment
Transformers up to 1 kvalkw
................up to 10 kva/kw
.................up l0 50 kvalkw
.................up l0 700 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Volt W ring System / Ckt
Misa Conduit �
Misc. Condudor
Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Pireworks Sland
Other Electrical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS I SPECIAL CONDITIONS
Quantity
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
50.00
$0.00
$0.00
$0.00
E44.40
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related
regutations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void ii work is not commenced within 1 BO days, or if work is suspended or abandoned
(or a period of 1 BO days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inapections and itnal approval must be obtained. Failwe to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
za.as-ae (Noo)
WORKERS' COMPENSA710N DECLARATON: �
I hereby aHirm uneer penalty ni perjury one of the following declarations: '
❑ I heve end will meinteln d certificate oi consent to seli-Insure lor workers' compensatlon, es provitled for by section 3700 of the Labor Cotle, for the pedormance of the
wolk lor which this perm�t is issued.
❑ I have antl wlil maintaln workers' compensation insurance, as required by section 3700 of the Labor Code, for tne pedortnanca oi lhe work for which this pertnit is issued.
My workers' compAfisetlP� Insurence carner and policy numbe� are:
Carrier/. palicy Number
�cfion need nof be comp�etetl i/ the permit Is va/ued at one hundretl dollers ($100) or /essJ
I tertify thet in the pertarRiance ol ihe work for whith ihi5 pertnil is issueQ I shell not employ eny person in eny menner s0 es to become subjact to the workers'
compensatlon laws ot Ce�ifornia, entl epree that II I shoultl become sub�ect to Ihe workers' wmpensatlan provisions oi Section 3700 of the Labor Code, I shall forthwith
comply wilh these provis� s/.J� / - T� )
ApplicamSigneWre: ���l��.LL�-� �0� � / Da�e: ���� O'
WAqNINO: FAILURE TO SECURE WORK ' COMPENSATIqJ COVEMGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYEP TO CRIMINAL PENALTIES PND CIVIL FlNES UP TOONE HUNDRED
TiIOU$AND DOLLARE (5100,000�, IN �DITION TOTNE WST OF COMPENS4ilON, DAMAGES AS PRONDED FOR IN SEG'fION 37080F THE LABOR CODE, IMEREST, /WD ATTORNEVS FEES.
LICENSED CONTRACTORS PECLARATION:
I hereby aHirm ihat I am Iicensed under provisions oi Chapter 9(commencing with Section 7000) of Division 3 of tha Business entl Professions Cotle, and my license is in full
force and eXacL Lic. q Class N
Comrador's SiqneWre: Dare:
CONS7RUC710N LENDING AGENCY:
❑ I hereby ettirtn t�at there is e construction lending egency For ihe Dedormance of the work for which Ihis permit is issued. (Sec. 3097, Civil Code).
Lentlers Nema�. Lentlei s Atltlress:
Signature: Date:
OWNER-BUILDER DECLARAnONS:
I hereby eRirm thet under penelty ol perJury Ihat I em EXEMP7 FROM 7HE CONTRACTORS LICENSE LAW Por Ihe tollowing reason (Sec. 7031.5, Business antl Protesslons
Code: Any ciry or counry w�ich requires a pertnit to construci, alter, improve, demolish, or repair any siructure, prior to its issuance, also requires the applicant for such permit
to tile a signed statement thel he or she Is Ilcensad pursuant to the provisions of ihe Contrectors License Lew (Chepter 9(commencing with Section 7000) of Divisian 3 0l the
Business and Professions Code) or thet he ar she Is exempt therefrom and the besis tor tha ellagetl e:emption. Any violetion of Seaion 7037.5 by any epplicam far a pertnit
b' ihe aDPlicant to e civil penelry of nol more than five hundred dollers ($500).):
I I, as owner ol the property. or my employaes with wages as their sole compensation, WILL DO TME WORK, and the strucwre Is not intentle0 or oHeretl tor sele (Sec.
7044, Business end Protassions Cotle: The Coniractors License Law does not apply to an owner ol property who builds or improves ihereon, end who does such work
himself or hersell or IhroUgh his or her own employees, provided ihat such improvements are not Inlendetl or ottered lor sale. It, however, ihe building or improvement is
sold within one year of ctlmplation, the owner-builtler will �ave Ihe burden of proving thai he or she did not bUiIG or improve tor purpose of sale.).
❑ I, es owner oi tha properry• em EXCLUSNELY CONTRAC7ING WITH LICENSED CONTRACTORS to consWc� the pwject (Sec. 7044, Business and Professions
CoOe: The contractors UGense Law does not apply to an owner oi pmperty who builds or Improves �hereo�, entl who contrects tor such pro{ect with a contractor(s)
licanse pureuant m ihe Contrectors License Laws.).
❑ I em axemp r sac. Business and Prof ssions Code lor this reason:
SignaWre: ��,4�-/� o � +� � Date:
Ownar ID verifietl Dy vefs license. ❑ Yes ❑ No Drivers License No. Expires:
Verification ol Owners�ip Dy (tyPe ol dxument, i.e. - properry tex bill or tleetl):
DIVISION Of INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certity ihet no ex�evation five (5) or more feet in depth into which e person is requiretl to tlescentl, will be mede in connection with work authorized by this
pertniL and Ihat no building structure, swfloltling, falsework, or demolition or tlismantling �hereot, will be more than ihirry-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
347, Tnle B, Celifarnia Administretive Catle).
❑ As owner-6ullder, I will not employ enyone to do work which would require a permit irom ihe Division ol Industnel Sefety, as noted above, unless such person has e
permit to do such work fram the division.
Signature: Date:
Division of Industrlal Sefety Pe�mit Number:
CERTIFICATE OF COMPLIANCE AND AUiHORIZA710N OF EN7RY: I certify under penalty of perjury Ihet I heve read ihis application antl state ihat ihe informetion given is
correct. I egree to compty wllh ell state laws antl ciry ortlinances relating to building consiruction, end au�horize representatives of Ihe Ciry of Costa Mesa to enter upon Ihe
above-descnbed r erty for Inspection p oses. I agree no to occupy or allow occupency ol eny building aNhorizetl by ihis permit until final inspection.
�.�'�,.��y'P i'c� c..v � S�� 0 /
Signature Of Legel Owner(s) Da e
AnNOr Authorizad Applicant
COOE 1. INSiECTIONTYPE D� UIIID�LS
1616 FixeC System Final Fife Prevention
1266
200
201
202
203
Pool Spe Final
Final Ra-Root
Final BIacWRetaining Well
Final Factory Fire Place
Final Sign
204 Finel Demolition
CODE 1 INSPECTION TYPE
206 Finel Mechanical
20B Final Plumbing
210 Final Electnca�
212 Final Flre Prevention
220 Final Plennin8 APP�a�al
222 Final Site
250 Final Building/Occupancy
PL1E It�Lfl
/!�7 ',9,�
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.cB��LDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 2HOS EUROPA DR
Suite:
Vicinity:
ParcelNumber: 13940408
App�icant: REEVES, RICHARD R
Address: 2805 EUROPA DR
COSTA MESA, CA
Owner: REEVES, RICHARD R
Address 2805 EUROPA DR
Contractor:
Address:
Zip:
Arch :
Address:
COSTA MESA, CA
Phone:
Zoning:
Phone: 714-444-4959
Zip: 92626
Phone:
Zip: 92626
Phone:
License:
Eng:
Address:
Status: ISSUED
Applied: O6/04/2001
Issued: O6/04/2001
ISSUED BY: ���_
Phone:
Zip: License: License:
SCOPE OF PERMIT
REMOVE EXIST.WOOD SIDING AND STUCCO. AS PER CUSTOMER , HE WILL SAND BLAST 3 SECTIONS OF THE HUSE
AND THE GARAGE AND INSTALL A COLOR COAT.
Plan Check: $0.00
Permit: $97.25
SMIP Res: $0.50
SMIP Com: $0.00
Other. $0.00
Inspection: $0.00
Total: $97.75
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0- 0
PARKING Exislina: o
NOTES:
Rear 0-0
Rear 0-0
Reouired: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
ieft 0. 0
Pr000sed: 0
Calc Valuation:
Claim Valuation:
Right 0-0
Right 0. 0
$4,000.00
sa,000.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 1247-92)
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 authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inspections and tinal approval must be obtainad. Failure to obtain inspections and final approval will result in the expiralion of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2446-08 (f✓00)
WORKERS'COMPENSAnON DECLARAnON: �
I hereby aHirm under penalty of perjury one of the tollowing declarations:
❑ I have antl wlll main�ein a certifiwte ol consent to self-Insure tor workers' compensation, es provitled br by section 3700 ot the lebor Cotle, for the peRormance ot Ihe
work lor whith this permit is Issuetl.
❑ I �ave end will meintain workers' compensation insu2nce, as requiretl by sectiqn 3700 of the Labor CoGe, tor the peRortnance oi Ne work Por which Ihis pertnit is issued.
My workers' wmpe�satlon Insurence carner antl policy num6er are: �-. �
Cartier: Policy Number:
is s cNon need nof be �pletetl i/ fhe Oermills va/ued et one hundretl tlollero ($100) or Iess.J
I certily t�ai in t�e peHo�mance ot the work br which Nis pem�it is issuetl, 1 shall not employ eny person tn any manner so ss to become subjeq to iha workere'
compensetion laws oi Celifornla, end egree that If I should become suD�act to the workers' compensation provisions of Section 3700 ot the Labor Code, I shall forihwith
comply with these p�y�p s _ p-- ,�J � �, � � � �
Applicent SigneWre: L_� 6�—Gi� if`. �E�l���� Date: �/�/� �
r �
WAqNINO: FFIWRE TO SEC�R RKERS' COMPENSATION WVERAQE IS UNIAWFUL AND SHALI SUBJECT AN EMPLOVEF TO CRIMINAL PEN T1E5 NDF CIVIL FINES UP TO ONE HUNDRED
T}IOUSANO WLURE (5100,0�). IN ADDITIIXJ TO THE COST OF COMPENSATION, DPhNGES AS PROVI�E� FOR IN SECTION 31060F THE IABOR COOE, IMEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATON:
I hereby aHirtn that I em liCensetl untler Dmvisions of Chapter 9(commencing with SSction 7000) ot Division 3 of the Business and Professions Code, end my licensa Is in full
force entl eHecL Llc. x Class a
Conlrectofs Signeture: Date:
CONSTRUC710N LENOING AGENCY:
❑ I hereby aHirm that Ihera is a construction lentlinq agency br ihe pedormance ot t�e work tor which this permit is issued. (Sec. 3097, Civil Code).
Lendefs Neme: Lender's Address:
Signature: Date:
OWNER•BUILDER DECtAAAnONS:
I �ereby eHlrm ihat under Penalry ol perjury that I em EXEMP7 FROM 7HE CONTRAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professione
Cotla: Any ciry or counry W�ic� requires e pertnil to consWct, alter, improve, tlemolish, or repair any sirucWre, prior to its issuance, also requires the eppliwnt br such pertni
to file a signed statement ��et he or she is licensed pursuant to the provisions ol the Contrectars Lieense Lew (Chapter 9(commencing with Sectlon 7000) oi Divlslon 3 of Ihe
Busineu Bnd Profeulon5 Code) or that ha or she is exempt lherefrom and Iha besis for the allegad exemption. Any violation ot Seclion 7031.5 by any applicanl for e pertnl'
subjects the epplicant to e civll penalry ol not more than five hundretl tlollars ($500).):
❑ I, as owner ot ihe property, w my empbyees wit� waqes as lheir sWe compensation, WILL DO THE WORK, a�M ihe strudure is not inlandatl or oflare0 for sala (Sac.
7044, Business and Professions Cotle: The Con�rectors License Law does not apply �o an owner of property who builds or improves thereon, and who tloes such work
�imselt or herselt or thwugh his or her own employees, provided that such improvements ere not imendetl or oHered tor sale. If, however, the building or improvement is
sold within one yaar of completion, the owner-builtler wiil have iho burden ol proving t�at he or she did not build or improve for purposa of sele.).
❑ I, as owner ot the property, am EXCLUSWELY CONTRACTING WITM LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business and Professlons
Cotle: The contrecto�s Licensa Law tloes not apply to en owner of property who bullds or Impmves t�ereoq end who contrects for such proJect wl(h a contrector(s)
Ilcense pursuent to the Comrectors License Laws.).
❑ I am exem�yyder �ec. �_ Business end Pmfessions Code for Ihis reason:
Owner ID venfied b�tlrivels Ilcense. ❑ Yes ❑ No
Venlication of Ownership by (rype ol daument, i.e. - O�aPerry tax bill or daed):
DIYISION OF INDUSTRIA� SAFE7Y PERMIT CERT1FlCAiION:
Orive(s LicenSe No.
Date:
Expires:
❑ I hereby certily Ihat no exwvation fve (5) or more faet in depth into w�ich a person Is required to tlescend, will be matle in connection with work euthorizeC Dy ihis
pertnit, and thei no builtling siruciure, scaflolding, falsework, or demolition or Gismantling theraof, will be mora Ihan thirty-si: (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Califomla Atlminisiretive Cotle).
❑ As owner-builtler, I will not employ enyone to do work which would require e permit irom the Division of Industnal Salery, es noted above, unless such pereon hes a
pertnit to do such wark iram the division.
Signature: Date:
Division of Industnel Safeiy Permi� Number:
CERTFlCATE OF COMPL��UICE AND AUTHORIZATiON OF ENTRY: I cenily under penalty oi perjury thai I have read �his application end state Ihet Ne Intormation given is
wrrect. I egree to comply with ell stete laws and ciry ordinances relating to builtling conslrudion, entl euthorize representatives of Ne Gity of Costa Mesa to en�er upon ihe
above-describe p rty lor inspection Ourposes. grea ot to�� acuPancy of eny building aulhonzed by lhis p�rtni� ntil finel� � ection.
(Q
Signature Of Legal Owner(s) T ate .
AnNOr Authonzed Applicant
CQOE I, INSPECTONTYPE
1616 Fixetl System Final Fire Prevention
1266 Pool Spe Final
200 Final Re-Rool
201 Final BIocWRetaining Well
202
203
Final Fectory Fire Place
Final Sign
20C Finel Demoli�ion
01TE 1NIID9ki
COOE� INSGECTIONttPE
206 Final Mec�anical
208 Final Plumbing
210 Pinel Electrical
212 Final Pire Preveniion
220 Final Planning Approval
222 Final Site �
250 Finel BuildincyOccupancy
QdIE I[�k$
/ i �
PBWECT�ODflE33: ZOOJ EUHCPA Dk
OWNEX'SN�ME: UASSON, PZERRE R
AOOflE33: MASSON, MARGARET E
2805 EUROPA DR
( COSTA MESA,CA 92626
(714)272-1983
ppCHlEN01NEER:
' nnoness:
NEG.NO.:
unrt:
uxR:
� PERMITTEE: SMITH ROOFING ( 805 ) 272-1483
M RO�BES8: 7] 3 2 E LJ— ]
LITTLEROCK CA 93593
110EN5ED CONTMC70B OECUM710N: I here�y aliirm that I am Iicense0 un0er Dmvisions al C�apter 9(cammencinp wit� Section
7000) o� Divlsian 3 of IAe Business antl Profauions COCa, and my licanse is in lull lorce antl eflect.
cin uc.: 0 4 21 S 0 sTptE uc.: 31917 2 � Sg C— 3999 �[n/.��
Date: q�y ` �Q SlOnature: ���/ —' "-'� ✓
WOPNEPS' COMPENSATION UECIAMTION: I �ere0y affirm that I have a cehificate oi consent ro sell-insure or a certiticate oi WOAers'
Compensation Ins r ca ar a certifieG coDY �hereol (Seciion 3800, Lah. C�.
raucv No.: 1��� 51 1— J � ezr. o��: 0 2/ O 1/ 91
•MPpNr: STATE FUND
CeNiieO coDY is hereDy lumis�etl. � CanilieE coDY �s li�with t�e ciry BUIIEinp Dm' 'smyp. _
Oate: � —� � ` �� Applicant: % �� /�J ��'�'1•
EXE1APf10N FPOM WOHKEPS' COMPENSITION DELUIWTON: (flu5 ucoan �eE not Ee mmpkte0 il �he pemil is lor one AwCred (f100) a less�.
I certity tlut in t�e OeRarmance of the woM lor wtiich t�is permit k iuue0, I stWl frot empby arry person in any manner sa az lo bewme
suGjEtt to ihe Workers' Compensation LawS ol Cdlilomu.
Date: SlOnatura:
NOTICE: II. aller maldnA ��5 d�laration, you ShaWd hemme suUject ro Ne Workers Compensation DraNsions ot Ue LaEor
CoOe, you must fonMnt� wmpry wii� wc� OravLsians or Ws perMi 5Aa11 De UeemeO revoke0.
CONSTIIUCTION IFNDINC �GENLY: I hereGy attirm tlut t�ea 6 a consWction ler�tlinp apency for the pedarmance al l�e woM for
wNch Itnt Dermfl ¢ i55ue0 (Secl'wn 3097, Civ. C).
LENOEH:
IIOOPESS:
OWNEB BUILDEB OECIAMTION: I Immby a111rm that I am exemD� �ram t�e Contractors' State Licen2e Law for the /o0ovnng reason
(Seclion 7031.5 Business an0 Vrofessional CoOe: My ciry al counry wAlch reduires a permit ro canstruct, alter, improve. Eemolish, or
repair any structure, pnor to ils issuanca, also reduires the aODfipnt lor wch permit to file a signeE statement that AeJshe is Iicense0
pursuant Io Ure D�sions of Vw ContrzctaK State License law (CMpter 9(mmmendnp wit� Section 7000) af Division 3 oi tAe Business
anE Pmiessions COGe) ar WI �ds�e a exempt therelrom an0 I�a basis tor Ne alle0e4 exem0�ion. My Waladon of Sepion 7031.5 Oy
any apDlicant far a permit subjttts Ihe applicam to a cNil penalry oi not mort t�an frve hunOretl Aallars (5500�.
I, as owner of tne pmperry or my employees wil� wapes as tAeir sole camDensatlan, will do tAe work, anE t�e
O strucWre is not imentleU ar ottere0 for sale (Sectian 7044, Business anE Pmiessional CaUe: TAe Contracrors' Siate Lkense Law
Joes not apPly ta an owner of a O�opeM who huilUs or imprwes [�ereon, and who Aaes suc� emrk himsel//Aersetl ar Ihmuph
his ar �er own emDloyees, provl4e0 t�at such imD�'ements are not intenOeO ar ottereE tor sale. If, Aowever ihe 6uilUinO or
impmvement is SOIE witMn one year of completion, tAe owner will Aave t�a hurtlen of pmNnq he/she AiE not 6ui10 or imD�ove
for the Durpose ol sale).
I, as owner of the pmDetly, am aKclusively contractinp wii� IicenseE comractors m construct t�e pmlect (Section 7044, Business
❑ an0 Protessians CaUe�. The Cont2ctors' Stata License Law tloes not apPN �o an owner al propeM � hmltls or improves Ihereon
an0 wAa coniracts br sucA Drajects wilh a contractar(s)license Dursuant Io Ihe Coniractors' State License Law�.l am awam
that proal ol iheir Wo�ker's ComDensaUon insurance sMultl �e O�avitle0 to me.
� I am exemD� untler Section: 8. 8 P. C.
tor t�is reason:
Date: Owner:
I tlo hereby ceniy ��at I am awam ol an0 un0erstan0 the reQuiremenis ol Califomia Healt� anC Safery CoGe Sections 25505, 25533, antl
2553G an0 t�at 1 or any fuNre OuilGinp occuDant will/will not (cirCla one) neeE to camply Wif11 said state cOUes anU ihe repuiremenis lor a
parmit for consimction or mo0itication tmm the ATrSiry ManaOement Oisinct. HesiEenGal construction aDP�iwtions are exempt Irom
tAese pmNsions.
�ate: ApDlicani:
I hereCy ceNty that I have reaE tNs apDlicatian antl state that t�e aDove iniormation is correct. I apree ro compy wHh all ciry an0 caunry
orGinances an0 sute lavrs reWtlnp to OuilOinp construcuon anU heaEy authonze representatNes nl Itns dry lo enter upon the ahovamentioneE
property far ins0ection purposes. ^ ��
9- /v- p� `_ '
Date: / Sipnawre:_0/
Oriver•s Licenu ar Socia� Secunry »:
i6a1J6 W�ite—BuiWinp; Green—Cotle Entorcament; Canary—ApO���V Plnk—Revenue; GOIEenroG—Asaasaor
�
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 048995
PERMIT NO: B 098995 PLAN CHECiC NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR , PURPOSE: ALT
SOH DESCRIPTION : REROOF W/CLASS 'C' FIRE RETARDANT SHAKES SQ FT: 7,000
CLAIM VALUE: 7,000.00 CALC—VALUE: 7,000.00 GROOP OCC; R-3 /N-1
COMMENTS: SMOKE DETECTOR(S) REQUIRED IN HOME.
�r*#�rx-****#�r**u�r****+r***���r�*********�**#*�r�r*�*x*+��*x*�r�**�#*x�r#*���*��**���e�t+r��
2 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 BIIILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT ZN REAR; FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PAR?CING REQ: PROV: PARCEL: 13940908 ZNE: REF NO:
PLANNING NOTES>
>
iE it iE ik if iF i4 if iE it i! i! it iF it #�lE iE # iE ik iF iE iF iE if iE iE it iE if iE iE iE �1f iE 3F iF ik 3t it iF # ik # if if- it iE iE �1E # iE iE if 3F it if� iE iF it iE iE if iE iE iE �1E 1f� 3k iE ih iE �)k iE iE iE iE 3E
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'I` S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY :_^ �_�/fA DATE: _
iF IE ik 3F it it iE iE iF iE iE it 3f iE �E iE jE jk if iE iE iE 3E iE 3F if jf iE if iE 1E �E iE ik iE if iE iE iF 3E if
LEGALIZATION:N F E E S U
BLDG PMT PLUMBING ELECT$��
PERMIT 90.00
' 9 y-�
�iET ,F�'g F�F'iF'iF"iF3FiF'3F'iF3E�ti�Di�(�i�t�*+riFiF���FiF� �
V 1EiEiEiElk3kiElEififififfkiE�E�1E�1EiE�EiFifiFiFiEdEiEjkjFiElkiFiE�)FiElEik
M A R Y STRUCTURAL SEGMENT;Y
MECHANIC FIRE SMIP/RES GRADING
SMIP/NON—RES
PLAN ��" '
ISSUE FEE r ' �
BUILDING—DIV—> PERMIT ISSUE PLAN.CHFf,CK TOTAL PAID DUE
TOTALS----> 90.50 0.00 .,t7;00 90.50 90.50 ,00
REVENUE DIVISION TOTALS--> COLL'ECT-ED:� 90.50 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHA�IIC FIRE SMIP/TOT GRADING PLAN—CHECK
90.00 F � .50
i(� if;E iF k iF it it ik i6 ik it �k iE if iF �F it ik fF if 3E if iE iE fF jElf if it if iF # if it it it jE iE jFrjGiE iE iE iE iE 3F jE it if iE iE!! iE iElE if �F iE ik ib iE iE iF iE iE it iE iE i! ik iE i! ik if iE?E iE iE
I N D I V I D U A L.'�,F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O,N.� UNIT COST TOTAL COST
SFR 7000 REROOF BY VALUE RE52DENY�A�L NOZONE 1.00 7,000.00
END .OFf FEES
_ ^ i.
r
,'�
' ^i
�•
01 OOOb9563-OOD69564 T r� � 9�.50
DRTE: 09/24/90 TIftE� iD:22
CONSTRUCTION AND PLANNING
APPROVPILS Permit # Date
1. Temporary Electrical Service or Pole .
2, $oil Pipe-Undrgrnd.
3. Electrical Conduit Utility-Undrgrnd. •
4. Electrical Conduit-Undrgrnd.
5. Steel Reinforcement
6. Electrical UFER Grnd.
7. FOotings
8. FpundatiOn �
9. Water Pipe-Undrgrnd. �
10. Structural Floor System '
11. Property Sewer Line & House Connecti0n �
12. Sewer Cap ' -
13. Roof Drains • ,
14. Rough Plumbing �.
15. Rough Electrical-Conduit
16. Rough Electrit Wiring
17. Rough Wiring Sign _
18. Rough Electriwl�T Bar Ceiling '
19. Rough Heating & Air Conditioning
20. Rough Factory Fireplace
21. Ducts, in Strutture
22. Ducts, Ventilating
23. Gas Pipe�Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T�Bar Ceiling (Structural) & Monocoat
27. Frame and Flashing
28. Lething & Siding
29. Insulation
30. DrYwall Nailing
37. Plaster Brown Coat
32. Electrical Power Meter-Final
33. Final Electric
34. Final Heating & Air Conditioning
35. Final Gas Pipe�Test
36. Hood or CanopY
37. Final Factory Fireplace
38. Final Plumbing
39. WBter Service�Final
40. Gas Service-Final
41. Solar pomesticFinal
42. Backflow Preventer
43. Backflow Irrigetion
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING yZt
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No - Date
PO . SPA
Inspector APPROVAIS Permit #
52. Pool & Equipmenl Lotation
.53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER-GUNITE
58. Electrical Conduit�Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P�Trap, O Undrgrnd.
67. APPROVAL TO DECK
62. Backwash & Receptor-Final
63. Heater & Vent�Final ' ' '
64. Plumbing SYstem - Final
65. Electrical-Final
66. Solar SVstem�Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
-�(n � G Gcr
Date �Inspector
70. Underground Hydro
71. Product Piping OGas ❑Oil
72. Underground Flush
73. Undergrnd.StorageTank �Gas ❑Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FINALINSPECTION
80. FOOD CERTIFICATE ISSUED
Notes: 'Qj '�i -A'n - r ....�✓_ w
PATIO COVER DETAIL 6/1/61
STATE-- f��
S�ZE SPACING SPAD
OVERHAN�G ppFTERS: o��* • ' , � �
ol �� SlOPEO FOR DRAIN
MAXIMUM %7TS AN
���
4' %
\ POST-BEAM �
CONNECTION _
3/g t 5 Lags 32% �
Predrill Ledqer �
Predrill Exiafinq '/y3 Deep
JOIS7 MANGER
or other approved methods
of euppurt • tie.
ALL LUMBER DOUGLAS i/R
'CONS7RUCT/ON� GRADE
`aosr �/
.l�J �Y a
SMOW SIZE SHOW SP4CING
SHOW LOCATION ON REVERSE SIDE.
DROP PATIO
�— SLOPE TO DRAIN
�� �'�.�
.-• a
ic
POST ANCHOR � : ��.. �. �
For Pipe Post. Embed �12�
Pipe In FootinQ•
Provide Flmge Or Weld Plote Screwed
PUDDIED SAND FILL
Remove G•ass And Weedf Down To No}urol GroAe�
CONCRETE MIX 1:3�4 MAXIMUM WATER CONTENT
7I' GALLONS PER SACK CEMENT.
Provide 26 Ga G.I. Flashing At Wood Floor Con
Or Bolled To Frame.
rr n
` ' ' dUe�
- CMF 00012-46 (BU 40) --
CONTINUOUS
LEDGER
TYPICAL JOIST ANCHOR
NOTE � USE REVERSE SIDE FOR PLOT PLAN:
No i r�r ti
FOR OPEN EGG CRATE
AIUMINUM OR PLASTIC
ROOF COVERING
MAXIMUM SPAN SIZE
'� I�� 0�� 2x6
- I 6� 0" 2'z 6'
I 5' 0" Yx 6'
I 2� O' 2"x 4"
1 I� 0" 2"a 4`
10" 0` 2'x 4'
SPACING
I 2 °4
is�i�
2,4 °/<
I 2'%
Ifi%
24 °/<
� NO 2
FOR SOLID SHEATHING.
SHINGLES OR BUILT UP
ROOFING.
MAXIMUM SPAN
15� I�
13� 3"
10' Ily
9' I 1 "'
8� 8"
�• �,.
NOTE: FOR PROPOSED OR FUTURE ROOM,OR WHERE PATIO
WALLS ARE TO BE BUILT. USE N0.2 CHART ONLY.
WIDER RAFTER SIZE MAY BE INTERPOLATED FOR
SPACING ONLY.
� FOR PROPOSED OR FUTURE
� WAL�S ARE TO BE BUILT
_AND ADDITION PLANS
ROOM OR WMERE PATIO
SUBMIT COMPLFTF HOUSE
� �
C �
�a7�
� �
� il�(Tn..,,nln�cnvv�
AP�'I�.���� �
�CITY OF COSTA MESA
�?/J �LANNING DEPT.
SU91KT TO BIDG. DEPT. RFG
�
BY . .... ... _.. DA7E.(� ?�� „ �
OIRC{TON Of PLANNIN(i S �
r���; I�I -Y��"��
/L/ �
y,�v•%•�JS
� � E
/
iiic��Y
�a�-;o ����, �ax�i�
� �. �,
�a�e �
o�. �e. ri a �- �1
L
� �� S�QrCE�
I � c
— 2 2
/
— � �xy �
I,J�nC 4'X 8° I.ec�io� o`%' �/ /`�'
\]PII m. �
� e.�nG �,e`Fweer � ��� 7� 7/
�t�v- -
�'err��4 # h�91� �__—
THIS NUMBER MUST A�,C0�4PANY
ALLINSPECTION REQUESTS
zl
OWNER NANAMERSFOORT
JOBADDRES5�2 05 Eura
r "�0
DA7E 11-06-79
IILDING
Na. 139-404-OS �OT TRACT FIREZONE VALUE
SUBCONTRACTOR
c.s
ROUGN PLUMBING
PROP. SWR, LINE L_I
SPRINKLING SVSTEM
MISCELLANfOUS
ROUGH ME<TING �N� �Ifl CONDITIONING
TEMPORnRY SERVICE OR POLE
UNOERGROUNO � POWER �
AO�GH WIRING
TRENCHES I i %OFMS STEEL REINF.
FLOOA SvSTEM
BONO BE4'n� STEEL REINFOpCE n
SMERLNING
FR4ME ANO FLASHING
LATMING - �N j I
PLASiEP. 9ROwN COAT
♦NO
eut�oir�c. Fir+a� I 9� U-
:'� ;' ` .COSO. BOXE 200 CIOSDTI/fi .---SAFCALI ORNFlIA 9 626 T
For Applicant to FiII in Completely — Use ink Only
AD'DRESS �C�S �u eC �l� %1 �
OWNEROR �nS �� ���JI�iJ7l=i�Sl GOI:T
TENAfJT
MAILING � �`
ADDRE55 a�OJ F1�'�/i� /�' �O{}1-�
C'�:STI� P'�LSH NO�`�J'_O/
CITV a
CANSTRUC710N j �
BRANCH / I
ADDRESS
ARCHITECT TEL.
ADORESS
CONTRACTOR ��
ADDRESS
TEL.
CITV NO.
F STATE CITV
� LIC. NO. LIC. NO.
{,y SIZE NO.OF BLDGS.
L OF LOT NOW ON l0T
a USE OF
� EXISTING BLDG.
y
FSeparate permits are required for
� electric, plumbing and heating work.
� VSE OF BUILDING AND WORK TO BE PERFORMED
F
Q
G
:� }-r�r« s c. �� �.
Q
>
i'
.�
z
w
0 I heraby ecknowladpo that I have reatl this appllcation antl steta
� that the above informetion is cortect and egrea to comply with
a all laws regulating builtlinB construction, antl 1 shall not employ
Z eny person in violetion of the workman's compensallon laws of
� Me State of Calitornia.
T
3 I he�eby ce�tlfy thet I em properly Ilcensetl as e contractor untlar
the State of California Business antl Professions Code, D1v(zion 3,
Cheptar 9, antl that such licanses ara in tull torco entl eftect, or I
am exempt from ihe provisions of the State of Celitornla Business
and Profassions Cotle, Division 3, Chapter 9. /
SiBnature of� ca� n/ ,/
Permittee � 2`�- /. ( e:--- ��h i fl
or
Authorizetl Aaent Date
APPLICAI_ _.� FOR�2I�UC�iIURAL PERMIT I 7.00 TL
��a,-- - �.,�o..�r . - '
Kin... � . -
A.P. NO. `� / � O (j� �
nnn F
BUILOING �ROS F
ADDRE55 �� Ld �Z,
UNIT OR
SPACE NO.
TR.NO. LOT
/
NEW ADD AITERIREPHIR MO
USE
ZONE � 1 T
B
APPROVEDSETBACKS
PLANNING ACTION
APPROVED
THE AMOUNT 51
THE PURPOSE OF
VALUATION
$�fU��
�
VAWE
E
%T
LK.
a`
V \
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n
i
u
m
N
VN UNDER VALUATION IS FOR m
'ABLISHING A PERMIT FEE ONLv: �
PERMIT FEE $ �OQ N
PLAN CHECK S O o
TAX $ 1w U
JV
TOTALPAID $ /7��
OWN�R PACESETPER W -'" ,T�INT VII�PIURE
JOB ADDRESS _�5 �ropa, gve.
G�NERAL CONTRACTOR Androc T�and�.Q,
AP No. 1 -I}Oj}- LOT 2( TRACT 1} 1� I'IRL 7.ON�
INSP�CTIONS � Signaturc � DA1'P . GROUP
Watcr
e
coat
�AT� NCT 2 3 i9b2
VALU� S 1�, 81.0
D13SCR7PTION OF WORK
TYP� V 7.ONE R-1
SUBCONTRACTOIt
,�� j 17920
COS� SA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COBTA MEBA. UL�FORNIA
For Applicani io Fill In Complefely
TYPE OR PRINT
BUILDING � NA l G i IYJ.nT7� i1i. _
COSTA MESA CALIFORNI,
G&y�'E)2 WES �
WNER
MAIL /�/ /Y/ INV�L��
A�ORES6 /
��,,. 9 /Lt ,¢ '�
�
ARCMITHGT //n • r�. �il � i L� TI
SIZE /� NO. OP BLDpB.
�F LOT �Z X� O(/ NOW ON lAT
LINB PROM
DESCRIPTION OF WORK
� EXTERIOR
�� ��c�iv�D
� OC, 1962
FINAPlCE DEPT.
CITY OF COSTA ��1ESA
APPLICATION FOR PERMIT
BUILDING
For Offiee Use Only
neceinr xa. I -�VyJ�� �
�VG
BY I D��6'R8C81VHD�� �AT[ I68U2D
�/ � X nnr ..
a��
COSTA ME6A.
FIRE
ZONE
APPROVED
ZONING
ZONE /J NO. OF U88 OP N
/( �I PLANB � BUILDINO
LEOAL 7 ti/ � /
A.P.No. �39— h�aY—a8
YARDS EVE6
4PPROVED ALLOWED
(CBNTHM LIN6 BT.) /
FRONT l7 / FT. `—
R. SIDE � FT. ��
L. SIDE -% FT.
rxrsw 26 rr �-
- - �,L3SiD• o•
I XERBBY ACNNOWL6�06 THAT 1 HAVB RHAC iM�B APPLIGTION TNE AMOUNT BHOWN UNOBP VALU TION 18 FOP TX[
ANO 9T�T8 THAT TH6 ABOVH 19 COPftECT AND AORBH TO COM-
PUIiP08C OP C9TAOLIBHINO A PHRMIT FEE ONLY.
PLY WITX ALL CITY ORDINANCEB ANO 8TAY6 u� W80UUTINO
eu��,nlrvo CONernurnoN. VALUATION `
SIGNATURE OP G PERMIT FEE S �1 �`9
PERMITfE � � " �S / �/. � e
/''AJA S � 1O PLAN CHECK $ aS S �
AUTHORIZED AGEN�'�-��� i 0 0
TOTAL FEE �. S d