HomeMy WebLinkAbout2813 EUROPA DR - Building Permits`�I
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PflOJECT ROUFESS: Z 8 i 3 ECR:.11�F1 L_1�
UWNEfl'S NAME: BJl�' GGRA: i' , fiLLSid� �RTH B
nooness: z 81 3 EUROPA DR
COSTA :�iESA,CA 42626
(714)546-0848
APCNIENGINEEfl: � AEG.NO.:
AO�HESS:
UNIT:
UNIT:
PEFMITTEE:E.B. Bl�RGC+PAY� (714)546-0848
nooaess: Zg13 EUROPA DR
COSTA vEsA CA 92626
LICENSEO CONTNACTOB UECLl�FATION: I �ereby aftirm �hat I am license� untler pmvisions af Chapter 9(commencing with Sec�ion
7000) al Div��sinn 3 0� �he Business an0 Pro�essions Code. antl my license is in �ull lorce antl efiec�
GITY LIC.: S7RTE UG.: ClASS:
�ale' SignaWre:
W08REflS' COMPENSATION �ECIAflRTION: I hereby aitirm that I have a certificate o� consen� ro sell-insure or a certificate oi Workers'
Compensalian Insurance. or a cer�ilietl copY ihereol (Section 3800. LaO. C�.
POLICY ND.: E%P. DATE:
COMPRNV:
❑ Cenifiea copy is here�y �umis�ed, ❑ Certifie� copy is lilea wi�h the ciiy Builtling �ivisian.
Da�e: ApplicanL
ENEMPTION FROM WOBNEBS' COMPENSATION DECLABATION: Qhis section need noi be campletetl it Ihe permii is lar one �unaretl (5100) ar 1¢55)
I ceridy ��at in Ihe pedormance ot Ihe work lor whic� Ihis permi� is issue0 I s�all � emplay any person in any manner so as � ecome
Subleci lo Ihe Workers Compensation Laws o� Califomia
�a�e�. S' � � _ 4 � Signa�ur .
NOTICE: I�. atter making t�is tleclaraiion, you shoultl become suhlecl �o the Workers' Compens n rovisio o� Ihe Labor
Coae. you mu5i lo�hwith comply wil� such pmvisions or t�is Oermil s�all �e �eeme0 revoke0.
CONSTBOCTION LENOING AGENCY: 1 hereby afli�m �hat lhere is a constmction lending agency lor Ue Deriarmance o� the work for
wNch this permii is i=.sued (Sec�ion 3W7, Civ. C).
LENOEH:
aooxess:
CITY GF C05TA VESA - BuILDI�G P_R�IT
PERvIT tiU: s 062126 PLA� CiiECK :�IO: 016�78-93 5
CONSTRJCTZON ?YPE: 5-N PER.�:IT TYP£: STR
JOB DESCRIPTIUN : 153 LIN FT Ur RCA:U wAL� @ 5' H_GH
CLAIk VALU=: CALC-VAi�UE: 3.050.00
L=R� NO: � 062��6
GUC':: Ai SJP�: JI
PJAPOSE; OT�
G�j L'T � 1 rj 7
GROtiP nCC; R-3 I
CQ�:N.ENTS : �
*+����+�,�����+�*��****�±�*�� *��xxt��r±��*>�#+�*x*��*t�*��**#*x���+�#x�*#*r*�*�-x � tt�*�*��*�
Z O N Z N G R E Q II I k E M E N T S
S E T B A C it S
------------ MAIDI BUZLDING ---------- -------- ACCESSORY BJIiDING ---------
FRhT: rT IN REAR: F'?' IN : R!dT: � i ZN REAR: Fi IN
iEFT: r'T IN RGHT: r? ZN �EFT: FT IN RG??�': FT Iti
PARICIyG R=Q: PRGV: PA.RC�L: 13990405 ZN�• R? REF 4d•
PLAANING NUTEs"> 153 SU. rT. OF 6' HIGii BLOCK WALL ALOtiG SIDE AI�i� REAR PRuP
> LSNE�.
�3F � if if if �E ?E �lE if ?} �,' �3E jF � iE }; 3!� * if if 3E i: i if ?F iE if iE �7F iE k if 3f if if �Jf i"t iE?E if ?? # if iE ii iE ### iF # 3F #�lc ai?f iE iF if if if 9E }E?E iE 9E ## tF?S lE �)f � z iE?f 'r 3E iE
U E V E L O P M E N T S E R V? C E S R E u U I R E M= N-T"S
ZONING APPROV£D BY s� 'LAT=: S�//
HiIiLDING A??ROVED BY : DATE: ���
A?PLIc:ATiUN ISSDED BY: ,� UAiE; 3""" ((� 3
?�ifif'lE'lEiEjE�'�E3F3F'IE'1E1f3E1Eif3E'N'jEiEiF1tT.�t.�:Ttl�i�Fn�'A!t*a..' tt .. hr �ltXftft'F�R!'< ifi'cKlc7fiL'i�'*jE#SiHRR![?F1t'itlkit'ifiE
if if if iE iE if iE �E iF ie iE iE ±f iE iE if if ii� iE'f. # iE iE 3f if !f iE if iE if �lE iF ic ii if i! #: -)c �7E iE iE iE?E iE �E i"' : iE ic # ik #!e iE # iE iE i'. � iE if iE 3E?!� �iE #### iE 1e if ie if 3E ic if �E
LEGALIZA2I0;3:D1 F E E S U M N A R Y STRUC_TJRAL SEGMEN::Y
owNex Bu�loEn oec�aFlnnoN: � nerebv anirm ihat � am exempt trom me camracmrs' sta�e �icense �aw �or ine �onowing reason BLUG P� 1 PLUMB ING EL�C 1 RIC i�IaCHAIV Z(: t iRE S�I P/RES tiRFLT1I NG
(Sec�ion 703L5 Business antl Pwfessional Cotle: Any ciry o� coun�y which requires a permit to construc�, alter, impmve, demolish, or �l =�(y S 1 6 3, 0 0 . S 0
repair any S�mcWre, prior to i�s issuance, also require5 ihe applicant lor suc� permii Io tile a sgned sia�emenl lha� he/she is I¢ensed
pursuant Io me O�ovisians ol the Comractori Stare License Law (Chap�er 9(commencing with Section 7000) ol �ivision 3 ot Ihe Business i S� � P���'v—=t'=��
and Pmfessions Code� or Ihai he/she is exempt iheretrom antl ��e Gasis lor ��e aileged exemp�ioa Any violation o� Section 7031.5 �y PLAN 4 0. 9 5 .�
any ap0licant lor a permit subjects �he ap0lican� to a civil penalry oi no� more �han �ive hundred Oollars (E500�. T_ SSUE FhF
I, as owner of Ihe properiy or my employees wiih wages as �heir sole compensation, will do Ihe work, antl the
BJILDING-D=V-> PERN3T ZSSi.iE P�AN-C?iECK '"O;A� FAID DJE
❑ Slmc�ure I5 nai intentled or ollered �or sale (Section 7044, Business and Pmfessional Cotle: The Contraciors' Sta�e License Law 1 OTAL S---- > 6 3, 50 �. 0 0 9 0. 9 5 S O 4. 4 5 1 � 4 �} 5 � 0
Ooes nol apply ta an owner oi a O�opetly w�a builds orimproves Ihereon, and who Ooes such work himSelUherself or Urough
his or her own employees, pmvided Iha� such impmvemenis are not inlenOeA or ofieretl for sale. II, however �he building or
impmvement is soltl wi�hin one year of campletion. �he owner will �ave Ihe 6urden of proving he/she ditl no� huild or improve
�or ihe puroose oi sale).
I, as owner at �he pmperty. am eKclusively contrading wilh I¢ensed contraciors to constmct �he pmlec� (Seciion 7044, Business
�� antl Pro�¢55ions Code: The Con�ratlors' Sia�e Litense Law tloes noi apply lo an owner Of pmperly who builds of impmve5 �hereon
and w�o contracis �ar such pmjects with a contrac�or(5) license pursuan� �o Ihe Contractors' Sta�e License Law�. I am aware
Ihai Dmof ol their Worker'S Compensa�ian insurance shoWU be provitled Io me.
� I am exemp� untler Section: B. 8 P. C.
for Inis reason: 1 A n �
p Q ( r F �J�L:.ii�G/
� oa�e: S� � i^// Owner: i�'
I tlo hereby renify iha� I am aware oi an0 waers�and Ihe requiremems o� Califomia Health antl Sa�ery Cotle Seciions 2 �5. 25533, and
2553A an� IAa� I or any future building occupant will/will not (circle one) neetl lo comply wi�h 5aid state codes and the requirements for a
permit lor conslmclion or moddicauan Imm iho Au Quahry Managemeni �ISVict. ReSltlenlial can5tmciion appllcallons are exemp� imm
Ihese pmvisions.
Dal¢: Applitanl:
I �ere�y cetlify Ihat I have reatl �his apPlicalion anU stale iha� Ihe above informa�ion is correct I agree lo comply wilh all cily antl counry
ordinances and s�atelawsrelalingio Ouiltling conslmciion antl he�eby aNhorizereD�esen�alivesofthrs cityto enleruponlhe above-mentioned
pmpeny brinspecuon pcurposes. ��� � ��.y� //{� /
Daie: �� u � J � SignaWrss���`OrM/W\M1.� �/ ���d /
Drivm's �icense ar Socia� Secwity p: v'
i641-46 While—Bmltlinq�, Green—Coee Enbrcemen�; Canary—Applicanl: Pmk—Revenue; Goldenmd—Assessor
REVENDE UIVISION TOTALS--� COLI;ECTED; 104,45 OVE�/SHORT; ,DO
BLDG �+MT P�UuBING ELECTR2C MECHANIC FIRE SMIP/TfjT GRADING PLAti-CHEC?C
63.00 .50 �0.95
?F #E?E !F?E ie?E iE iE iE iF iE i(� j(-?E iE iE 3E iF iE?F?E if ie 3E 1E i�Y ie 3f 4 iE if ?E iE iF ie 3f iF 3E if if +.` iE �?e iE # iE # iF ie iF;# 3E jF 3E 3f # if # 3F fE jE?�: jf #,f # iE iF'r' i%if ii if 3E iE iF
I N D I V Z D U A L c E E 3 R E A K D O i�I N
TYPE QTY L E S C R I P T i O ti UNZY CUS? TOTA�, COST
5FR 153 RES-CU�iCRETE BLOCR�AALL /?i. 20.00 3,060,00
E?dD OF FEES
O1 Q013e434-�0138936 T QT 104.4`
DpTE� 45(11/93 TIflE� 14:57
�. . �- -
'r------- -.
I CONSTRUCTION A1D PLANNING
APPROVAL$ Permit � �-
1. Temporary Electrical Surc.cz or Pole
2. Soil Pipe-Undrgrnd.
3. Elcttrical Gonduit Ut�hty�Und�grnd.
h, E�eet��eal Gondwt�Und�y�nd.
5. S:�e' Remforcement
6. Eccb:cat UFER Grnd (�
7. Fcot�n�y � Q-R�_ AJ
v.1�x+[i�
8. Founaat�on
� 6 l�,d!er P:pe�Undrgrrn.
10. St�ucturai F;oor Svster�
1 i. ?�on-'•tv Se�roe� Lma &� Ho,.�a .r,o�nect�an
72. Sraer Cap
13. Roof Drair�s
14 Rough piumbing
15. Rough Electricai-Cor.tlu�t
16. Rough ElectricSJrting
77. Rou9h lV�r�ng S;yn
1E. Rough Electrical�T Bar Ce�l�ng
I 13. i�^t. h;ie�tin� 6 A�r C�•d�icn�^.g
f�"�-' ---
� 2�. R[�.,�h ��Ct�'7 ��rr�..�,�Ce
21. D,.,^;, �_ $t•<<CturG
22. Ducts, Venbiatirg
?_3. Ges Pipe�Rough & ?��st
24. RooF Frarn�nc�
7;. Prol Sheath��.ng
2[ '�::�r Ce�!,ng ISt.� „�i',. i. ��.�.n'oCoat
27. F!�rne crtd Flaihing
� 2II. l.ac.��ny & Sld'ng ---- -
i
I29. Iny�'ut,c^.
'--- --
�.'. ❑-�-__,� ^p ._-_
'! ; . 3.0�:.� Co.,t
�------ - -----
��- -32. �'r_'�Inca! Fo�.�,e� ^. .:�-'___ „ __
� 33 Fina, Elect��c ___�_
34. Fin: I HepUna � A�r Coi,:.,ti0n ;;�
35. Fi� ' C��. Pice�T: 1-- -
�. 35 Ncc:7 u G:roP�' -----
' �7 r, i F:rta'1' F�,nn s�:
�`38 Fln�: P.umb���.g -- --
r39 1�,::i Sr-rv'CE-Fira� _ �-
r40. G:-� S�.n� ce F�al
i 4^. c',� . '�om�., �.c.r:.
�Z ]:C,cf;p�,y PrCVEf1tE�
�' 43. 13ackflow Irngation
�44. Lar�dsetpe hr.gauon System `
� r.5. S��ved Attenuatior
� <6 F,���d;�ap �egu!at.o�s
� 47. P'�:.'>'_ STRUCi L'RE u"o�JIL����!G
I _ __
� 48. rl�!ALPLAivP!I�IG
� 49. ElEctrlc Rztease to Edison
4 50. Gas Rilease to Southem Caiifomia Gas
51. CE'1TIFICATE GF OCCUPA��CY
f�'o. Da:e
Date
- -- I POOL .VA ---�--- j - �- -
Inspector � qppROVALS Perm�t=� � Date �I^spec:�.
i
52. Pooi fu Equ'pmznt Lvcauo-, I .
53. Steel Reinforce-nrnt � J
54. Forms -���.
`I 55. Eiectrica: Bord�ng i � --�`
i-
� 56. Rocgh Plumbin{� L� P�as�vrc Tast �
-} � --
_� 57. APPROVRLInCOVE:R��U'�'i?F --I-- �
7�y�}- 58. clectncal Condwt �ndic�na. I��
�/ }
59. Gas P�pe, G Ur�rqmd , Tcs! �� ,
---------rt- ' . --
, 67. RzCk�.tiath Linc;. P.Tr,C, ��.� : n�r�. i �
' ' --- -- - - -..
� 67. AFPROL'PL TG L"_C'< i -
-�- -----;-- --'- -
+G3. Bacx;ass.� 6 Reec:a. � -, . � ;
----- - -- r-- --
63. H2ater & Vent-I�ii'.ul � I . '
$4, f•�umbi^y SYStrm Fu I ' �
-- ---�--c =--- -
' G5. E!ectrical-F:ral I
� ---- _-�- - -
66. Solar Systam�F�n;,! ' ( I
-.--- - - �-- - --- - -+ � ----��---� -- -_
G7. i=encing & Acc�ss ApP� ��':.�! . I.' 1
� G8. APPROVED f-OR P; A51 �,ilf�G � rI
-----1----�--- --
G9. POOL'S�A SVST�?^S Fln!A:. � ,
� FI'iE uEPT. REGUIR:'�..F :"--- �,---- -- , -
� -----' H� ?nOVrtL'J P�.� � - ------'
' 70. �'ocr��a..:�d �. . � - - - � � -
- ' - ---- -- ' .
� 7 i. Proc.uc; °.pin� �: C'.�. ' Oil L�
�-'-� I 72. Underground Fwe.,,--�� ------ I f�- �
-----�- -- - - � ---- �
�-----� - -
I%3. Under.qtnJ.Sorct �..�.:c 'G;s .� Jil �
____ _.� -_- _. _. %. G„cri,e�7 Hyu��� . .. __ _ _ _ ._J_ -___- -�__.
_. ... -_ti._- _____ _ ._ . _ ___-___.�__. . _�,__
-�_- , 75 C•V Cha� •�a I
__T.__ _
. �--_ __ _ _- _ _____ __ _ __.
- �'-_-- i5. DryStar:cr;e
-- -- �77. F!;:ED SYST,---- INAL .-- �-_-
---�---- � -- -
� 7e. FiRE PRE�i. F�^:..I. . '
_ _��_ � _-_ _ _ _ _--_ ___-. _ _ ' _ _ -.
�� • i HE�,!_Y��.: �EPi. rlE�Cif c':'c;�l- �
_'___ '_i_ --�' -"_ __-_ " _ _ __ _ _
� � /�'. �' ..til I��.� . . . . , � - %.
--- - - i----�- ---- ---- - - - - - - -- - - - -- -- -
T 4C FCGU C�;i-1F ':,�r1 I"S'•'��` �
-- ---1- � ! �
IVotes: /�p�,�
--- --T--1- 57�i� oK v_a �..��Q--
------�- --' - . -_ .
--�- --- -- �
---�-J- �--�---------._ �
, �
�- --�--.--' -'----- - . . .
----j---t- ----
' ' _�-� _ -'__ _ __
J '.
~.
�
�
�
��9'�11� # �o�-�
THIS NUMBER MUST AGCOMPANY
ALL INSPECTION REQUESTS
i�
F�R 19�SPEC�i��S
CALL
754-562b
or
754-5627
AP�'ROVED
City oi Co�ta Mesa Building Dept.
BY DATE I% 19�
THESE PLANS MU T BE ON JOB AT ALl TIMES MAKE
NO CHANGES WITN UT PRIOR APPROVAL OF DEPT.
'THE ISSUANCE OF2 GR N?ING OF A PCViM1T OR 4PPR0`iAL OP
PLANS ANU 3i'ECIPICFSI. NS SH; LL NCT 9E CONSTFUGO l O BE A
PFRM{T FOR. 6R AN AP qO��AL G��, nt!Y VIOLA'Y10N CG' ANV OF
THEPflOVI$IONSOFTF!i' C��'�Ji_ ^.'%�F��1.ti;':'nESUSs!^:G?OGIVE
AUTHpRfTV TO VIOLATE�OR CAItC°L T?E Pf0!'ISIONS OF THIS
CODE SHALL BE VALID EA:;�P7 It2 SO FAF AS 7HE�l4UHK OR USE
WV9CHITAUTHORIZES�S AV:iRA.
THE ISSUANCE O`r PEH;A;i SASED UPON PLANS AND
SPECIACATIONS SHALL T PRE'✓ENT TNG 6UILDING OFFICIAL
FROM THEREAFTER REOy1RING 7HE CORRECTION OP ERRORS iN
SAID PLANS AND SPE IF�CATIONS Ofi FROM PREVENTING
BUiLDING OPERATIONS 8 ING CARRIED ON TNEREUA9ER WHEN
IN VIOLATIDN OF THIS C DE ON OF ANV OTHER ORDiNANCE OP
THE CtTY. �
, j ( ` i // !
� � Cf/ ': �4 _'_ '
� i� ��� ' '7 �...—. L.
..1 ..._ . .. - " '_
�
ADDIT10tJS,
BE APPRO'
SURVEY OF
MAY BE R
19Q� �
ETIC1�'1S, �� CORRf
EY !NE PLA�PJING
�/��
PPRO �
����
PWNNINt3 D�?.
!Q i0 �1D0. DBL Na
�G.DA� �• 1
� 0� /IiNNI�q
...�..i.r
- LINE
IRED
� —~ :t; �
_�
SHALL
��
��
�
�
W
W
Q
�
N
e,
�
W
W
C
�
N
_ STREET o- _
TYPICAL 6�� CONCRETE BLOCK FENCE
Cement Coping Oot�onal �
Channel Block With 13/8�
Horizontal Top of all
Fences
For Fences 5' o� Less
Vert. Bars 3/S"yS at 4' �0" O.C.
For Fences Higher Than 5'
Vert. Bars 3/8"� at 32" O.C.
Fill Celis Solid With Grout
W here $teel Occurs
Reinforcing Steel Shall
Conform to Sec.A-15-39
A.S.T.M.
AllSteelto be Lapped
24" or to Code
NATURALGRADE
�;;.�,y �., „
��Ai,. � ((p� . > �a
TWO 3/8"d BARS o nn
CONTINUOUSTOP � .
& 80TTOM
G
HOf27Z.STEEL MUST BE TIED IN �
PLACE AT TIME OP TRENCH
INSPECTION. D� I ' .
i
0
a x
LL F
u
> w
a2
a
>Z
a
—WIDTH
SEE CH�
BE LOW
ING REQUIREMENTS CHART
GENERAL- NOTES
MORTAR; p�e Part Plastic Cement, and
Three Parts Sand
.GROUT: One Purt Cemenf Three anG
One Half Parts S�and
COPING: One Port Cement, Three
Parts Sand
CONCRETE: WQII Mixed 1:2-t/2:3-I/2
MaY. ot 7- I/2 Gallons of
Waler Per Sack of Cement
GROUT MAV BE POURED FROM THE TOP
OF THE FENCE IN CELLS WHERE STEEL
OCCURS.
CELLSANDAREASOF HOR120NTAL REIN-
FORCEMEN7 SHALL BE CLEAR, CLEAN &
FREE OF AlL MONTAR DEBRIS, E7C.
�H OF E4RTNTCOTH
V? THE HEIGTH OF FENCE
��LOW BOTTOM OF FOGTiNG
WIDTH . . . 14" . 14" . 12",.,. . ,
TNICKNESS . . . . . . 10��, . 10�� . . . . . 8��.
DEPTH OF EARTHTOOTH . 24�� . 20�� . . . . . . . . . . . 16��. . .
SPACING OF EARTHTOOTH. . 12' 14� ..... 16�. .
City of Costa Mesa, �alifornia
Building Department
2ev�Ep riov. az�
SCALE: I/2�� = I'
12"
8 ��
12"
16'
PARTY WALL AGREEMENT
THIS AGREEMENT, made and entered into this
� , , r
� zh day of
Mp�% /q93 ,byandbetween �-�SinlaR�N l3- 8�2G�R�F1"
hereinafter referred to as "LANDOWNER;' and _��� �G��CJ
hereinafter referred to as "ADJACENT PROPERTY OWNER"
It is hereby agreed that a party wall will be constructed on the property line
between
CoS�-
�,. . --�- G1 �0%
in the City of Costa Mesa, County of Orange, State of California, as per map recorded
r.
in Book �'� , Page3� -3�Miscellaneous Maps, in the office of the County Recorder
of said County. The party wall shall be permitted to encroach ,9 S�(��E3�Sf%��
IN WITNESS WHEREOF, the parties have entered into this Agreement the day and
year first above written.
.�. LANDOWNER ADJ�T PROPER��
. G�r�%�
(Signature) (Signature)
�� � s►�6,��,� �. ;� <<,����e�Fr� ��or�-w R �ti�-sr�m
Name (Typed oi Printed) . Name (Typed or Printed)
a��3 �=��oP� a,�
(Address) �QS, �,A �L�A �.,�
4'a6�2� �
190646
.�goG EU��f�� D�'
(Address)
NOTARIZATION REQUIRED
Aov���ant to fill in all soaces eacept those within neavY �oraer lines antl sign all aDVropriate aeclantions.
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. A P# Zone
f3 3 S8 S8
Projer�Address `I 0 D ] S Main Building: llccessory Building:
Applitant'S Mailing AddrEss �`�e � A'�G a� � /4IMdd[! TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR E Front Z
❑ CONVERSION ❑ DEMOLISH ❑ OTHER T O
O6Jner's Name r� Phone DESCRIPTION OF WORK/USE OF BLDG. �P '✓ �M � C! � B Rear N
ndd.�'ss ��i3 �aru a CaSik lrlttk a �
Ar<h/Eng.—T Licenu No. TVPE OF PERMIT GRADiNG ❑ FOUNDATION S7RUCTuaA� C Right N
Address p ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL I g� Lef[ R
Con�Vactor's Name 5M �fh- �d0 'r'IQ�phone �%S'l!2 �� / ��OTHER Ping. Ref. # Parking Req./Provided E
� �p HOJECT DESCRIPTION SQ. FT. �%� oCCUPANCV � n
Address (mailing) �� '� aUC (�7��/ �.(J��b? � ,�( �f f/ � �.p Planning Notes: ry�
CONSTRUCTIONTVPE VALUATION$ ��OG. T
CityLicenSeNo. � ZONE GRADINGCV.YDS. ACRES $,
I.ICENSED CONTRACTOR DECLARATION
I hereby aftirm that 1 am lirensetl untl¢r provisions o( Charte� 9(coTmencing Remarks: �. � MOU ��'L '��j �
with section ]000) of Oivision 3 of the Business antl Professlons Cotle, antl �
my license is in tuu for e antl ettecL � � - ELECTRICAI PEES
�1 License Class '— License No ��9� 7� -
Date �B_�, y—CF Si9nature PLUMBING FEES /automatic Washer Transformer ❑ 15-50 KW '
\ WORKERS' COMPENSATION UECLARATION • � ConstruCtiOn Pole SUb. ❑ 50+ KW
I hereby atiirm Ihdt I hdve a certiticate ot consent to Selt-insur¢ O/ d Ce�tlticate Bar Sink ShOw¢�5
-d ' Workers' Compensation Insurance, or a certifietl copy thereot (Section Backflow Preventer Service Sink Cooking Unit Meter ❑up to 100amps
)0. Lab. C.)
i�9 59 5/l S�QtY Fuh Dishwasher Meter ❑over 100 amps
licy No. Company Backflow IrrigatiOn Sewer Cap
Certitietl copy Is hereby turnished. Dryers ❑Gas ❑Electric Sub Panel
Ce tietl Fo�py i5 (iletl with [he city Bw tling,D'iy �s�ion.J7 r �.'• BdthtUhS Sewer Connection .'
Datej��Z�(��Q APplicant�� t`�r�/�/ Fan
EXEMPTION FROM WORKERS' COMPENSATION DECLAR� Clarifiers 5012� CAII¢Ct0�5 Motors �0.1 HP.O1'h-8
(This section neetl not be complete0 it the permit is fo� one huntlred (5300) or Di5hWd5h¢! Solar Piping � F�A�U� Inc. Solar �9-15 HP 016-15+
less). �
I certify that in [he performance ot tM1e wo�k tor which thls pe�m�t is is5uetl, I - FixtU�ES
shall not employ any pe�son in any manner so as to become subject [o the Drinking Fountains $Oldf Tdllk MiC�OWdv¢
Workers' Compensatlon Laws ot California. . - �
oate 5lgnature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light
N0710E: If, after making this tleclaration, you shoultl become subject to the Outl¢t5 Ran 2
Wolkeri' Gompensation plovisions of [h¢ Ldbo! Cotle, you mu5t fOrthwittl FIOOf$i0k5 Ufin81 9
comply with such provisions or this permit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV GaSServiC¢ Outlet5 WatefCloSet SwitCheS Sign
I hereby affirm that there is a construction lentling agency tor the periormance -
ot tne worp (or wnicn mis permit is issuetl (5ection 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections
l.entler's Name
Lenaers natlress - Kitchen Sink Water Service Generator �0-5 KW �5�15 KW Trash Compactor
OWNER BUILDER OECLARATION
I hereby alfirm lhat I am exempt trom the Contractor'S Lic¢nse Law for tne LavdtOrieS AUtO-WaSh
following reason (Section �031.5 Business antl Professional Cotle: Any city or
county which requires a permit to construct, alter, improve, tlemolish or repair � P—Trap L3undry Trays
any st�ucture, p�io� to its iszuance, alm �equi�e5 the appllcant f0/ such permit
to file a Si9netl statement tFlat he/She I5 IicenSetl pulsuant to the plovi5iOn5 ot ROOf Dfdif15
tne Contractor's License Law (Chapter 9(commencing with Section ]000) o(
Division 3 ot lhe Business antl Professions Cotle) or that he/she is exempt . Reinspection Fee $15 Issue Fee $ 3
`:refrom anG the basis for the allegetl exemp[ion. Any violation ot Section
.="-)1.5 by any applicant for a permit Subjects Ih¢ appllcan[ to a civil
�':`"�alty ot not more than �ive huntlretl tlouars (5500). 3 DEVELOPMENT SERVICES REQUIREMENTS:
� �l 1, as owner of tbe property or my em0�oyees with wa9es as their sole Reinspection Fea $75 laue Fee $
2oning Approvad By Date
compensatio0, will tlo the wo�k, antl the slructure Is not in[entletl O�-offeretl- -
for sale (Section �044, Business antl Professional Cotle: The Contractor's MECHANICAL FEES Building Approved By Date
License Law tloes not apply to an owner of a property who bulltls or improves lintian Issued B �G Z
thereon, antl who tloes such work himself/he�selt or fhrOu9n his or he� own APP V �et
employees, plovitletl that such Impfovements are nOt Intentletl Or ofteretl for BOil2� HOOd Of Typ¢ I ❑
sale. It, nowever, tne builtling or improvement is soltl within ona year of com- Canopy Type II ❑ SUMMARV OF FEES
pletion, the awne� will have the bu�Gen of proving he/She tlitl not builtl o� im- Dl1Ct - Und2f G�OUnd �
provetortnepurposeoisale). BUILDINGPERMIT $ %�•��" SMIP $ S
❑ I, as owner of the property, am exclusively contractln9 wim Iicensetl <on- Duct -Structural Refrigeratfon System p�p,N CHECK $ PERMIT
tractors to mnstruct the project (Section 7044, Business and Protessions Cotle:
The Contractor'S License Law does not applY to an owner o� property who Duct- Ventilating ❑0-100,000 BTU ❑100,000 BTU PLUMBING $ ISSUANCE $
builtls or improves thereon. antl who conVactS Tor such o�oiects wrth a ron-
tractor(s1 license pursuanc to cne Cantractor's License Law). I am aware tnat Exhaust System ❑ Multiple ❑ System Fiepair/Alteration P�N CHECK 25% $ ENERGY P.C. $
proof o4 tneir Worker's Compensation inzurance shaultl be proviaetl to me. ELECTRICAL $ GRADING $
❑ I am exempt untler Section B. & P. C. tor this reason Firepl/Fact. Blt. iC60 �k Fire Dampers MICFOFILM $
PLAN CHECK 50% $ l
Date owner '� Heating System & Ducting Registers MECHANICAL $ 1� .) �+
I hereby certity that I have reaa this application antl state tnat the above ❑0.100,000 BTU �100,OOOBT TOTAL FEE $
information is conect. I agree to comply with all tlty and county ortlinances PLAN CHECK 25% $
antl state laws relating to builtlin construction, antl hereby authorize repre-
sentatives of tni ity to ente� upo�ne above-m¢ntionetl proper[y to�
In50ection Du�po 5 . .lai /D�2S�..g�
Signature �"���� Date
Drivers• License r SS �y � Reinspection Fae $15 Issue Fee S a . O1 1�v017734-000t774Q ���T i�.�..$� '
n�rF� �ni�cirza rrnc_ ��ezo
0865-46, rev. 5/88 White - Pink - Accountin9; GOltlen�Otl - ASsesso�
.,
' CONSTRUCTION AND PLANNING POOI PA ,,
' cPPR0,�4LS Permit# Date Inspector qppROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole .', 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. � "� � 53. Steel Reinforcement
3.� Electrical Conduit Utility-Undrgmd'. ' " 54. Forms '�
i
4.• Electiical Conduit-Undrgrnd. . �• ` 55. Electrical Bonding „
5.. Steel�Reinforcement� ' 56. Rough Plumbing & Pressure Test .�
i.
6.iEfeclricalUFERGrnd. � 57. APPROVALTOCOVER-GUNITE '� .• i
7., Footings � �,� , 58. Electrical Conduit-Undrgrnd. ,�- �, �
8.� Foundation � ' 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. ' • .; 60. Backwash Lines, P-Trap, O Undrgrnd. �
10. Structural Floor System `�i '�� 61. APPROVAL TO DECK
11. Property Sewer Line & House Cohnection � ' 62. Backwash & Receptor-Final �
'+�
12. Sewer Cap ' '' „ 63. Heater & Vent-Final
13. R�oof Drains �� l '� ' 64. Plumbing System � Final �i'.
14. Rough Plumbing •, 65. Electrical-Final .
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring ' 67. Fencing & Access Approval
17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING �
-18. Rough Electrical-T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning . FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace � � APPROVALS Permit #
21. Ducts, in Structure •� .. 70. Underground Hydro
22. Ducts, Ventilating ' � 71. Product Piping O Gas ❑ Oil
, 23. Gas Pipe-Rough & Test , 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil
25. Roof Sheathing � . � -1 �/- 74. Overhead Hydro
26. T-Bar�Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing �'. 76. Dry Standpipe
28. Lathing&Siding .�'., 77. FIXEDSYSTEMFINAL
29. Insulation � 78. FIRE PREV. FINAL
30. Drywall Nailing ,. HEALTH DEPT. REQUIREMENT
31:-Plaster Brown Coat ' , 79. FINAL INSPECTION
• ,
32. Electrical Power Meter-Final� 80. FOOD CERTIFICATE �SSUED
33. Final'Electric Notes: �
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test �
36. Hood or Canopy
37. Final Factory Fireplace �
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer �t
43. Backflow Irrigation �
44. ,Landscape Irrigation System
45. Sound Attenuation . �
46. Handicap Regulations '�
47. FINALSTRUCTURE&BUILDING �219 �%'KI
48. Special Requirements Completed -
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY •
No. Date , � '�
�� �
COSTA MESA BUILDING-SAFETY DEPARTMENT
- P. O. BOX 317 COBTA M68A. CALIPORNIA
For Applieani to Fill In Complefely
TYpE OR PRINT
BUILDING L� 7 r.2yAr 4349,p
ADDRESS � �� CU OQFI �(� �Vt
COSTA MESA. CALIFORNIA
� ARCNITECT
LICTN�. B � � - N0: ,� /� 3vs
SIZE �J No. OF BLDGB
OF LOT �^� X I �� NOW ON LOT�
USE OF
EXISTING BLDG.
86TBACK LINH PROM /
ceMrew oP eTREET 4 REAR YARD
SIDE YARD LEFf L IRIGHT �
DESCRIPTION OF WORK
NEW I�II ALTERATION I II ADDITION
REPAIR I IIMOVING I IIDEMOLISH
81ZE OING � �S^ ROOMS / STORIES
EXTERIOR WALL k%eOD ROOF ,` W��
COVERING S UPOa�I COVERING /YE%7V✓'SIF
U8E OF BUILDING AND WORK TO BE PERFORMED
i HEPEBY ACKNOWL¢DGE THAT 1 XAVE RC�D i1116 APPLIGTION
AND BTATC TXAT THE AB��1E IB LOftRBGT ANO AGREE TO COM-
PLY WITN ALL CITY ORDINMIC¢9 AND BTATE LAWH R6GULATING
BUILD�NO CONBTiNR10N.
SIGNATURE OF �
�E RECEIVED
c� MAR 2 1967
FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Offiee Use Only
fiECEIPT NO. P�i�T�NP�
VJ
RECEIV D BY OA%j�� RE E DATE IBBUED
�� K ��� "V �nrn
BUILDING
A�ORE56
COSTA MESA. CALIFORNIA
FIRE
ZONE TYPE GROUP C
APPROVED
BY DATE
ZONING
ZONE NO. OP ...y U98 OF NEW .Lq
R� � PLAN9 � BIIIIDINO � Jµ n
�e°�o,o..�u �o� z9 .-�r �Y3
(CENiR
--�I6
7
6
36
CJ/� � e
Y�
e
0'i
T
EVES
ALLOWED
f.
r. `
�. —
�4'
�CZ
�./L(A �
i
THE AMOUNT 6HOWN UNO¢R VALUATION I6 FOP TNE
PUPPOBE OF FBTpBLI8HIN0 q PERMIT FEE ONIY.
VALUATION ��J
PERMIT FEE $ iJ/J
$/bJ / / / � PLAN CHECK $/� —
TOTAL FEE $.✓_J �