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Home My WebLink About2333 ALABAMA CIR - Building Permitsb `� Applicant to fill in all spaces exeeot tnose within neavy Doreer lines ana sign all approo/�ate Geclarations. _ CI�J7'IF COSTA M�� CONSTF�UCTIO�� Pro�.ct Address � � p �� ! �'!�L_ Applicant's Mailing Address �/�� -7 Owner's Name _�-/-1�L- Pho,ne��/ o Address � 1� Areh/Eng. License Na. Address 1� /�� p� ��q�/�/� Contracror's Name-�<�L�.�{,e�� , Phone � 5 � I/1%1 ' � A /�,y� Address (mail"ng) � �1� i�V�-k' Ciry LicensP No . �n� � � LICENSED CONTRACTOR DECLARATION I hereby aHirm that I am Ilcensetl untler provisions of Charter 9(commencinq with section ]000) of Division 3 of fhe BuSiness antl Professions Cotle, antl my litense is in tull rce antl effect. � C, License Clas i e se Date Si9nahre � WORKERS' COMPENSATION DECLARATION I hereby atiirm that I have a certificate ot consent to self-insure or a certificate of Workers' Compensation Insurance, or a certifietl copy tnereof (Section 3800, Lab.�I,A) ^ .1 _ � Policy No 1 JJ I�� COmpany �- rtifietl copy is hereby furnished. Da[eer.[ifj,¢i cppy is filetl �+'Appl canitY��A I�nO�Nv_ _ v -�-'4 � F EXEMP'�ION FROM WORKERS' COMGENSATION DECLARATION (This section neetl not be completetl if the permit Is for one huntlretl ($100) or Icss). I certify that in the performanCe Of the work fOr which this p¢rm�t is i55uetl, I shall not employ any person in any manner so as to become subject to the Workers' Compensatlon Laws of Calitornia. Date Signature NOTICE: It, after makin9 this tleclaration, you� shoultl become subject to che - Wo�kers' Compensation provi5ions Ot thE Ldbor Cotle, you must tor[hwi[h comply with such provisions or this permit snall be tleemetl revokeG. CONSTRUCTION LENDING AGENCV I nereby a(fi�m tM1at tM1ere is a const�uction lentling agency to� the perto�mance of tbe work for which this permit is issuetl (Section 309] Civ. CJ Lentler's Name Lentler's Atltlress OWNERBUILDER DECLARATION 1 hereby atfirm that I am exempt irom the Contractor's License L.dw for tne following reason (Section 7031.5 Business antl Professional Cotle: Any city or county which requires a p¢rmit [o construct, alt¢r, improve, tlemolish or r¢pair � any st�ucture, prbr f0 its issudnce, a150 rEquires the applicant for suCh pe�mit I to file a si9n¢tl 5[atement that he/sh¢ is Ilcensetl pu�suant to Ihe provisions ot ! tne Contractor's License Law (Chapter 9(commencin9 with Section ]000) of '�, Division 3 of the Business antl Pro(essions Cotle) or tha[ he/she is exemp[ Itherefrom antl th¢ basis for tne allegetl ex¢mptiOn. Any violation of Section ]031.5 by any applicant (or a permit subjects the applicant [o a civil �enalty of not more than five hundretl tlollars (5500�. � I, as owne� of the property or my employees with wages as fheir sole �mpensation, will tlo the wo�k, antl the structu�e is not intendetl o� offe�etl ior sale (Section 7044, 8usiness antl Professional Cotle: The Contractor's License l.aw tloes not apply to an owner of a property who builtls or Imoroves lhereon, antl who tloes such work himself/herselt or through his or ner own emploYees, provitletl that such improvemen[s are not in[entletl or offeretl for sale. If, howeveq the builtlinq or improvement is soltl within bne year of mm- pletion,-the owner will have the bu�tlen Of proving h¢/She tlid mt builtl or im- ��ova fo� tne Ourpose of Sale). I, as owne� of the prop¢rty, am exclusively cont�acting with Iic¢nsetl con- tracto�sto con5truct the project (Section ]064, Bu5ine55 antl Professions Cotle: The Contractor's License Law does not apply to an owne� of Oroperty who Cuiltls or improves thereon, antl who Wntracts for such projects wlth a con- tractor(s) I¢ense pursuanl to the Coniractor's Licenze Law). I am aware that proof of tM1eU WOrker's Compensation insurance shoultl be provitletl to ma. ❑ I am exempt untler Setlion B. & P. C. �or IhiS rea5on Oate Signature � Drivers' License — owner _ I have reatl thiz a 1 agree to Comply I to builGmg const / to en� / # a counry orainances eby duthorize r¢pre- ioneC property for Date�� Z �� Q — -- .,,.,. ,..,. TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR �❑ CONVERSION ❑ DEMOlISH ❑ OTHER A p # - DESCRIPTION OF WORK/USE OF BLDG. � S Main Building: TVPEOPPERMIT GRADING OF�urvDATiorv ❑STauCTURAL T Front ❑ TENANT ❑ ELECTRICAL I_.d,�LUMBING ❑ MECHANICAL B Rear ❑ OTHER A PROJECT DESCRIPTION 5Q. FT. occuPArvCv C Right S Left CONSTRUCTION TVPE VALUATION $ ZONE GRADING CU.YDS. ACRES Pl�g. ReF. # Remarks: , ' Planning Notes: Sink Preventer Irrigation athtubs rinking Fountains loor Drains loor Sinks as Service Outlets Kitchen Sink Lavatories P-Trap Roof Drains Reinspection Fee $15 6oiler Duc[-UnderGround Duc[ - Structural Duct - Ventilating Exhaust SyStem ❑ Multiple Firepl/Fact.8lt. ICBO # Heating System & Ducting ❑ o-i oo,000 eTu O i oo,00a qeinspection Fee � $15 CMF 0865-46, rev. 10/84 White - Builtlin9: Canary - Applicant; Pink - Accountin9: Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Issue Fee Haodor Typel ❑ Canopy Typell ❑ Refrigeration System ❑0-100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers laue Fea FEES 2017 2/�9/87 I� � Zone Accessory Building: ' Parking Req./Provided ' �t�'�il F ( � b 7 ELECTRICAL -- Automa[ic Washer Transformer ❑ 15-50 KW ConstructionPoleSu6. � 50+KW Cookin9 Unit Dishwasher - Dryers ❑Gas ❑Electric Fan F.A, U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generetor �0.5 KW 05-15 KW Meter LJup to 100 amps Meter ❑ovec 100 amps Sub Panel Motors OO-7 HP O1 h- 8 Inc.Solar 09-15 HP 076-15+ Microwave Pole Light Range Sign Standing Sections Trash Compactor 500� �TL FEES Z O N I N G R E Q M T S a31 �- Reinspection Fee $15 Issue Fee $ 3 FEES DEVELOPMENTSERVICESREQUIREMENTS: . Zoning Approved By Date Building Approved By ' Date Appliption Issued By �Yl� Dat� SUMMARV OF FEES . BUILDING PERMIT $ SMIP - $ � � PLAN CHECK $ PERMIT-' PLUMBING � $ y� - �SSUANCE $ PLAN CHECK �25% $ � ENERGV P.C. $ ELECTRICAL § GRADING $ PLANCHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ ; eD $ 3 � PLAN CHECK 25%� $ CONSTRUCTION AND PLANNING POOL & SPA APPROVALS 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-Undrgrnd. 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 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structurel Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 73. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 75. 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 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # _ 21. Ducts, in'Structure 70. Underground Hydro 22. Ducts, Ventilating 77. Product Piping �Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush � 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing � 74� Overhead HYdro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. FrameandFlashing 76. DryStandpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 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 ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test� 36. Hood or Canopy 37. Final Factory Fireplace � 38. Final Plumbing �� 39. Water Service-Final � � � �� 40. Gas Service-Final . 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY ^. No. Date _ _ �_j x a CITY OF COSTA MESA REQUEST FOR OCCUPANCY ' TR71CT N0, ��9 3 DATE /O- 30-�9 LO`� NO . 3 f ADPRESS .�,�3 /�-`ql�qvnq C-1 rc �e �OS �A %�QS Cj The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa . il�e unciersigned, by executing this agreement, acknowiedges that j�-they) (� were) advised that this tract has not been given final inspection nor has it'been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the city at the time the final tract map was approved. The city assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by sux'ety bonde The undersigned agrees to indemnify and hold the city harmless fram any claim resulting in damaqe or per�onal injury to the undersigned by reason of the aforementione�},uyf'�Q"pleted condition. s Developer and/or �dthorized representatide Lendez � "„"`"�°�`°' 3333 ALABAMA CI nWNED;SNAME:SHINTO ERNESTINE � AGUFESS:KEARNS� ERNESTINE S 3333 ALABAMA CIR COSTA MESA,CA 92626 AqCH/ENGINEEfl: � 7 1 4 � S�I S— S 4 % Z qEG.NO.: ADOflE55: ueiT: . UNIT: PE"minEE.J.P. CONTRACTORS INC. (714)921-2370 ' nooeess: z p4 p8 (4� N, GLASSELL �, LICENSED CONTHACTaH�BECCAI(Fi�N: I hereby a��irm Ihal I am licensea un0 re p��rovis9 � oi �apter 9(commencing with Section 7000) nt �iNsion 3 0� �he Business and Pmlessians Cotle. antl my license is in full force antl e��ect. c�rr STATELIC/� g4913 j� ,c�uss:C-39 �at _ � �4�Signature: _ (I �( Z WO fl5' COMPENSATION OECLAflF ION: I hereby a��irm Iha have a c �i�ca e ornsent to seu-insure or a ceniiicaie oi workers' Compensa�ion Insurance. or a cer�ilietl copy Ihereof (Section 3900. Lab. C). aoucrNo.:W933101312 ExP.oare:03/29/94 camraxv:CA COMP INS, CO ❑ Cenifietl copy is here6y furnished j�J Cerlified copy is �iled with Ihe ciiy Building Division. �a�e: Npplican�: 7 C�✓� / E%EMPTIO FPOMWON PS'COMPENSATIDNOECUflATION: (ihi55eclianneeano�becomple�MilNepermili5laronehunUre0�5100�arless�. I cetlily t�al in ��e pedormance of �he work tor which I�is permit is i55ueQ I sAall noi employ any person in any manner so as �o become 5ubjeci �o �he Warkers' Compensalion Laws of Cali�omia. Oate: ' Signamre: NOTICE: I�, atter making �his tleclara�ion, you shoultl become 5ubjec� �o ��e Workers' Compensa�ion pmvisions of �he Labor Code. you musi �otlhwiih compty wilh such pmvisions ar this permi� shall �e tleemed reuoked. CONSTflUtTION LENOING AGENCY: I hereby affirm I�al Ihere is a constmction lending agency for �he perlormance al �he work �ar which Ihis permit is i=.sued (Seclion 3W7. Ci¢ q. �� PERVTHE 1991EEDETOFTUHC OWNEP 601LOEfl OECWNATION: I hereby a�firm Ihai I am exempl fmm ��e Conlraciors' S[aie License Law lor �he lallowing reason (Seciian 7031.5 Business antl Pm�essional CoOe: Nny city o� counry which requires a permit to cons�mc�, alter, impmve, demolish, or repau any s�mcture, prior �o its issuance, also requires Ihe applicant �or suc� permit �o �ile a signed 5�aiemen� Ihai he/she is licensed pursuam �o �he promsions af ihe Comrac�oK State License Law (Chapier 9(commencing wit� Section 7000) of Division 3 oi �he Business an0 Prolessions Catle) or Ihai helshe is exempl �herefrom an0 Ihe Dasis �or Ihe alleged exemp�ion. Nny violation o� Sec�ion 7031.5 by any aoPlicant tor a permit subie��s ihe applicant to a civil penalty of not more ihan live hunOretl Oollars ($500�. I. as owner ol Ihe v�aPeny or my employees wilh wages as iheir sole comDensation, will Oo �he work, and the ❑ shuc�ure is not inten0etl or ol�erea �ar sale (Seclion 70a4. Business antl Pmfessional Code: The Con�radors' S�a�e License Law Ooes nat avPty to an ownerol a pmpeny who huilds orimD�oves ihereon, antl who eoes such wOrk himself/herself orihrough his or her own emDloyees. pmvi0etl �ha� such impmvements are not intentled or o��erea �or sale. I( however Ihe building or improvemen� is soltl wi�hin one year of completion, �he owner will have I�e burUen ol pmving �e/she did nol huild or improve lor the purpose o� sale�. I, as owner ol ihe properly, am exclusively con�rac�ing with licensetl conVac�ars �a cons�mc� �he pmlec� (Section 7044, Business ❑ and Pmlessions CoOe: The Contracrors' Siale License Law tloes no� apply m an owner ot Dmperty who builOs or impmves thereon and who conVac�s lor suc� pmle��s wi�� a contrac�or(5) license pursuan�to Ihe Con�ractof5' S�a�e License Law) I am aware iha� pmoi ol �heir Worker'S Compensation in5urance should be pmvitled �o me. � I am exempt untler SeC�ion: B. 8 P. C. lor Ihis reasan: Oaie'. Ownec I tlo here�y cenify Iha� I am aware a� antl underslan� �he requiremen�s oi Calilornia,Healih antl Safety Code Sections 25505, 25533, antl 25534 antl ihal I or any luture buildmg occupant willlwill no� (cirde one) neetl �o comply wi�h said s�a�e codes ana �he requirements for a permi� for consimc�ion or motlifica�ion Irom Ihe Air �uality Management �isVici. Residenlial cans�mc�ion applica�ions are exempi imm Ihese pmvisions. Dale'. Applicant: 1 �ereby cer�ity ��ai 1 have rea01hi5 application antl slale thal ihe a0ove in�ormation is correcl. I agree �o comply wilh all ciry antl counry ordinances and Stalelawsrelalinglo building consimction antl �eie y aWhorizerepresenlalives ofihis cirylo en�eruponlhe above-mentioned property �orinspection pnurpo5es. �, � Date: %� � SignaWre� �S'��' �' Orivm's License or Social Seariiy a: t64La6 Whi�e—Bmlding; Green—CoOe EntorcemenL Canary—AOPlsanl; Pink—Revenue; GoltlenroE—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: B 062680 PLAN CHECK NO; N CONSTRUCTION TYPE: 5—N PERMIT TYPE; STR JOB DESCRIPTION ; APPLY "GAF TIMBERLINE" COMPO ROOFING PERM NO; B 062680 GOVT; N SUAP;. N PURPOSE; ALT SQ FT: :�6— CLAIM VALUE: 3,810,00 CALC—VALUE: 3,810.00 GROUP OCC; R-3 /M-1 *�***��*+t�t**�r*��*��r*****�t�**OOD�r*�*+Nt**�****�r*��r** �t��r*******�*x*****x **D***� �r Z O N I N G R E Q U I R E M E N T S s s T B A c x s ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN PARKING RE • PROV; PARCEL: 13958123 ZNE; REF NO; PLANNING N I'ES> , ' � iE 1k if if iF iE iF if if if if iE k iFiE iE if fF 1F ff 1flE �FiF fE if it if iF 1E iE k iE ik iE iE iFiF iE iE iF �f iF ik iFlF iF if if iFlkjFlE iF iFlEiElf if iE �flElE iF iE iF iFlf iF if 1E iF i61F iF iF iE iE iE D E V E L O P M E N T S E R V I C�E S R E Q U Z R E M E N T S ZONING APPROVED BY , BUILDING APPROVED BY ; APPLICATION ISSUED BY iF 3E iF iE if iF-lE iF iE itlFiE if iEif iE 1F iE iF iF 3F �r**�*�r***+e*�*�+��r�r*�r�r LEGALIZATION;N BLDG PMT PERMIT 63,00 PLAN ��r�r*��*��**�r�r�t*�r��r F E E ,S. U M M A R PLUMBING ELECTRIC MECHANIC DATE; DATE; ��nATE • -� l 3 iE1E1EiflFiFifiEiEiF �F1k ��r�*�r**� �� r�*�***�r*�r**�r*** �r*�r Y STRUCTURAL SEGMENT;Y r FIRE SMIP/R50 GRADING SMIP/NON—RES ISSUE F6E '% HUILDING—DIV—> PERMIT ISSUE PL'AN—CHECK TOTAL PAID DUE TOTALS----> 63,50 0,00 �.0,00 63,50 63,50 ,00 �1 � REVENUE DIVISION TOTALS--> COLliECT'ED; 63,50 OVER/SHORT; 00 BLD63P00 PLUMBING ELECTRIC MECHANIC F'IRE SMIP/TO�T GRADING PLAN—CHECK � iF it if fE iE 1E 1E iF i! �k iE iE k 1E iF iE iF iE iF if if iE iE iE iF iP iE 1E iF 1F iElf 3E iFlE?E if df if� iF if iElF 1k 3FiliF 1F k iEiE ik iF )FiE iFlf if if iF 1E iE if iE iF iE iF if iF iF if # iE 3E if iF 3F iF iE I N D I V I D U A L• F E E B R E A K D O W N TYPE QTY D E S C R I P T I O._N UNIT COST . TOTAL COST SFR 3810 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 _3,�,00 END OF FEES � ��/��, j. �D ' `� � JUN 211993 CITY OF COSTA MESA ?� �"9"�" - " �CONSTRUC7iON AND PIANNiNG POOt PA �.1PPROVALS Permit # Date Inspector APPROVALS Permit # Date lnspector ��. Temporary Electrical Service or Pole . , � 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd.. , � 53. Steel fleinforcement 3. Electrical Conduit Utility•Undrgrnd. . 54. Forms 4. Electncal Conduit-Undrgmd. ' 55. Electrical Bonding 5. Steel Reinfo.cement - 56. Rough Plumbing & Pressure Test 6. Electr.ical UFER Grnd. 57. RPPROVAL TO COVER�GUNITE 7. Fpotings 58. Electrical Conduit�Undrgmd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash �ines, P�Trap, � Undrgrnd. 1Q. Structural FloorSystem 61. APPROVAL TO QECK , i t. Property Sewer Line & Nouse Connection 62. Backwesh & RecepmrFinal 72. Sewer Cap 63. Heater & Vent-Fina! 13. Roof Orains 64. Piumbing System - Final 14. Rough Plumbing 65. Electrical•Final 15. Rough Electricai-Conduit 66. Solar SYstem-Finai 76. ftough Electric 4Viring 67. Fencing & Access Anproval 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electricai-T Bar Ceiling 69. POOL/SPA SYSTEto1S FINAL 19. Rough Heating & Air CondiUoning FIR�E,DEPT. REQUIREMENT 20. Rough Factory Piraplace _ �_ ' ; ,APPROVAL'S Permit # � � 21. Ducts, in StrOcture � 70. Underground Hydro 22. DuGts, Ventilating � , � •71. Product Piping � Gas � Oil 23. Gas Pipe-Rough & Test _ � • - ' ,72, Underground Flusli �' � i 24. Roof' Framing� _' � � �� /_ . 73. �Undergmd. StorayeTank f> Gas ❑ 0�: 25. Roof Sheathing �'��_(��j� 74. 6verhead Hydro �- I7-r 26. T-Bar Ceiling (Structurall & Monocoat 1 V 75. bry Chemicai 27. Frame and Flashing . _ 76. Dry Standpipe . 2$. Laihing & Sitfing `` -, � 77. FIXED SYSTEM �(NAl 29. Insulation � I � 78. FIRE PREV. FINAL � � 30. Drywall NailTg � � I HEALTH DEPT. REQUIRE(v1ENT 31. Plaster Brown Coai . _ I 79. FINAL WSPECTION 32. Electrical Ppwer Metet�Finai � � i' 80. POOD CERTIFICATE ISSUED 33. Final Electric � � Notes�-� `(!Y��- - 34. Final Heating & Air Conditioning � � 35. Final Gas Pipe�Test - � 36. Naod or Canopy � � � ' i 37. FinaLFactory Fireplace � I� . 38. Final Plumbing ' I • - I - 39. bVater Service-Finai I � _ . 40. Gae Service�Final � � � i i . 41. Solar pomestic-Finai ' � 42. Backflow Preventer , � � 43. Backfiow Irrigation . � - � 44. Landscape Irrigation System � . �� 45. Sound Attenuation c 46. Handicap Regulations " - ' �/ � 47, fINAL STRUCTURE & BUILDING •/-d� 1(�y �� ! { ` d/ 48. FINALPLANNING i I , 49. Eiectric Release to Edison � � � - 50. Gas Release to Southern California Gas Co ! � 51. CERTIFICATE QF OCCUPANCY ' No. Date l PFOJECT`` �osess: 3 3 3 3 ALABAMA C I l:mNneP3 NRME: SHIN�I�O ERNESTINE -p�"wEss:KEARNS� ERNESTINE S 3333 Ai.ABAMA CIR COSTA MESA,CA 92626 RXCM/ENGINEEH: � 7 1 4� S 9 S— 4 4 7 z qEG.NO.: ADDHE55: UNIT: uxiT: "E"mi"EE:J.P. CONTRACTORS, INC. (714)921-2370 aooxess: z484 N. GLASSELL ORANGE CA 92665 LILENSE� iNACTOP �ECLANATION: I �ereby allirm thal I am licensed unaer D�ovisions o� C�ap�er 9(commencing with Sec�ion 7000) ol rvis 3 of �he Busine5 and Professions Code, anA my license is in �ull lorce ana ellect. c�Tr� . �� areuc.�g4913 cu�ss:C_99 �aie' _ SignaWre: _7�� WO ENS' COMPENSRTION OECUIPATION: I here�y aHirm ai I ha a cerldica�e oi con5eni �o sel4insure or a cerlilicaie of Workers' Compensaiion Insurance, ar a cer�ibetl copy ��ereo� (Sec�ion 3804 Lab. C). roucvNo.: 33101312 ExP.o^TE:03/29/94 COMPnNY: CO P I N CO ❑ Cehi tl apY �5 umished. Cer�ifietl copY is �iletl wi�h �he ci�y iltling �ivision. Oate- ' pDlicant �//�� EXEMPTION FROM WOHKEflS' CUMPENSpTION OECLAPATION: (This ec�ian neetl noi he comple�e0 ii �he Dermit is �or one �untlred ($1W) ar less). I certily I�at in the pedormance o� the work tar whic� �his permil is issuea. I shall nol employ any persan in any manner so as �o become sub�ect lo Ihe Warkers' Compensa�ion Laws ol Calilomia. Daie: Signalure: NOTICE: Ii, alter making Ihis Oeclaraiion, you should become subjec� to ��e Workers' ComDensation provisions o� �he La�ar Code. you mus� forlhwil� comply with such pmvisions ar Nis permit shall he AeemeO revoketl. CONSTHUCTION LENOING FGENCV: I �ereby a��irm thai �tlere is a cons�mction lentling agency for the peAormance of t�e waB for which Ihis permii is issue0 �Seqion 3097, Crv. C). �E"oEp:pROVIDE SMORE DETE:CTORS ADOHESS:PER THE 1991 ED, OF UHC OWNEB BWLOEfl OECLABATION: I here�y aifirm Ihat 1 am exempt Imm t�e Conlraciors' $tate License Law tor Ihe following reason (Sec�ion 7031 5 Business ana Pmfessional Coae: Any cily ol counly w�ich requires a permii to consimct, al�er, imOrove, tlemolish, or repair any stmclure, prior to its issuance, also requires the applicant for such permit to �ile a signed slalemeni �hal he/she is licensetl pur5uani Io Ihe pmvisions ol Ine Comracmrs' State License Law (Chapter 9(commencing wi�� Section 7000� o� Division 3 oi the Business and Pmfessions CoOe� ar tha� he/she is exemp� ��erelmm and Ihe basis lor �he alleged exemD�iort Any viola�ion of Sec�ion 7031.5 by any aOPlicani lor a permii su�lecis �he applicanito a civil penalry ol no� more t�an �ive hunOreA doltars (5500). I, as owner o� Ihe pmpertY or my emplayees wi�h wages as ��eir so@ compensa�ion, will do ��e work, and Ihe ❑ s�mclure is no� imenaeA or ol�eretl lor sale (Sec�ion 70aa. Business an0 Pm�essional COJe: The Contrac�ars' Sta�e License Law tlaes nol aDDly lo an owner ol a propehy who �uilas or improves thereon, antl who tloes such work himsell/hef5elf or ihwug� his or her own employees, pmvided Ihat suc� impmvements are nat in�ended or o��eretl �or sale. I�, however �he builtling or impmvemen� is sold wi�hin one year oi comple�ion, Ihe owner will have Ihe bur0en of pmving he/she did noi build or improve lor tne Durpose of sale�. I. as awner o� �he pmDerty, am exclusively contracting wiih licensed contmctors �o constmct lhe pmjec� (Section 704A, Business ❑ ane Pmlessions Code'. The ConVac�ors' Slaie License Law tloes not apply �o an owner ol pwperty who �uiltls or impmves thereon I ana who contrac�s lor such Orolac�s wi�h a contractor(5)license pursuan�lo the Conlrac�ors' S�ate License Law),I am aware ��ai pmol of their Warker'S Compensa�ion insurance shoultl be pmvitlea �o me. � I am erempl untler Section: B. 8 P. C. lor this reason�. Oale: Ownec I do �ereby cenify �na� I am aware ol antl understantl Ihe requiremen�s of Calitomia Mealth antl Safery Cotle Semians 255�5. 25533, and 25534 and �hal I or any fulure builemg accupan� will/will no� (circle one) need �o camply wi�h 5ai0 s�a�e codes antl t�e repuiremen�s �or a permil lor consimc�mn or mo0ificatmn Iwm �he Air Oualily Management DisVicL ResiOential consimction applicalions are exempt Imm IheSe pmvisiDnS Date: ApDlicani: I hereby ceritly Ihat I �ave reatl Ihis ap0lication antl slaie thai I�e aba in�orma�ion is yerpecL I agree to compty with all ty anU county ordinance5antl5ta�elaw5relaling�o�uildingconSlmc�ionanOhereb u orirerepr 31i€ �thisciryioen�erupan ve-men�ioned pmpeiry br �ns c�ian p poses � �aie'. � Signalure: Iorive�'s t�cense or ocial Securi�y x: 1641�46 White—Builtling; Green—Cotle Enlorcemenl; Canary—Apphcanl: Plnk—Revenue; Goltlenrad—Assessor CZTY OF COSTA MESA - BUILDING PERMIT PERM NO; IB 062896 PERMIT NO: IB 062896 PLAN CHECK NO; N GOV'C: N SUPP; Y CONSTRUCTION TYPE; 5-N PERMIT TYPE; OTH STR PURPOSE; OT'H JOB DESCRIPTION ; APPLY "GAF TIMBERLINE" COMPO ROOFING SQ FT; CLAIM VALUE; 3,810,00 CALC-VALUE; GROUP OCC; R-3 /M-1 COMMENTS: AT FRONT APPLY O/WOOD 5HINGLES/AT REAR T/O RESHEATH �� TO R �� 1� �r��r**x�r�r�r*+��e�r*�r�x�r�r*�*x�tx��***�r***��r*x*��*�*� x�*��+r�r*�lt�r�r�x* 2 O N I N GS ERTEBQAUCIxRSE M E N T S REQUIRED ------------ MAIN BUILDING ---------- --------- ACCESSORY HUZLDING --------- FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN PARKING REO; PROV; PARCEL; 13958123 ZNE: REF NO; t5 PLANNING N TES> > 1E iF it if ik iE 1E it if k if if if i! if iEiE if iF if if if ik il-!F # iElE ik iFiF iE iE iE it iE iF iE il� 1f iE �E i! iE 3EiE if 3(� iE�ElE 3E iE iE iF iE M iEiE iE �klE 3F iE iF iE iE �lE iE iF 3F lF 36 �E IFlE �1f iF if D E V E L O P M E N T S E R V I C H S R E� U 2 R E M E N.T S ZONING APPROVED BY DATE: �' BUILDING APPROVED HY ; UATE; " APPLICATION ISSUED HY• � DATE; �% iEititx-kiFititititkitititiEieiFiEitiEititiFifiF 3FiFiF *X7F1 iFR�i��F3F- lFii- •lf£iF3FiF'iFiF3F3F7Eit%lEititx-i6itx��iF�+E3t ifiFiklk�liF1E�FlE�FiliElEdFiFikkiFiFifitlF�tifiFiflFlF�l�fiEiE3FiF1E�F1F1EiEjE�)fif �lEiEifk�%itiE7fiF1ElFifiE�kiFiE-IFifiEifjkif�I4�Ei!)S'1EiEiEl41t1EiFiEjt�E LEGALI7.ATION;N F E E S U M M A R Y STRUCTURAli SEGMENT;Y HLDG PMT PLUMBING ELECTRIC MECHANIC F'IRE SMIP/RES GRADING PERMIT 30,00 i - SMIP/NON-RES PLAN ISSUE EEE BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTALS----> 30,00 0,00 0.00 TOTAL PAID ; DiJE 30,00 30,00 / � ,UO REVENUE DIVISION '['OTALS--> COLLECTED; 30.00 OVER/SHORT; 00 BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GkADING PLAN-CHECK 30.00 iE it k iE iE �1f i! iE 1! 1E iE iE if if iE iF if iF iE iE jF 1E iE if 3E 1E iE �)E iE 1E �IE 1E iE iE iE dF # 3(� IF iP i6 i(� 7F * 3E �F iF if iF if-�1F iF 1E 1h if 3F iE iF 3E iC� ih ih !E iE iE 1F iP iE if� # IE IE i4 iF !E ih 1E if 1E I N D I V I D U A L F E E B R E A K D O W N ' TYPE QTY D E S C R I P T I O N ONIT COST TOTAL COST INS 1 BUILDING RE-INSPECTION FEE 30,00 30,00 END OP FEES 61 Q014231&-0�142318 T� T 30.0� UATE: u7i0br'93 TII1E: 13:58 . � CONSTRUCTION AND PLANNING POOI a �rA �PPROVALS Permit �'-r Date lnspector APPROVALS Permit # Date Inspector �1JTemporary Electricai Service or Poie � 52. Ppol & Equipment Location ' 2, Soil Pipe-Undrgrnd. - 53. Steel Reinforcement . 3. Electrical Conduit Utility-Undrgmd. � 54. Farms � 4. Electrical Conduit•Undrgmd. ' 55. Elecirical 6�nding I 5. Steei Reinforcement 56. Rough Plumbing & Pressure Test 6. Elecvical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit�Undrgmd. 8. Poundation � 59. Gas Ptpe, � Undrgmd., Test 9. Water Fipe-Untlrgrnd. �. 80. Backwash Lines, F-Trap, � Undrgrnd. 10. Structural Floar System � 6S. APPROVA� TO DECK � 1 t. ProperiY Sewer line & House �Con�ection � 62. Backwash & Receptor-Final 72. Sewer Gap � 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. ElectricabFinal 15. Rough Electrica6Conduit 66. Solar SYstem-Finai 16. Rough Electric4Viring fi7. Fe�cing & Access ApProval 77. Rough 4Viring Siyn 68. APPROVED FO{i PLASTERING 18. Rough Electricai-T Bar Ceilin9 69. POOL(SPA SYSTEMS FINAL � 19. Rough Heating & Air Condi;ioning FIRE DEPT. REQUIREMENT 20. Roiigh Factooy Fi�ep'.ace � APFROVAiS Permit # 21. Dutts, in Struciure 70. Underground Hyciro 22. Ducts, Venti�eting 71. Product Piping � Gas ❑ Oil . 23. Gas Pipe-Rough � Test 72. Underground Fl�sh 24. Roof Framing � 73. Undergrnd. Storage Tank �.7 Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ce�ling (Strucxuraii &�Vlonocoat - 75. Dry Ghemical 27. Frome and Flashing � 76. Dry Standpipe � 28. Lathing & Siding ' , 77. FIXED SYSTEM FINA�� i � 29. insulation � I ' � 78. FIRE PREV. FINAL 30. Drywal! Nai�in9 � ' NEALTH DEPT. REQUIREMENT 31. P:aster Brown Coat � j 79. FINAL INSPECTION� ` 32. Electrical Power Meter-Final I i•{- 80. FOOQ CERTIFICATE ISSUED 33. Final Electric � � Notes: _I 34. Final Heating $� Air Conditioning �' � , ! 35. Final Gas Pipe-Test �� 36. Hood or Canopy � i 37. Final Factory Fireplace � � -- 38. Final Piumbing � � 39. 4Vater Service-Final i ' 40. Gas Service�Finai � 41. Solar pomestic-Final � i t 42. Backflow Preventer � � 43. Backflnw tnigation 44. landscape IrripationSYs[em 45. Sound Attenuation� 46. Handicap Regulations 47. fiNAL STFUCTUftE &.gUILDING � T�j�� . 48. FINAL PLANNWG � �.• � L �. 49. Elec[ric Release to Edison 50. Gas flelease to Southem California Gas Co � 5L CERTIFICATE OF pCCUPANCY No. Date Z o- U Z Q am J � J V1 Q W p] J m J Q U N Z a w� aw W Z J Q m z J � W w � _ Z � W � � � 70 F z Q U J a a Q 0 i" � z 0 � U � � f" y z �-� � 30 I 2 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BUILDING � � � � ��L� � �/ ADDRESS �1 �.IIL��I OWNER HerflB9 IiCV. i�.0. MAIL ADDRESS 1104 E. 17th Street TE�. CITV Fon'Fa Ana NO. �.{%�%n BRANCH 1 ADDRESS ARCHITECT M CONTRACTOR Owner AODRESS CITY L C NO. 2 2560 SI2E OF LOT jOO y � TEL. NO. CITY LI0. NO. INO.O BF L� NOW ON LOT NIEWBLDG. 14`nJ 9. F'tA00MS S STOF COVEERINGAL� StL1[:RO COVERING /OO}RF1�C USE OF BUILDING AND WOFK TO BE PERFORMED vaio /�PR 21i-6Gcn,;,OQ1306# **�115.50 APPLICATION FOR BUILDING PERMIT RECEIV BV DATERECEIVED DAT ISSUI ,�/.,l y a a-� � i � A.P. NO. — BVIIDING AODRE55��,3" TRACT �`'C W ADD A TER OWNER SE W (.l�t FIRE � 20NE � T APPROVED BV 20 NO.OF_ � PLANS-, VARDS APPROVED MAIN BUILDING (FROM C/L�STyFET) FROfYT 5 S� F _T. R. SIDE � � FT l. SIDE I U FT. FEAR � FT. DISTANCE BET. MAIN BLDGS. VAR. #E �.�.P.# V �s�c� .oavaovEo / . / / . LOT 3 � I BLOCK USE OF NEW,�„�// BUILDING / VARD$ APPRO` ACCESSORV BUI BET. MAIN & ACCESS. BLDCS. DATE APPROVEDS' � __ i�/�- I hereby acknowletlge ffiet I have reatl this application antl state R•T"°�• LD OR SPEC AC. REQUIR_�,._� ffiat the abova intormation is mrrect and agree to comply with all laws regulating building construction, antl I shall not employ any person in violation of the workman's compensation laws of ffie State ot Caffomia. T ��^ � J� I heraby certify ffiat I am properly licens¢tl as a convactor untler D SQ. FT. o the State ot Cal�tornia Business and Protessions Code, Oivisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, antl Mat such licenus ere in tull force and effect, or 1 THE PVRPOSE OF E5TABLtSHING A PERMIT FEE ONLY: m am exempt from the pmvisions of the Stat¢ of Califomia eusiness Q VALVATION antl Professions Code, Division 3, Chapter 9. N PERMIT FEE 5 • � ) Signature of r (%n p m Permittee $�� { yU � PL,AN CHECK $ � • �D E �!J/ o Authorizetl Agant � ��D LL TOTAL FEE $ OWNER HEgMES DEVELppMQVT DATE 5-1-69 JOB ADDRESS 2ZZ2 plahamo ri�.nlP BUILDING PERMIT N0. �0]_]2 INSPECTIONS SOIL GAS WATER (�Cy �2 G ROUGH PLUMBING PROP. SWR. LINE OUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING ANO AIR CONDITIONING TEMPORARV SERVICE OR PO�E UNOERGROUN� � POWER � ROUGH WIRING TRENCHES . FORMS STEEL REINF. FLOOR SYSTEM 90N� BEAM � STEEL REINFORC� n SHEATHING FRAME ANO FLASHING LATHING - IN OIIT SUBCONTRACTOR PLASTER, BROWN COAT � t �}'!/_ I I I STRUCTURAL, FINAL � }�' HEATING, VENT., REFRIG. AND N.C., FINAL � PLUMBING, FINAL ANO GAS TEST �' �� ',�� BOIL�ING, FINAL f�,[,� V�- SPECIAL REOUIREMENTS C✓v�q II �