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Home My WebLink About204 AMHERST PL - Building Permits� �•I DJECTl�UflE55: �(�4 �VyjGR'J'T P'u OWNEB'SNFME: SIICARDl KlRMA iM aooRess: � 927 iRA��Y::ii��DS I,tv NEWF'OFiT BEACH,CA 92660 545-2813 RflCMIENGINEEfl: AOOflE$5: NEG.NO.: UNIT: UNIT: PEBMITTEE: �7XCF.L ROOFING ( 719 ) 555-0314 aooeess J331 LSTCHFZELD DR fiIJNTSNGTON BEACfi CA 92646 LICENSEU CONTBACTON OECLABATION: I hereby aifirm ��a� I am licens untler ovisi ns of Chapter 9(commencing wi�h Sec�ion 7000) of Division 3 oi Ihe Business antl Pmiessions COAe. an y licen is in � .orce n0 elfect. cirvuc.:0477/?}4� sraTeuc.:S5233 us '— 9 Date: �Z� SignaNre: _ _ _ . . — _ — � WOBKE LOMPENSFTIONDECLABATION: Iherebyalfir ha�l aveacenificateofcons IIo5eI6in5ureoracetlihcateo�Warkers' Compensaiion Insurance, or a certifie0 capy thereol (Sec n 3800, lab. C�. 1LICY NO.: E%P. URTE: 'OMPANV: ❑ Cenifietl coDY is hereby lumishetl. ❑ Certilietl coDY �s �ilea wi�h ihe ciiy BuiiOing �ivision. �aie: ApPlicani: _ E%EMPTION FflOM WOflKEflS'COMPENSATION OECIANATION: I ceNty that in Ihe pedormance of t�e woB lor which �his p Subleci ro Ihe VJorkerY/ C�ompensalion Laws oi California. Da1e' ��i� '% — '-[ � SignaWre: _ NUIICE: If, afie� making Ihis Declaration. you should Catle. yau mus� �or�hwi�h compty wiih such pmvisi CONSTBUCTION LENOING RGENCY: I �ereby aBir al w�ich Ihis permitis issuee ($edion 3097. Civ. C�. LENOEP: aooAess: noi be campl 4 if ihe permit is �ar one hunUreA (5700) or less). ial�m y any person in any manner so as to become i�come suCle�� o`tne Workers' Compensation provisions o� the Labar � or thi5 permii shall �e deeme0 revoked. �here is a constmction lentling agency for the Dedormance of ihe work tor OWNEN BUILUEH OECIAflFTION: I here6y aftirm that I am exemDt �mm �he Con�radors' $tate License Law �or �he tollowing �eason (Seclian 7031.5 Business antl Professional Code: Pny ciry of coun�y which requires a permil �o cons�mct, alter, improve, tlemalish, or repair any SlmcWre. prior lo i�s issuance. also reqwres the applicani tor such permii to �ile a signetl s�a�emen� Ihai helshe is licensed pursuam to IAe pmvisions o� �he Coniracmrs' S�ale License Law (Chapter 9(commencing wiih Sec�ion 7W0) of �ivision 3 0� �he Business antl Pmlessions Catle) or Iha� helshe is exempt Ihere�mm antl �he 6asis for the allegetl exemption. Any violation of Seciion 7031.5 6y any applicani �or a permi� su6jei�5 the apDlicanl �o a tivil pCnatly of nol more Ihan �ive huntlred tlollars ($500�. I, as owner ol �he pmpeny, or my employees wi�h wages as Iheir sole compensation, will do the work, and �he 7 vmcWre is nol Inientled or o��ereJ �or sale (Sec�ion 7044, Business and Pm�essional Catle: T�e ConVacbrs' State License Law tloes noi appty ta an owner ol a propeny who builds or impmves thereon, and who Ooes such work himsel�/herself or thmugh his or her own employees, pwvitleE [hat such impmvemen�s are no� imentled or oifered for sale. If, however �he builtling or impmvemen� is soltl wi�hin one year al campletian, I�e owner will have Ihe burden oi pmving he/she OiA not �uiltl or impmve �or ��e purpose ot sale�. I, as owner oi t�e pmpeity..am ¢xclusively comracting with licensetl contracrors to consimct ihe pmject (Section 7044, Business ❑ and Prolessions Cade: The Conlractors' State License Law does no� apply lo an owner o� pmperty who builOs or imD�oves [hereon and who contrads br such pmlecis wilh a coniractor(s)license Dursuantlo Ihe Coniractors Staie License Law),I am aware ihat pmof oi Iheir Worker's Campensa�ion msurance shoultl be pmvided �o me. � I am e�empt untler Seclion: B. 8 P. C. br ihis reason: Oate: Ownec I tlo here�y cenify Ihat I am aware ol anA untlerstantl Ihe requiremems of Cahbmia Heallh and Sa�ery Code Sections 25505, 25533, an0 25530 and that I or any IUWre Duiltlinq occupan� wilVwill no� �circle one) neetl to compty with saiA siate codes and �he requirements br a permii �or conslmc�ion or modilica�ion imm Ne Air Oualily Management DisVict. ResiC¢n�iai con5lmciion apPlicaiions are eKemO� ��om IheSe prDvisi0n5. Oale: ApplicanC _ I herebY �eni�y ��atl have reatl Ihis applicalian antl stale�hal e ardinancesands�atelavrsrelatinglo�uildingconslmc�ionan eb properry lorinspection pur0ases. �a1e: � 9" Y � Signa�ure' Driver's License o� sociai Searity a.- �$ � is correcL I agree to comply with all ciry antl counry palives o� ��is ciry �o emer upon �he ahove�mentionetl t6ab46 Whne—BmlOing: Green—Cotle Enbrcemem: Canarv—Appl¢anl: Pink—Revenue: Goltlenmtl—Assessor CYTY Or CO�TA MESA — BUILDING PERM�T PERM NO: B 051611 PERNIT NO: B 051611 PLAN CHECK NO: N GOV2: N SUPP: N CONSTRJCTZON TYPE; V—N PckMIT TYPE: STR PJftPGSE: P.:,'I' JOH DESCRIFTION : i/OPF �EROOc Trt/ COMP SQ FT: 4,`l00 CL,AIM VAi,Jc: 4,'100,00 CALC—VAi,JE: 4,200,OQ GROIJP OCC: R-3 / iOMME!3TS; PRT—iNSPECTION RE(�UIRED �lEiFififdF�M�YiEdf�}EN�X�dEif�)F�iE4£jE9f�If�IEif�lf�lE�XiE7E dE�3f�lf�XiE�IF�fE�%jE#iF-0E�%df�M�1F�1'�1E�kiE�Y-�IF��k��)(.}(..K..�x.7p.�(..�{ry�..�.7F.r..I4iE�1p�Y�3(�EiC�d(�#aFdE3E#� Z O N I N G R E Q U I R E,M E N T S sETs�,cxs ------ ----- MAiN BUILDING ---------- -------- ACCESSORY bUILDiNG -------- FR,�7T; FT iN REAR• rT IN FRNT: FT IN REAR; : i IN LEFT: FT IN RGH'F: PT ZN LC.I?: FT Ih RGHY; rT TN PARKING REQ• PROV; PARCEL: 14196505 2NE; REF J�O: PLANN_TNG NCSTES> ? 3E iF 3E iE # 34 if �le rt'i� )f ?F if 3F k if #k iE iE # if� ic iE �lf � if 9E * i(� iF 3t 1'r iF ae YF i(� iE !i- iE # if� k if'k if� i!� i�F # ib M;� 1F iF 1F if # iF iF 1E R�li� Y� Y; #F # 3f� 34 3f 3f� i!� 3F }. )'r �Y }'� y ib # 1f fE D E V E L O P N E N T S E R V I C E S k E Q iJ I R z iu a iv T S Zt7N3i�iG APPROUED �Y . BUZLDItvG APPROVED BY : APPLICATTON ISSUED B • — — i't il'if i%'if'ii'if 16ib N'iF'lf ih iE iF iE ii IF if �f iF 1!' '.'. r - - y. jf if� 3f 1E ie i'c fE 3h k If iE iF iF # iF �Y.- iF if ?E .Y�-% N� } iF ie ?i.2i.3f iF !P ih 3f X� k I,EGAiIZATION;N . E c BLDG PNT PiUNBING E.n PERMIT 72.00 Pr.AN I5St7E FEE DATF.: DAiE; �--�� DATE; O � `� 3F-ff� iF�r�h'�� £irF.�3F£'£R7F3F ieT� Y 3i 3F #� iS� � Y� IE 3F 1F��i� }} iE ih iE � i4 iE 3E Y sF ic'JF jF IE # 1E ic {: if' il� if ib'1F �e N� K=i # iF 1E if'1E �F if 3�- iE-J6 -I("7t"}. lE iE'k i4- S i7 M M A R Y SiRDCTURAl, SEGNENT: Y IC MECHANIC FIRE SM�P/R�5 GRADZNG .50 5M1P/NON—RiS BiJILDING—DIV—> PaRMIT ISSJE PLAN—Ci-InCR TOTAL FAID Di7't: TOTAi�S----> 72,SU O,OQ 0,00 72,50 72,50 ,00 REVaNJ� DIVISSON TOTALS--? COi,LECTED; 7:,',50 OVEk/SHORT: ,00 3'LD?lPM�T� FLiiMFiING ELnCTRIC ,HECHANIC FIRE SMIP/TOO GRt1DIt�G PLAN—CiiECK 3F if ii ff #� i�lF � ii �i ii ?E !E if fi i4 3E )f f4 3E )F 1F iE iE �M'� iE IE 1E 1F if ii� )E ?f� ff� 7F � iE k if iF 3F ii �e # 3e jE R if 1f �3f !F iE 3F ii� 3E fE i4+} 3F iE iE ii� ii� �N� if 36 i(� �1%if iE ii� �k+#'� �IFY.� 3i K iF Z N D I V T D G A L F n n B k E A K D Q W N TYPE QTY D n S C R Z P T I O N UN�T COs'T TOiAL COSi SrR 4200 REROOF HY CrALUE RESIDENIAL NOZONE 1,00 4,"100.OQ END OF cEES o, U�C3h472—[lUi�.,4i3 -r�_� ,� ;�.:c DNTE- C�4105!OI TTii�E: I2::4 '� CONSTRUCTION AND PLANNING ' � �' SPA APPROVALS Permit # Date Inspector qPpROVALS Permit # Date Inspector ; i;` 1. Temporary Electrical Service�yr Pole � 52. Pool & Equipment Location � 2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement � 3. Electrical Conduit Utility-Undrgrnd. 54. Forms .- 4. Electrical Conduit-Undrgrnd. 55. Electrical Bo�ding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings /� 56. Electrical Conduit-Undrgrnd. 8. Foundation „ 59. Gas Pipe, O Undrgrnd., Test - ��, 9. Water Pipe-Undrgrnd, 60. Backwash Lines, P-Trap, � Undrgrnd. � 10. Structural Floor System ,' . 67. APPROVAL TO DECK , 11. Properry Sewer Line & House Connection :�� 62. Backwash & Receptor-Final - 12. Sewer Cap -. ,.i 63. Heater & Vent-Final ' 73. Roof Drains "' 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical�Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electriwl-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rou9h Heating & Air Conditio�ing FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 77. Product Pipin9 O Gas ❑ Oil 23. Gas Pipe�Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil � 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Ceiling 1Structuraq & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 2S. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. flEQU1REMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Gonditioning 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 pomesticFinal 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irripation System 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE & BUILDING .b%._ �w�. � 9�, ._ � �_ O 48. FINAL PLANNING 6' 49. Electric Release to Edison 50. Gas Release to Southem Califomia Gas Cn 51. CERTIFICATE OF OCCUPANCY No. Date CITY OF COSTA MESA BUILDING DIVISION F200F COVERING CERTIFICATION Permit No. � S � � � � Property Address Owner �{�n� �U.!✓Ci'C_ ' � / ._ - ConVactor State Contractor License Number .�SZ 3...3�' Classification � 3% I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the above address in conformance with Chapter 32, and Section 1704 of the latest adopted edition of the Uniform Building Code, as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the manufacturer. ❑ I further certify that i am the owner of the proper[y. (Owner-Builder permittee only). ❑ I further certify that I am: Owner of sole proprietorship company ❑ Full partner of the company ❑ Limited partner of the company ❑ Officer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shall be binding on all successors or assigns oi the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. Received by Building Division By: W9o�4s Wnilx.Builtlmg DivJ Ganary�Conlratloq Pmk-Owner �jLl'�_ l �a-rf �/ wS Company Corporzt Name J�33� L��c/��/�c��r ► `�: i , /�I� AOG��ant to /ill in all sDaces ezceo< those witnin heavy oortler lines antl sign all apvropriate tleclarations. II CI I Y"OF COSTA MESA CONST RUCTION PERMIT P�F$MIT NO. TRACT NO. LOT NO^ UNIT NO. . . � / 1 (Y ..7 �n�� cl�� +� o� Project Address z�!� /�j�1U,Qr S( Pl ApplicanYs Mailing A dress .�' �`� Owner's Nam.e�,��(��^� '� "�aN d�WL� Phone i Address rz`=T /'1��"�t �� i �' Areh/Eng. License No. � Address �� ,��y�, ' Contrector's Nam � Ap/ u Phone 1JL'CSxffi � Address (mailing) %1� �-�F /N .�•��N�K .✓f4fd I' K Ciry License No. Z� 2� Y _ LICENSED CONTRACTOR pECLARATION I ttereby atfirm that I am licensetl untler provi5ion5 of Charter 9(commencing with section ]000) ot Division 3 of the Business antl Pro�essions Cotle, antl my Ilcense is in full orce antl eftect. License Class Lice s � - Date �'��± Signature ""'1RKER5'COMPENSATION DECLA ATION reby aitirm that I have a certificate oi mnsent to self-insure or a certificate No�ke�s' Compensation Insurance, or a Certi(ietl copy the�eof (SeCtion ..aoo, �b. c. �/ A/ ,% S'tQT.: �'�..i(� PolicY No. Z7�Vv k^'i��7ComPany Certirietl �opy JISf'��IetlbwitM1rthehci�ty Bw�i Mng Di,rw'c�ion�e� Date��_1��Q� APPlicant /�{)Yy( ✓� r EXEMPTION FqOM WORKERS' COMPENSfiT10N DECLARATION (Thissection neetl not be completetl if tM1e permit is for one huntlretl ($300) or less) I ce�tify that In the performance of thE work fOr which thi5 perm�t is is5uetl, 1 \ sball not employ any persOn in any manne� so as to become subjeci to the `v Worker5' Compensation Laws ot Cali(omia. Date Si9nature � NOTICE: If, after making this tleclaration, you shoultl become subject to the Worke�s' Compensation provi5ion5 of the Labor Cotle, you mu5t Porthwith \comply with such provisions or this pe�mit shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV � I nereby affirm thaY[he�e is a const�uction lentling agency (or the pe�fo�mance of the work for which tnis permit is issuetl (Section 309] Civ. C.) LenGer's Name � Lentler's Aatlress OWNER BUILDER �ECLARATION I hereby afilrm that.l am exempt from the Contractor's Llcense Law for the tollowing reason (Section 7031.5 Business antl Professional Cotle: Any city or munty which requires a permlt to construct, alteq improve, tlemolish or repair any Structure, prior to its issuance, a15o requires the applicaM for Such pe�mit lo (ile a si9netl statement that he/she is licensetl pur5uant to the provisions ot •he Cm[ractor's License Law (Chapier 9(commencinq with Section �000) of vision 3 of tM1e Business antl Professions Cotle) or that he/sne is exempt �.refrom antl the basis for the allegetl exemption. Any vlolation of Section .31.5 by any applicant for a permit subjects the aOPlicant to a civil �enalty of not more than five huntlretl tlollars ($500). LJ I, as owner of the property or my employees with wa9es as their sole compensation, will do the work, antl the structure is not Inientled or oiteretl for sale (Section 7044, Business antl Professional Cotl¢: The Contractor's License Law tloes not appry to an owner ot a property who builtls or improves ihereon, antl who tloes such work M1imself/nerself or through his or ner own ¢mployees, provitletl that such ImProvements are not intendetl or offeretl for sale. If, however, the builtlin9 or improvement is soltl within one year of com- Oletioq the owner will have the burtlen of proving he/she tlitl nOt builtl o� im- prove for the purpose of sale). ❑ I, as owner of [he property, am exUusively contractinq with licensetl con- tractors to construct the pro]ect (Section 7044, Business antl Professions Cotle: The ConVactor's Li<ense Law tloes not apply to an owner of property who builds or Imoroves thereom, and who contracts tor such projects witn a con- trac�or(s) Imense pursuant to the Contracfor's Li[ense Law). I dm aware that proOf of their Worke�'s Compensation insurance SM1oultl be provitletl to me. ❑ I am exempt untler Section B. & P. C. Por this reason Date Owner _ 1 hereby certify that I have reatl into�mation is correct. I agree to c antl state laws relating to builtling SEMdfIV¢5 O( Ih15 CI�Y [O ¢O[CI inspectlon purpose l Signature JJ. Drivers' License or � tate that the above tl county ortlinances :by authorize re0re- ionetl property tor Date `��!F_XC TYPE OF CONSTRUCTION LI NEW� ADD LJ ALTERATIOf� LI REPAI R ❑ CONVERSION ❑ DEMOLISH OTHER DESCRI ON �ORJCfJySE OF I�Jit.J TVPE OF PEFMI ,—J ❑ GRADING�� FOUNDATION STRUCTURAL ❑ TENANT IJ ELECTRIGAL LJPLUMBING ECHANIGAL ❑ OTHER PROJECT-DESCRIPTION 5�. FT. oCCUaA v CONSTRUCTION TVPE � VALUATION $ ZONE GRADINGCU.VDS. ACRES Remarks: � �. ��' 3(� �`7 �O. C.1 � ��o ,o � r-�-� _ �� . � Sink Preventer Irrigation Clarifiers Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories Roof Reinspectian Fee $75 Boiler Dutt - Under GrOund Duct - Structural Duc[ - Ventilating Exhaust System m Multiple ❑ Firepl/Fact elt. ICBO � Heating System & Ducting ❑0-100,000 BTU 0100,OOOBT Reinspec[ion Fee � $75 CMF 0865-46, rev. 10/84 White - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - A55essor PLUMBING Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Laundry Trays laue Fee Hood or Typel ❑ Canopy Type I I ❑ Refrigeration System ❑0-100,0008TU ❑100,OOOBTU System Repair/Alteration - Fire Dampers Registers laue Fee $ 3 $ 3 A.P. # S Main Buildi E T Front Q B Rear A C Right K Left � S Ping. Ref. # � Planning Notes: Automatic Washer Construction PoleSub. Cooking Unit Dishwasher Dryers '❑Gas ❑Elec[ric Fan F,A.U. Fixtures Device Bozes Outlets Garbage 6472 10/31/86 Building: ELECTRICAL . , Transformer ❑ 75-50 KW ❑ 50+KW Meter ❑up to 100 amps " Meter �over 100amps Sub Panel � Motors C�7 -7 HP � 1'/h - 8 Inc.Solar �9-15 HP �16-15+ Microwave Pole Light � " KW LJS-15 KW Standing Sections . ' Trash Compactor FEES Reinspection Fee �$15 Issue Fee � $ 3 DEVELOPMENTSERVICESREQUIREMENT(yyl o �G • 2oning APProved BY- l� ^n ��Date V/ �" �� Building Approved 6y-0� Date_LO 1� Appliwtion Issuad By -Date � SU M RY OF FEES BUILDING PERMIT $ �� SMIP $ Q. SA PLAN CHECK $ PEFMIT - PLUMBING $ '�.�!� ISSUANCE $ , PtAN CHECK 25% $ �. DO ' ENEfiGY P.C. $ ELECTRICAL $ /� S�O GRADING $ PLAN CHECK 50% $ �� MICROFILM $ - MECHANICAL $ � TOTALPEE $ � PLAN CHECK 25% $ �""'"!�- d�— G'"'`� �"t'`',1� . �pc,J CONSTRUCTION AND PLANNING . POOL & SPA APPROVALS Permit# Date Inspector pppROVALS Permit# Date Inspector 1. Temporary Elecfrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. �.� �b („�j) 53. Steel Reinforcement 3. Electrical Conduit Ut'li y-Undr m�. J,S.,fL '�, 54, Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings �) � 58. Electrical Conduit-Undrgrnd. 8. Foundation (�p � D(d 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. ' (�-6�b �,� 60. Backwash Lines,�P-Trap, O Undrgmd. 10. Structural Floor System u Q � 61. APPROVAL TO DECK 11. Propzrty Sewer Line & House Connection 62. Backwash & Receptor-Final 72. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing SYstem - Final 14. Rough Plum6ing !-��f-f? L�r) 65. Electrica6Final - ' � 75. Rough Electrical-Conduit 66. Solar System-Final ' 16. Rough Electric Wiring 67. Fencing & Access Approval ' -19-F� . t7. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. h Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace VAIS Permit # - 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush � � 24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil 25. Roof Sheathing - �� 74. Overhead Hydro . 26. T-Bar Ceiling (Structural� & Monocoat 75. Dry Chemical � 27. Frame and Flashing L � Q� 76. Dry Standpipe 28. Lathing & Siding )�ile' 77. FIXED SYSTEM FINAL � 29. Insulation y B� 78. FIRE PREV. FINAL • 30. Drywall Nailing �� HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED ' • 33. Final Electric �� Notes: � t� g(� �(� rL f.✓�� 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test - � 36. Hood or Canopy � 37. Final Factory Fireplace 38. Final Plumbing 7�� 39. Water Service-Final '. �, . 40. Gas Service�Final � � � 41. Solar pomestic-Final . � , ` 42. Backflow Preventer � 43. Backflow Irrigation 44. Landscape Irrigation SYstem 45. Sound Attenuation � � 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING �� . . 48. Special Requirements Completed � � , � ' 49. Electric Release to Edison . ' r� : 50. Gas Release to Southern California Gas Co i 51. CERTIFICATE OF OCCUPANCY " ►'� No. Date � ► � � ADC��tant to fill in all s CITY OF COSTA MESA � PERMy ,T NO. CONSTRUCTION PERMIT / = � Address �0�1 Am/lE.esr �4G• eo5/'9 Arch/Eng. License No. Address Contracto��IC /F/G �r�Cr.O��E.�� within heavy bortler lines antl sign a1l approoriate tleclarations. � TRACT NO. LOT NO. BLDG. NO. I hereby affirm that 1 am Iitensetl untler provisions of Charter 9(com- menCing with s¢CtiOn J000) of DivlSiOn 3 of tnG Business antl PIOt¢SSi005 COtl¢ antl !Oy IIC¢058 IS 111 fUll f0lCG dOtl ¢� 2Ct. ucenSe�C�/S� � l.icen�e N��9 DateJ c�nariiro� �4>0 WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selt-insure or a C¢rtifiCat¢ of Wo�kers' Compe05dtiOn InSUlance, oI a celtitietl copy ��I';j`?�tifl¢tl COpy Is her¢by tu�nishetl. � ��ertifletl copy Is filetl with the city Builtling Division. EXEMPTtON FROM WORKERS' COMPENSATION DECLARATION (This setlion neetl not be tompletetl if the permlt is for one huntlretl SE300) or IezsJ. cer[ify [hat in the performance of the work tor which this petmit is issu¢tl, I shall not employ any person in any manner 50 a5 to become subject t the orkers' Compens ti ws of Ilfornia Date �s � $i9natur�� NOTICE: I! after making this tleclaration, you shoultl become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply wi[M1 suGh provisions or [his pe�mit shall be tleemed �evoketl. CONSTRUGTION LENDING AGENCV I h¢reby affirm that there i5 a.const�uttlon IeOtlinq agenty fo� the per=. formance;of'the`work�foriwhich tbls permit is`issuetl (Section,3097 Civ. CJ. Lentler's Nam¢ Lentler•s Atltlress OWNER eU1LDER OECLARATION I her¢by atfirm that I am exempt from tne Contraclor's License Law for the following reason (SectiOn 7031.5 Business antl Protesslons Cotle: Any city or munty which requires a permi[ to con5truct, alter, improve, tlemolisn or repair any struc[ure, prior to its issuance, also re- quires tne applicant for such permit to file a signetl statement that he is licensetl pursuant to the provisions of the Contractor'S License Law (Chapter 9(COmmentinq with Section ]000) ot Division 3 of the 6usiness antl Professions Cotle) or Ihat he is exempt therefrom antl the ' for the allegetl exemp[ion. Any violation of Section ]031.5 by ipplicant for a permlt subjects lhe applicani to a tivil penalty �l more than five huntlretl tlollars ($500). �J I, as owner of the property, or my ¢mployees wiih wages as their sol¢ Compen5ation, will tlo [he work, antl ihe sVucture is not intentletl OI Off2l2C fOI SdIQ. ($2CSIOf1 %044� BOSI0055 d�ld Professions Cotle: The Contractor's License Law tloes not apply to an ownet of a p�operty who bulltls or improves thereon, antl wno tloes such work himself or throu9h M1is own employees, proviCetl thal Such improvements are mt intentletl or ofteretl for sale. If, howeve�, the builtling or Improvement is soltl within one year of completion, the owner will have the burtlen of proving he tlitl noi builtl or imp�ove �or the purpo5e of sale). ❑ I, a5 owner of the property; art� exclusively contracting with li<¢n5etl contrattors [o tonstruct Ihe project (Section ]044, Business antl Professions Cotle:'TM1e Contractor's License Law tloes not apply to an owne� of property who builtls o� improves thereon, antl who con- t�acts f�om such projects with a contractor(s) licesnetl pursuan[ to the ContractOr4 �icense Law). ❑ I am exemp[ untler Sec[ion B. & P. G(or this reason Date �Owner 1 hereby certify Ihat I have reatl [his dppliGatiOn antl State IM1a[ th¢ above intormafion is correcL I agree to compty witn all city antl county o�tlinances antl state laws relating to con5t�uctlon, dntl hereby authoriie representativez of this ciry to enter upon the above men[ionetl p�operty fa� mysp-¢ ct n pu,r�p s_e_s.- �i. b Signature �^ - ' �"�r�'^�_�— �/ „e s�a DIIV2Y5' LIC205C ' S$ iF � � / . ' � TYPE OF CONSTFUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOlISH ❑ OTHER DESCRIPTION OF WORK TVPE OF PERMIT O GRADING ❑ FOUNDAT.qIO,N, ❑ STRVCTVRAL ❑ TENANT ❑ ELECTRICA� prLUMBING ❑MECHAI ❑ OTHER PROJECT DESCRIPTION . SQ. FT. OCCUPANCV_CONSTRVCTION TVPE VALUATION ZONE GRADING CU. VDS. � ACRES PLUMBING BATHTUBS TOILETS LAVATORIES KIT. SINKS FLOOR SINKS DRINKING FOUNTAINS INTERCEPTORS SWIMMING POOL WATER SERVICE GASSERVICE WATER HEATER SEWERCONNECTIONS SOLARTANK_ SOLAR PIPING SVS. ISSUE FEE �,'d 0 MECHANICAL PLAN CHECK SHOWERS URINALS DOUBLE LAVS DISHWASHERS 5 V MP$ FLOOR ORAINS CLARIFIERS PTRAP ALTERATION - OVTLETS BTU OUTPUT COLLECTORS� ., ' �� ` � PLANCHECK HEATING SVSTEM 0-300,000 BTU ANDDUCTING 100,000+BTU REFRIGERATION 0-100,000 BTU SVSTEM 100,000 + BTU BOILERS BTV SVSTEM REPAIR,ALTERATION EXHAUST SVSTEM MULTIPLE ISSUE FEE CMF 0865-46 White-Building; Gnary-Applican[; Pink-Accoun[ing; Goltlenrotl-Assessor , � . .. , � a�iFa ain�iei ZONING REGULATIONS A.P. � 20NE PLNTGp. REF. � BU D pqOPERTVNLINI SEpTEBACK GL 5T. L�EFTYARD � SIOE YAR RIGHT REAR YARD (TO P/L) PKG. SPACE REq. PROVIDE� STREET WIDTH� PARK FEE ZONINGAPPROVEDBV DATI SPECIAL CONOITIONS: ELECTRICAL GENERATOR TRANSFORMER HPPLIANCE MOTORS (INC. SOLAR) PLAN CHECK 0-1 KW_ 1-10 KW 10-50 KW_50 + KW 0-1 HP_1-10 HP 30-50 HP 50 t HP 'FIXTURES- 'OUTLETS SWITCHES GAS TUBE SIGNS PO�E LIGHTS PANELS MAIN SERVICE ISSUE FEE �LICATION SUB AMP BV SUMMAHV OF FEES BUILDING PERMIT $ PLANCHECK $� PLUMBING $ P� PLAN CHECK S ELECTRICAL S P�AN CHECK $ MECHANICAL $ PLANCHECK $ � SMIP $ PERMIT ISSUANCE $� GRADING S E MICROFILM $ TOTAL FEE 5 LE55 AD- VANCEPC $= FINAL FEE $ S VD TL CONSTRUCTION AND PLANNING �'OOL & SPA. � APPROVALS Permit# .53 Date Inspector qppROVALS , - Permit# Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil ipe- ndrgrn 44. Steel Reinforcement 3. Electrical nduit Utility-Undrgrn 45. Forms � 4. Electr'rcal Condtiit-Undrgrn 46. Etectrical Bonding . tee ein orce 47. Rough Plumbin & Pressure Test - ' 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe•Undrgrn 51. Backwash Lines P-Tra ❑ ndr rn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Rece tor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing 14. Rough Electric-Conduit �56. Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final 76. Rough Heating & Air Conditioning � encing & Access Approval 17. Ducts, in Structure 5. ApPROVED FOR PLASTERING 18. Ducts, Ventilating . 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing - 21. Roof Sheathin 22. - Frame and Flashing NOTES: p�e -�C �iq,�Kq/ g,/p_S � 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning - 30. Final Gas pipe-Test ' 31. Final Plumbing � 32. Water Service-Final 33. Gas Servicp-Final 34. Solar pomestic-Final 35. Landsca e S rinklin S stem 36.�- Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed � 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date ' - ' ' - r COSTA �� MESA BUILDING DEPARTMENT P.O.BOX 31� COSTA MESA. CALIFORNIA �EE �ECEIVE� FINAN�� 0��. FOR APPL►CANT TO FILL IN APPL�CA�TrO$N� FOR PERMIT AooRE55 2o Anherst Bd-.'%�� BU I LD I NG COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. T�, % : OWNER Princeton .uti�i• MAIL �1r� RECEIVEO BV OATE RECENEO OTTE ISSUED ADDRE55 �9 E• 1/th St♦ �'�( 1~ cirv C�$t'd 'v'••$'d V�1• TNO�. 8-1159 ADDREI55 nRCHirecr C3T19on�ccidlebrook N�o: oR EN�iNEER COSTA MESA. CALIFORNIA ADDRE55 �'den VS"D�e FIRE ZONE ZON�`((�� NO.OF TVPE GROUP CONTRACTOR��O��OgP'i �T: NICO. ��i lJ I PL4 � !{l I \ ADORE55 �] F'• 1/Yh SV• NO�. 8-1159 gyPROVEO � DATE �E�A� �or 5 CORRECTIONS oescraPnor+ NO. � BLOCK TRACT 29 5 A.P. NO. SIZE NO.OF 6LOG5. OF LOT now orv �oi USE OF EXISTING BLDG. SETBTCK LINE FROM < c[H1ER OF SiRe[i JO� REAR VARD 2�� SI�E YARD RIGHT S� LcFT S� DESCRIPTION OF WORK NEW p ALTERATION ADDITION REPAIR MOVING OEMOLISH I SITELDING 1IdO S lU ROOMS 6 STORIESy 3J{O E%TERIOR WAL ROOF !� COVERING �t CCO COVERING y USE OF NEW OUILDING rrlth attached garage. Plan 730B I NEREBY ACKNOWIEOGE TMAT I MAVE REAO TNIS f�PPLICATION AND STATE TMRT THE P90VE IS CORftECT nNO AGREE TO COMPLV WITH iLL CITY OflDIN�1NCE5 AND ST.1TE 'LWS REGULATING 6UILUING CONSTRVC- TiO�v. � VALUATION SIGNATIIRE OF PERMiT FEE $3��00 PERMITTEE • , � 15,139�� PLAN CHEGK � 1��00 IJike & Colegrove, Inc. 54 �0 AUTHORIZED AGENT TOTAL FEE $ � �M. owNEx PRINCETON, INC. � DATE 10-1.7-58 los aDnxrss 204 Amherst Rd, BUILDING PERhIIT NO. %S19 GENERALCONTRACTOR Dike 8. ColeF!TOVe ' VALUE� 1�1'i9_00 AP. No. LOT 22 TRACT 2955 FIRE ZONE DESCf21PTION OF WORK Rca_ R, Gar_ f Ip 1°'= " TYPE ° ZONE �-1 PLAN NO. If�IBP�E�TbIONS ( DATE PERMITS ISSUED �� Q�� 7. J 8UBCONTRACTOR DATE NUMBER d aYW� coat