HomeMy WebLinkAbout3321 ALABAMA CIR - Building Permits„ -=
Z .
a U
�- Z
ZQ
O v~i
dm
J �
J �
Q W
O] J
- p7
J Q
U N
Za
W �
aw
W Z
J �
m Z
J �
W w
� _
Z F
w �
�O
�
Z
Q
U
J
a
a
Q
�
H
N
Z
O
F
U
�
�
F
y
Z
s-ze � � � I 09
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 7200 COS7A MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
BUILDING `
ADDRESS � �a � l�
OWNEF H0YID88 DCV. CO•
CITV Santa Ana NOL �i7—
CONSTRUCTION _
BFANCH lyv�isroaaway qvenue
ADDRE55 g�,n lTiego, California
ARCHITECT TEL.
��cx K. Dorius rvo 675-i1
aooaess 2712 E. Coast Hwy. Corona D M
CONTRACTOR Owner
ADDRESS
TEL.
CITV NO.
STATE ,^ CITV
�IC. NO. 'Z5`�F�/ LIC. NO.
SIZE � NO.OF BLDGS.
OF LOT LOCI X� I NOW ON LOT O
USE OF
EXISTING 6LDG.
SIZE Of NO. OF
NEWBLOG. 1 O 6. PtROOMS STORIES
EXTERIOR WALL ROOF Comp�a8r�
COVERING BLUCCO COVEFING
USE OF BUILDING AND WORK TO BE PERFORMED
Residence w/attached eareee
va�o
P.PR 2�;-69cMs=.001303� **� 137.25
APPLICATION FOR BUILDING PERMIT
RECEyyEO $V DQTE R� E�ED DATE ISSUE
��,� s� a s�-i —,
PEFMIT NO.
A.P. NO. �- n/l
BVIIDING � � a n %i� �U 1
ADDRESS [.(� A�iYL(/
TRACT(p(�� LOTd� BLOCF
OWNER
IFE.��
ONE
PPROVED
�4- ! i.._..._ ,
VARDSAPPROVED
MAIN BUILDING
IFROM GL ST$EET)
U
DISTANCE BET
MAIN BLDGS.
VAR. #
GU.P. #
APPROVED
USE OF NEW
BUILDING
VARDS Af
BET. MAIN &
ACCESS. BLD
DATE �
�
I hereby acknowledge uat � na�e read uis application ene state HOLD FOR SPE IAL REQUIR£M�"'i 5
Mat the above intormation is rorrect antl agree to cOmply with
all laws regulating builtlin8 construction, antl I shall not employ
any person in vi0�ation of the workman's compensation laws of
the State of Califomia. T �.,p/ ry% m
'L II SQ. FT. ^ O
I hereby certity that I am properly licensetl as a contractor under
the State of Calitornia Business antl Professions Cotle, Oivisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR �
Chapter 9, antl that such licenses are In full forca and effect, ot I THE PUflPOSE OF ESTABLISHING A PERMIT FEE ONLV: m
am exempt trom the provisions ot the State of California Business �
VAIUATION
antl Professions CPtle, Division 3, Chapte /. �/� �
PERMIT FEE $ V �
�
Sig^ature of � /'��-' m
Permittee � 5,..�/��/� ja _. PWN CHECK $� � .- E
�T� /'7 /j `o
Autharizetl ABent TOTAL FEE ^y /� /' � J LL
OWNER ��S DEVEinPNNIENNT DATE 5 }�
JOB ADDRESS ��21 plphama f:irrl F+ BUILDING PERMIT N0. �0109
AP No. _
GAS
WATER
SUBCONTRACTOR
�r�.�����rr���i�.�r,i��i�irni�i�r..��fi�ac�r.c�R:L��r.no
oirioNiNc
11N0ERGR0UND � POWER []
ROUGH WIRING
TRENCHES � FORMS � STEEL REINF.
FLOOft SVSTEM
BONO BEAM � STEEL REINFOpCE n
SHEATHING
FRAME AND FLASHING
LATHING — IN . OOT
l c
PLASTER,BROWN COAT
STRUCTURAL, FINAL
HEATING, VENT., REFRIG. ANO A.C., AL
PLUMBING, FINAL AN� GAS TEST
ELECTFIC, FINAL
BUIL�ING, FINAL
SPECIAL REOUIREMENTS
E
.: �aUCj. J, AII PA[u ,q. A'siY-Yst
G ZO-74CM5�0015i7� 5.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626
PP CA ION FOR BUILDING PERMIT
ForApplicant to Fillin Comp/etely qEc I DATE RECEIVED D E ISSVED
BUILDING �'j2/'1/ /11 /1'bAMA CrTLGC� � � ��
ADDRESS .J l �� �"%C,+777
OWNER (� Guarzvhl CoA� I` g'—S��'��� PE�MITYO
A.P. NO.
MAIL a I^ �/� BUILDING ^
Z ADDRESS 2 �%{� r/r/ /TZGL�E' RIODRESS �� �J9 %Ii�'//-/ C�� .
d U CITV C���ry �Ij y NpL' ' TRACT 4�(y ��7 LOT p( 7� BLOCK
Z
ZQ CONSfRUCiION �DN� _ W ADD A P
O N LENDER
2 m
J � BRANCH y�
J � OWNER I�N
a w ADDRESS ,,�
m J p `_ VALUE p v
'Ja ORENGINE R 11�����' � NEL. 5 �O �L $ '�
U Q FIRE
W� ADDRESS 20NE VPE GROUP
a w APPROVED �^,,( �%��
JO CONTRACTOR BV , DATE(,J��(I•'-
m z
J � ADDFESS �
w W TEL. �ONE Q NO.OF USE OF NEW %/ U
�= CITV '-� ryp, �\ P�� � BUILDIMG r t
ZH
w O STATE ,__ CITV YARDS APPflOVED YARDS APPROVE�
y 2 LIC. NO. LIC. NO. MAIN BUILOING ACCESSORV BVILDING
7O � (FROMGISTREET) /�
O'F LOT NOW ON LOT FRONT FT. TI/FTCN�
VSEOF /Ty� G� E FT O"
EXISTING BLDG. fJ/�
F" $IZE OF NO. OF ��
Z NEWBLDG. ROOMS TORIES L.SIDE FT. R FT. ��
a EXTERIOR WALL ROOF �
V COVERING COVERING � CCG REAR FT. FT.S
J USE OF BUILOING AND WORK TO BE PERFORMED DI5TANCE BET. BET. MAIN &
a MAIN BLDf35. ACCESS. BLDGS.
a
Q VAR.#` DATE
O I D Q �J� G.U.P.# APPROVED
F APPROVED ��' ' — �' O �'�
�
z
�
VI hereby acknowletlge thet I hava reatl this application and state �
= thet the above into�matiOn is co�rect antl agr¢e to comply wlth
� all lews regulating building construction, antl I shall not employ �
F any Oerson in violation ot the workman's compansation laws ot
y the State of Californie. �
ZI hereby certity xhat I am properly IicenseC as a conttacmr untler SQ. FT, o
the State ot California Business and Professlons Cotle, Divisicn 3, HE AMOUNT SHOWN UNDER VqLUATION IS FOR
Chapter 9, and thet such �{�anses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: �
am exempt from the provisions of the State ot California B iness VALUATION ��l Fl
antl Protessions Co i is'on 3, I p2er . $ �� N
PERMIT FEE ]
Sienature ot . f�,� � m
Permittee $ �/)/1 PLAN CHECK $ E
✓V �� �..4�/% LL
QUMOri20d AgBni � , ��%
TOTAL FEE $
OWNER
COADY. R. F. & Gudron Jr. DATE 8-2
DRESS 3321 Alabama Circle BUILDING P
�L CONTRACTOR pwner Bldr. DESCRIPTION of WORK Patio
FIRE ZONE VALUE 8 500.00
SUBCONTRACTOR
ROI/GH PLUMBING
PROP. SWR. LINE
SPRINKLING SY51
MISCELLANEOUS
HOUSE CON.
ROIIGN HEATING AND PIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNOERGROUNO [] POWEft �
ROUGH WIRING
TRENCNES' FORMS STEEL REINF.
FLOOR SVSTEM
BON� BEAM � STEEL REINFORCE �
SNEATMING
FRAME ANO FLASNING
LPTHING - IN n OIIT n
PLASTER, BROWN COAT
STRUCTpRqL, FINAL
NEATING, VENT., REFRIG. AN� A.C., FINAL
PLUMBING, FINAL AND 6A5 TEST �]
ELECTRIC, FINAL
BUI�OING, FINAL
Applicant to fill in all spaces exeept those wit�in heavY Oortler lines antl si9n all appro0riate tleclarations.
=i8239 12/04/86 5.0� T
CITY OF COSTA�MESA CO ST UCTION PE MIT PER 1 N.q. 'TRACT NO. LOT NO. UNIT NO. � � -
� �l (oS 03 �
,
Project Address ' � ,
AppliCant'SMailin9 A_dd�ess I TYPEOFCONSTRUCTION NEW �ADD� ALTERATION REPAIR
yy� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER
Owner'sName �,f��^-�nn��� Phone � �DESCRIPTIONOFWORK/USEOFBLDG. A'P'# _ 2one -
Address �� ) S Main Building: . Accessory Building:
Arch/Eng. License No. TVPE OF PERMIT GRAOING FOUNDATION STRUCTURAL T Front p
❑ TENANT ❑ ELECTRICAL �-'� '❑ MECHANICAL g N
Address q�'rLVMBING R¢a�
ContreCLoYSNam � / Phone � � OTHER � A . _ �
/ PROJECT DESCRIPTION 5Q. FT. ' oCCUaANCv C Right N
Address (mailing)
K G
� CONSTRUCTIONTVPE VA�UATION$ g Left
City License No. v � � R
LICENSED CONTRACTOR OECLARATION ZONE GRADING CU. VDS. ACRES Ping. Ref. # Parking Req./Provided E
I hereby affirm tha[ I am licensetl untlet provi5ions of Charter 9(commencing q�marks: Planning Not¢5: ry�
WISh SCCII00 ��00) Of p1VI5�0O 3 of roe Business antl Prole55ions Cotle, antl
my license is in ful o� e ntl e(fecL �//�/y ��//,�� //� , S
� License C ass 'ce se o. ��'__'_"'^/_ , . D� li L
(� Date Siynature PLUMBING FEES
1 WORKERS' COMPENSATION DE LARATION Ba� Sink ShOwe�s ELECTRICAL FEES
� I hereby affi�m that I have a certificate of consent to Self-insu�e or a certificate
' of Workers' Compensation Insurance, or a certitieC copy thereof (Section BackfiowPreventer ServiceSink - ' ❑ 15-50KW
� 3800, �ab. p /. � � / Automatic Washer Trensformer ,
Policy No. '���qn���� Company �,.l�Qwi�`L Backflowlrri ation � . ❑ 50+KW
�rtifietl copy is hereby furnishetl. 9 Sewer Cap ConStrucUon Pole Sub.
Cer i ie qpq is " etl with the city tliqg��o� n. Bathtubs Sewer Connection Caoking Unit � Meter ❑up to 100 amps
Date Applicant A�� ,rrr.ti-��
EXEMP ION FROM WORKERS' COMP N ATION DECLARATION Clarifiers $ola� COIIect0�5 � Di5hw35he� � M2L2/ ❑Ov¢� 100 drnp5
(Tbissection neetl not be mmpletetl if the permil i5 to� one huntlr¢tl (E300) or .
I¢ss). Dishwasher Solar Piping . Dryers ❑Gas ❑Electric Suh Panel '
I certify that in the per(ormance oi the work for which thls perm�t i5 iSsuetl, I
shall not employ any person in any manner so as to become subject to'the Drinking Fountains ' Solar Tank Fan
Momrs �0.1. HP 01'/: - 8
Workers' Compensation Lawspf California.
Date Signature Floor�Drains Swimming Pool w/Spa F.A.U. Inc. Solar 09-15 HP �16-15+
NOTICE: If, after making tM1is tleUaration, you Shoultl.Gecome subject to the _
Workers' Compensation provisions o( [he Labor Cotle, you must /orthwith FIOOfSinks Urinal Fixture5
comply with such p�ovisions or this permit Shall be tleemetl revoketl. Mic�Owdv2
CONSTRUCTION LENDING AGENCV Gas�Service OuLIEtS Wdt2�C105¢t
1 hereGy at9rm that there is a construction lentling agency for the performance ' ' Device Boxes Pole Light'
of ihe work for wM1ich this permit i5 issuetl (Section 309], Civ. C.) InterceptOrs ' Water Heater Qutlets Range
Lentler's Name
Lentler's Atltlress ' Kitchen Sink. � Water Service .-
OWNER BUILDER DECLARATION Switche5 Sig�
I hereby atfirm that I am exempt from the GonVactor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections
following rea5on (Section 7031.5 Business antl Professional Cotle: Any city or
county which require5 a permit to construct, alter, improve, Cemolish o� repair P-7�yp LduOdry T�ays ' G¢ne�2t0� �0-$ KW �5-1$ KW
any structUve, prior to Its i55uance, also requires the appliCdnt for sUch permlt T�35h COmp2CtOf
to file a signetl statement that Ite/she I5 licensetl pu�suant to the p�ovisions of ROOi D�d105 ' '
th¢ Contrdclor's LiGense Law (Chapter 9(commencing with Section 7000) of
Division 3 of=the Business antl Professions Cotle) o� that M1e/sne is ezempl �
theretrom antl the basis fo� the allegetl exemptiOn. Any violation o� Section � '. '
7031.5 by any applicant to� a petmit 5ubjec[s the applicant t0 a civil
�enalty of not more than �ive huntlretl tlollare ($500). -
1, as owner ot the prop¢rty or my employees with wages as thei� sole ReinSpeMiOn Fee $15 �55ue Fee $ 3
compensation, will tl0 the wo�k, antl [he structU/¢ i5 no[ intentletl Or offerEtl Reinspection F¢¢ $15 ISSue F¢e $ 3
for.saie (Section 7044, Business antl Professional Cotle: The Contractor's MECHANICAL FEES
Licenre l.aw tloes not apply to an owner of a�property wno builtlz or improves
tnereon, antl who tloes such work M1imselt/herseH or tnrough his or her own � . VPe I � , DEVELOPMENT SERVICES REQUIREMENTS: ' '
employeez, provitletl that such imp�ovements are not intentletl or offeretl tor Boiler Hood or T � ,
sale. It, howeveq the builtlin9 or improvement Is soltl within one year of com- C2nopy Type I I ❑ ' Zoning Approved By Date
pletion, the owner will have the burtlen ot proving he/she tlltl no[ builtl or im- Ouct - Und¢r Ground Buildin A roved B
p�ove for the pu�pose of Sale). 9 PP Y Date�,tv��
� � I, as owner of the property, am exclusively conbacting with IlCensetl con- DuCt - St�UCtW21 Refrigeration System Application Issued By � Date � Z' �/ ��
Vactorsto construct the project (Section ]044, Business antl Professlons Cotle: �
The Contracmr's License Law tloes not apply to an owner of property who Duct - Ventilating ❑0-700,000 BTU ❑100,000 BTU SUMMARV OF FEES '�
builtls or improves lhereon, antl who contracts for suth p�olects wltn a con-
tractor(s1 i¢ense pursuant to the Contractor5 Licenre l.aw). I am aware that Exhaust System ❑ Multiple ❑ System Repair/AI[eration BUILDING PERMIT $ �$MIP $
proot of their Warker's Compensation insurante shoula be provitletl m me. _ PLAN CHECK $ —�����— PERMIT
❑ I am exempt untler Sectian e. & P. C. for this reason FirepVFact. Blt. IC80 # Fire Dampers PLUMBING $ .J UV ISSUANCE $
oate owner Heating System & Ducting Registers � PLAN CHECK 25°6 $ ENERG� P.C. $
I hereby certiry that I have reatl this application and state that the above ❑0-t00,0006TU �100,OOOBT - GRADING $
iniormation is correct. I agree to comply with all city antl county ordinances � ELECTRICAL $�
antl state laws relating to builtling construction, antl�hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ �
sentatives ot this ciry to ent upon the.above-mentionetl property for �q�J�
inspectionp ose ' r-� � MECHANICAL $ TOTALFEE $�
Signature Date !1
Drivers' License or 55 � � Reinspection Pee $15 Inue Fee .� $�& PLAN CHECK 25% $ �
CMF 0865-46, rev. 30/84 White - Builtling; Canary - AOP��cant: Pink - Accountin9; Goltlenrotl - Assessor
CONSTRUCTION AND PLANNING P�� 'P'�'
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electric8l 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
.1:
�a.•
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. Structural Floor System 61. APPROVAL TO DECK. �
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & VenbFinal �- �
13. 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
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. Storage Tank � Gas ❑ Oil � y
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
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
3S. Final Plumbing (o �'� L�I'
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
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
--._
PPOJECTAUOflESS: 33'21 ALABAMA CI
owNEnsNnmE:MILLMAN PAULA L TR
aooness:3321 AL�ABAMA CIR
COSTA MESA,CA 92626
ANCM/ENGINEEN:
aooeess:
flEG.NO.:
UNIT:
uxiT:
PENMITTEE:LUKE ROOFING, INC. (714)633-8798
nooaess: y32 N VATAVIA ST
ORANGE CA 92667
LICENSED CONTRACTOH UECLAflATION: I hereby aifirm �Aat I am licensetl unAer pmvisions ol Chapter 9(commencing with Section
7000� of �iv�sion 3 olihe Business antl Pm�essians Cotle, antl my I¢ense is in full�orce antl ellecl.
ciTvuc.:033014 srnreuc.�12648 — ��' = 9//
oa�e: G:.�u ��� Signaiure — Gr^�'1
WOflKEBS' COMPENSRTION OECLAPATION: I Aereby a�firm that I h ce�ilicate ol consem to selbinsure or a cetlilicate ol Workers'
Compensa�ion Inwrance. ar a cerlifie0 coDY �hereo� (Section 3800. La�. C�.
POIICY NO.: EXP. DRTE:
COMPANY:
❑ Cenifietl copy is hereby lurnishetl. ❑ Certified coDY is tiled wit� the ciry Building Division,
�ale: NpDlicani:
E%EMPTION FNOM WOBKEflS' COMPENSATIDN OECIARFTIUN: (This Settion n¢¢tl noi Ue tompl¢Ietl if �he permit i51or one hUnOreO �$1W) or less�.
I certily Ihal in the pedormance ol the work lor which Ihis permi� is issuetl. I shall no� employ any person in any manner so as lo became
suble���o iM1e Worker5' Compensation Laws of Calibmia. /�/J_ /
Da�e: G - "�" �� SignaNre'. 6 //�/x ` �
'�, NOTICE: II. atler making I�is declaralion, you shoula Gecome subl the Workers' Compensa�ion pmvision5 ot �he Labor
CoOe. you mus� Iotlhwiih comply wilh such pmvisions or Ihis permi� shall be deemetl revoketl.
CONSTflUCTION LENUING RCENCY: I �ereby a�firm Ihat there is a constmclion lentling agency for �he pedormance ai the work for
which Ihis permi� is issued (Section 3097. Civ. C�.
LENOEN:
AOOHESS:
OWNEB BWLOEH DECLABATION: I hereby atiirm �ha� I am exemp� Imm t�e Contrac�ors' $�a�e License Law for �Ae following reason
(Section 7031.5 Business antl Pmlessional Cotle: Any ci�y o� counry which requires a permi� lo consimct, alter, improve, tlemolish. or
repair any s�mc�ure, Odor lo its issuance, also repuires Ihe applicant br such permi� lo lile a signed statemeni Ihal he/she is licensed
pursuant �o Ihe provisians ot Ihe Comractors' S�ale License Law (Chapler 9(commencing with Section 7000) o� Division 3 ot �he Business
antl Professions Code) or Ihat he/she is exemp� �herehom antl the basis tor �he alleged exemption. Any violation o� Sec�ion 7031.5 by
any applicanlfor a permit subjecis Ihe applicant �o a civil penalry ol nol more Uan live �undretl tlollars (5500).
, as owner ol the pmpe�y or my employees wi�h wages as Iheir sole compensa�ion, will do �he work, and ihe
❑ stmclure is no� mlendeA or offere0 for sale �Section 7044, Business and Pmlessional Cotle: The ConVac�ors' State License Law
doe5 not aD�ly lo an awner o� a pmpetly who builtls ar improves ihereon, and who Ooes such woB himself/hersel� or thmugh
his or her own employees, pmvided thal such impmvements are not intendea or oHered for sate. If, however ihe �uiltling or
impmvemeni is soltl wilhin one year ot cample�ion, Ihe owner will have Ihe burtlen of pmving helshe Oid nol bui10 or imprave
lor the purpose of sale�.
I, a5 owner o� t�e pmperiy. am exclusively contrac�ing wilh licensea conirac�ors �o consiruc� �he prolec� (Seciion 70a4, Bu5ine55
❑ antl Pmlessions Code: The Con�raclors' State License Law does no� aDPty Io an owner o� property wha �uiltls or impmves �hereon
anA who conlrac�s for such pmlecis with a canVac�or(s�license pursuan� to I�e Contractors' S�a�e License Law�.l am aware
�hat D�ooi ol Iheir Worker's Compensation insurance shoutd be pmvitled la me.
� I am exemp� under Section'. B. 8 P. C.
for Ihis reason:
oaie�. owner:
I do here�y [eriity lhal I am aware al and under5lan0lhe repuiremen�s o� Calilornia Healih anU Sale�y CoOe Sections 2550.5, 25533. antl
25534 and Ihat I or any fuWre bwlding occupan� will/will not (cirde one) neetl to comply wi�h saitl state cotles and the requirements �or a
Oermil �or conslmciion or modificalion imm ��e Nir Ouality Management �isiric�. Resitlential cans�mc�ion applica�ians are exemp� �mm
Ihese pmvisions.
Dalc. Applicanl:
I �ereby [erlily ihal I have reatl Ihis applica�ion antl sta�e Iha� Ihe a0ove intormalion is carteci. I agree ro compty wi�h all ci�y anU counly
ordinances and s�aie laws relaling lo builtlmg constmc�ion antl hereby aWhorize representa�ives o� this ci�y to enier upon ihe above-mentioneU
prOp¢r�y fOr m5pec�ion putpose5.
Daie' ���-�j Signa�ure: ����
�river's License ar Sociai Securi�y a:
1641�46 Wbite-6uilaing', Green—Code Enlorcement: Canary—Appllcanl: Pmk—Revenue; Galtlenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT FERM Nc�; H 062838
PERMIT NO; B 062838 PLAN CHECR NO; N GOVT; N �UPP; N
ICONSTROCTION TYPE; 5—N PERMIT TYPE: STR PURPOSE; OTH
JOH DESCRIPTION : T/O FLAT,APPLY NEW ROCR630YR COMP O/WDSH SQ FT; 4,000
CLAIM VALUE; 4,000.00 CALC—VALUE; 4,U00,00 GROUP OCC; R-3 /M-1
COMMENTS: APPLY 30YR COMPO OVER EXISTING WOOD SHINGLES / NEW ROCK AT FLAT
*� �r �r�r�r �*�e*�*�r�r*�r*�r�r�x �e**x *x *�x�� ***+t*�r�t �+t*** x��t+t�r**�r****x �r***x *�e* x *�******�r*� ***
ZON ING REQUTREMENTS SMOKEDETEG��`OR
5 E T H A C K S pC Cn
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDIN6-��� r�-u
FRN't: FT IN REAR; FT IN FRNT; FT IN REAR: FT IN
LEFT; FT IN RGHT; FT IN LE:FT; FT IN RGHT; FT IN
PARKING REQ • PROV; PARCEL; 13958126 ZNE; REF NO;
PLANNING N�51'ES>
�
If �k 3E itiE if 3E lf �f iE 1E 3E iF �t it iF if iE if it iF iE if iE i! if iF iE iF if 7F iF ik IE iF iE 3E iE it ik iklF 3FiF 3E iF iE iF 1E ik iE ik iF iE iE%i!!F ff �t iE iF iE IE if �f if �F 3E�* !E iF if iF 3F %iE # if
ll E V E L O P M E N T S E R V I C E S R E Q U I R E M E N"�T-.S
ZONING APPROVED BY DATE; � �
HUILDING APPROVED BY ; DATE;
APPLICATION ISSUED BY: DATE; �Q�3 O
iEikikiEkititifitiEiEififiEiEitiEifiEiEikit i iEiEiFiEitll��l�ikifiE �e i(%if
IflFifiF7kikiF!liE1EiE!!!k#lt1El!!F!f!ElfififiF�1E�1E�lElf!lif9EifikiE%iE1E�lEifif�lEifiF iEiFikiF � itiEik�lEiElFiEififM-iflkfklElFififiElFitlE'1f1FiE�lEifiElEif
LEGALIZATION;N F E E S�7; M! M A R Y STRUCTURAL SEGMENT��L
BLDG PMT PLUMHING ELECTRSC'�MECHANIC FIRE SMIP/�tES GRP.DING
PERMIT 63.00 ' ,50.'
, • SMIP/NON—RES
PLAN -
ISSUE FEE '
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 63.50 0.00 �•0.00 63,50 63,50 ,00
REVENUE DIVISION TO'I'ALS--> COLLECTED: ,. 63,50 OVER/SHORT; 00
BLDG PMT PLUMBING ELECTRIC MECHANIC'.r FIRE SMIP/TOT' GRADING PLAN—CHECK
63.00 ,50
�1F if !F 3E iE iF if fE k iF iElF 1E iE if if iE if 1f �lFif 1E iE iE if if !E iE iF 1f if IF ik if iE if 1F if iE-IF iF i�-lE if if 1E iF iE 1F if i(-if iE ik iE if 1F iE 1E IF iE iE 1E lE if it iFlF 3E iF iE iF # iF 3f iF iE iE if
I N D I V I D U A L F�E E H R E A R D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SF'R 9000 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 4,000.00
END OF FEES
'1
f
% �i
01. 0014?084—OQ1420E5 T O T 63.54
DATE: 0?/�1/93 TIhfE: i`:27
j-.���
CONSTRUCTION RND PI.ANNING Pp��' �' `�
APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
7. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement �
3. Electrical Conduit Utility�Undrgmd. 54. Forms
4. Etectrical Conduit�Undrqrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ' �
6. Electrical UFER Grnd. 57. APPROVAI TO COVER�GUNITE
7. Footings 58. Elec2rical ConduiaUndrgrnti.
8. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Strucmral Ploor System 67. APPROVAL TO DECK '
it. Property Sewer Line & House Connection 62. Backwash & ReceptorFinal �
12. Sewer Cap 63. Heater & Vent-Finai �
13. Roof Drains 64. Plumbing System - Final
74, ftough Plumbing 65. Electrical�Final �
75. Rough Electrical-Conduiz 66. Solar System-Final �
i6. Rough Electric Wirf�g 67. Fencing & Access ApP�oval i
17, ftough Wiring Sign 68. APPROVED FOR PLASTERING �
J
18. Rou h Etectrical-T Bar Ceilin s
9 9 69. POOL/SPASYSTEMSFINAL
79. Rough Heating & Air Condiuoning FIRE DEPT. REQUIREMENT �
20. Rough Factory Firepiace . APPROVALS Permit $-` I
21. Ducts, in Structure 70. Underground Hydro �
22. Ducts, Ventilating � 71. product Piping CGas ❑Oii
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 {Structurall & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAI. i
i
i `
29. Insulation 78. FIRE PflEV. FINAL ' !
30. Drywall Nailing � � HEALTH DEPT, REQUIREMENT I
37. Piaster 0rown Coat � i 79. FINAL INS?ECTION I
32. Electrical Power Meter-Final 'i I_ : 80. FOOD CERTIFICATE ISSUED �
33. Final EleCiric � I ' Notes: Q`� '�
/O GU✓�G-fL..,_�O �O/� �
34. Pinal Heating & Air Conditioning � I, �,,� 7�1y� 1
35. Final Gas Pipe�Tsst � I i �Q p�k� dG�r[e, /�� �(�c3>e Snree�o�e �
36. Hood or Canopy ', Qg%. 7-/L-pf�j%
37. Final Factory Pireplace � �` �
� ..r-.---J
38. Final Plumbing ' �
39. LVater Service-Final I � -
40. Gas Seroice�Fina� �
41. Solar pomestic-Final � i
d2. Backflow Preventer ' ' . �
43. Backflow �rrigation
44. �andscapelrripation�System,
45. Sound Attenuation _-' --}- !
46. Handicap Regulatioris , i �
��� _ �.
47. FtNAL STRUCTURE & �UfLDING ! �
48. F3NAL PLANNING; ', `•.
49. Electric Refease to Edisort� � ; .
50. Gas Release to Southern California Gas Co �
57. CERTIFICATE OF OCCUPANCY � -' �1�
No. Date .