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Home My WebLink About2016 BALEARIC DR - Building Permits.wn�ssa�ew�w,a: z016 BALEARIC DA uNT: °°'"E"s"""E'°'°w�'": STRONG, WALTER R TR FLOOD: AE-46 �ooness: z016 BALEARIC DR COSTA MESA,CA 92626 RPYl.1.N14NG NIDXEA4: AIiCHRECT OX F1NdlFFA: u�cx on �•s woness: uc. xo.: UNT: coNm�cTarsruwe: EMPIRE PLUM&ING HTG/AC ( 714 ) 530-7320 caim�crorrswuiwa 11381 WOODBURY A0D"Eu: G.G CA uG�.: 652877 92643 uM*: LILENSED CONTHRCTOHS DECLANRTION: I Mreby eflim uMm penely d Po�ury Ihet I em licenaed under proviaiana d Chaptar 8 (cwnmenaip wn� Section ]000) d Orvisun 3 d the B�siroea e�y PMeasiom Code. yA mY �� u in lull /arce vM eHeq. c.No.: uc.cuss: C-36 ucV.No.:r. 6�52877 EXP: ae: l�' �� co�i�a F� �"V... fi�n.v�,./'-'"� NEF BUILDEN OECLAFATION: I hareby effilm urMar penely d per'Nry �lat I em e�amq imm iM Canuauas lironee Lew 1« Me Idbvnnp reeson (�ion )0�1.5 Bueinean aM Profesabns Coda: Rny cdy a rounly xA'rh rpuirea a permit lo cauVucl, eller, imOrove. Eemda�, or repeir eny sVuclure, prior lo i�s oauvKe, also requires tM epplireni for wch parma io fib e aq�nd a�atement �Iw he a she n licensed Wrs�� o ihe parisims M Ur Canlreqors Licensa Lew �Cheptar 9 �mmmendnp wnh Sed'nn ]000) ol Div6ion 3 0l lha Busineee anE PrWesauna Code� a tMl M w sha is eaemq Ihseimm enE iM be�ia /w Ihe elbpeE exampian. My violetion W Seaion )W 1.5 by enY eVP��I lor a parmn subjatla IM epplicent to e civil paralry W nq mae then ive huMrad dollen j$500�). � I, es axner W Ihe propeny a my empbyeee wRh wagea a+lhe'v ede mmpenaetion, vrill do tha woM, end the evunuro e nrn in�endad w oflered lor sele (Seclion ]MI. Busirrees eM Pmlesaons Code: Ty Cpnlredois Licmfe LnwEoea rM epply loan owror d prope�ly wlw bulds w vn0�� herean, end xfio does such wwk MmmX or hareert w Ihrouph ho w her own employeee. 0�� het such imprwemems era rd imeMed «d1ereC lor sab. tl, Mwever, IM Wikiep w'vnpioremenl o eoM within ma ymr d ewnpb�ion, the awrer-buiNer will heve ihe buNen d povinp he or eha did nd buib or improve lor tha WT�e a/ aele). I� I, es ownar d Iha DropeM� em exduaively mntreding wnh IicenaeE convec�ore lo conalrud I�e prapcY (Sedion ]OM, Businese erd � PMessiona Code: TM Contreeore L'eanse Law doea rwi epqy lo en owrer d peopMY ��ika a impoves thereon anE who I conVec�a fw wd� prqecls vnln a mnlredot(s) Icenaetl pursuanl la Ihe Conlreclore License lew�. ,❑ I em exampt untler Seclion: B. 8 P.C., /a t�ie roemn: • , Dete: p.mer: i I Eo hereby crerlity �hPo 1 em eware d enE untlentend �ha requiromema d Gelilana HmXh eiM Selery Gode Sediana 25505, 2553�, aM �. 255�a, eM Md I a erry Mure Wikirq accupeni will / w11 rut (a�cb mre) need to compty wih vitl mela mEea eM iha reyui�emanb 1« ��, eparmnlormnaweiionorrmdife�aiionlromtMRv u�enTyl,ianepemenlDimna.RnideMalmnslrudioneppFralionse�aezempt/mmiheae pro.dsp�a. Dete: Apqram: WONKEP'S COMPENS�TION DECLAHATION: 1 he�eby elfi�m urMsr penaM1y W papury wn d �lie tdbxiip dederatnm: � I heve eiM xil meinlan e cerlRr.ele ol mruenl to aeMinaure for xakare cwnpeneyion. m qwidad fa by SeUbn 3)00 d the lebor coaa, ra ma rono��e w m, � m�.n��n mti re�n �a ��aa. I� 1 have enC wiA meiMain workers mmpemetion insurem, av rpuiretl by Senion 3]00 d tM Lebw COEe, br tM parlamarra d iM J� wwk fa whiM thia pertnh u iaued. My wnken' compenution imuranca mmx eM pdiq number ere: c�a�: ��LCOMP EXPIRES Poi�rN�me�.: r,aFtit7�AS 01/O1/97 (Tn;s sedia, n.ed nw ae comd�ae � me re�r;: ro. ono nund.ee dwws Is�w/ a'roa.) � 1 cenh' �� he perlormence d �he work for wh'rh �hie peimn ie isauad, I sIW I nd employ eny pareon in eny menner eo es to become aublecl lo ihe rkers' compamalion kwe d Cdiiwnie, erM epree Ihei if I ehouW bxm�e wpjeif io tM xakeie' wmpena-e7�ion°�' W SaCion 3100 d iha Labo� COCe, 1 eli��e/l`�ohhvrith oomp�y xM �hoae p iswns. Dm _ 1) l° I�� n�pr i: I��`/�-VH�' C/�v�.✓V� am/ip: Fallun ro sscuro worten'ronpenutlon eovsraps /i unl�wlu( entl �IWI aWJset en employsr ro er/M�ul psnelXsa ane clNl X� up ro ons huntlrod fhovuM Oo/Nri (JIW,000), In atltl/tlon ro lM cwt ol rompxustbn, Wmepu u provldetl br In Sxtlon J105 0/ Ms L�or Cods, lnhres( antl attomsy i/wa. CONSTPUCTION LENDINO ApENCY: I liareby elfiim uMar peneM1y d perryry ilat �here ie e mnsirudion bMinp eper�cy lor the penoimence d �ne work �« wnid� �no romie fs eauea (seaon aos1. cN. cl. LENDEH'SNpME: � LENDEP'S ADDqE55: I ceniiy I�m I heva reed this eppl'r.alion e�M 9ale thel Ne abore iniametim ia carM. I epree to wmply xilh ell tlty enC rounry mdinanma enE siete levn relating lo buildinB ro�e��uCion erq hereby eu�Mrrza reprevanie�ivae Mthis ay b emer �pon tM ebove-mentioned qoperry /arinspedion Wrpoees. KAREN EICHMAN Pnm Nema I J�� 1 � ♦ � A '� w�.L.iY� . . . L . . ... .. .._ . . Dale: � (5151-06 W P) Selmy: Green-Fle; Carery-Applcem; Nnk-q¢V�ue; Ooldenrod-Aeseaaw CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: M 076231 PLAN CHECK NO: N CONSTRUCTION TYPE; PERMZT TYPE: MEC SOB DESCRIPTION : C/O F.A.U/ 75K. BTU CLAIM VALOE: CALC—VALUE: PERM NO: M 076231 GOVT: N SUPP: N PURPOSE: OTH SQ FT: GROUP OCC: R-3 / COMMENTS: X ��**+�**��**��***�**��***�**�**��r+�***�**�*******�**�*�*x**�*��**�x***�*** Z O N I N G R E Q U I R E M E N T 5 S E T H A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT ZN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 13945314 ZNE: REF NO: PLANNING N6TE5> ' �� iE * if fE 9E'lE iE iE iE iE'lE fE 1E 1E 9E iE 1E iE'7E 3E 1f �klElE jE 1E IE iE iflE 1E 1f iE 1E 1f 1E iE 3E 1E iE 1E 1E'7E 1E iE 1E'IElF iE'lE'IElE iE iE 1E dE 9E'IE 9ElElE f(' iE iE iE 9E 1E jE 3ElE ik iE 1F 1E 1E �E fE fE �E D E V E L O P M E N T S E R=V I C E S R E Q U I R E M E N T S ZONING APPROVED BY `�' DATE: BUILDING APPROVED BY ; �1 DATE: . C��_I q p! APPLICATION ISSUED HY: ' n/�� DATE: 1� 3J lU *�-*�E***i�**i�-it*�E*�EiEic�iE*iEit�3f�iFiF"iF��Fi�7F'iFiF�7FiFiF7FiFiF iF 7FiFiF '�:F�F3F3FiF3F�F�F**it*****i�* iEi� LEGALIZATION:N F E E S U M M A R Y STRUCTURAL EGMENT:N HLDG PMT PLUMBING ELECTRIC MECAANIC FIRE SMIP/RES GRADING PERMIT � 9,00 i` 25� SMIP/NON—RES PLAN ISSUE FEE � 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE TOTALS----> 9.00 15.00 � 0.00 24.00 24.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 24.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 24.�� / iE if 3E 1E jE iE iF 1F iF iF aE iF if if iE iE 1f iF iF iF if if if IE iE iE iE iE iE 1f iF iE i(� 1E iE iE iE iF�1E if iF 1E 1F if iF iE iF �F 1E ih iF iE iF iE iF iE iF iE * iF iF dF iF 1E iE iE 3i' iE iE iE 1E iE iE iE dE if 1E 1E if I N D I V I D 0 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 MEC 1 INST FORC—AIR/GRAV FURN <= 100 K BTU 9.00 9.00 END'SOF FEES j"� ' �� ./ , -. � . � . � - � o - -. -. — �' ^� _ (% CONSTRUCTIpN AND PLANNING J,OL & SPA ' � APPROVAIS Permit # � Date Inspecror qppROVA�S Permit # Date inspecror i. Temporery Electrical Service or Poie 52. Pool & Equipment Location � 2 Soil Pipe-Undrgmd. 53. Steel Reinforcement 3. Electiical Conduit Utility-Undrgrnd. 54. Forms A. Electrical Conduii�lindrgrnd. 55. Electricai 8ondng � 5. Steel Reinforcement � 56. Rough Plum6ing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings 58. Electrical Conduit Undrgrnd. 8. Foundation 59. Gas Pipe, � Undrgrnd., Test 9. Wate� PiPe�Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgmd. 10. Structural Floor System 61. APPROVAL TO DECK t t. Props�tY Sewer Line & House Connection 62. Backwash & Receptov-Finai 72. Sewef Cap r' '� -"�� "� 63. HeateF & Y�t1Pipal! 13. Roof Drains 64. Plumbing SYstem � Final 14. Rough Plumbing 65. Elecirical-Fina� 15. Fiouqh Electrica{�Conduit 66. Solar SYsxem-Final 16. Rough Electric �9iring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPRQVED FQR pLASTERING 18. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL ' 79. Rough Heating & Air Conditioning , FIRE DEPT. �iEQUIREMEfVT 20. Rough Pactory Fireplace .. � ` . APPROVAtS _:, Per'mit # 21. DuctS, in Structure- 70. U�derground Hydro 22. Dutts, Ventilating . � 71. Product Piping C7 Gas OOiI 23. Gas Pipe-Rough & Test � � 72, Underground Ftush - 24. RoofFraming . � � 73, Undergrnd.StorageTankC7Gas ❑Oil 25. Roof Sheathing - . 7q, pverhead Hydro � � 26. T�Bar Ceiling (Str�cturaq & Monocoat 75; Dry Chemical 27. Frame and Flashing -� 76. Dry Standpipe ' 28. Lathing & Siding ' � ' 77. FIXED SYSTEPq FINAL 29. Insulation � 78. FIRE PREV. FINAI � 30. �rywall Nalling _ HE(�LTH DEPT. REQUIREMENT 31. Plaster B�own Coat { 79. FINAL lNSPECTION 32. Electricai Power Merer�F�nal 80. FOOD CEFTIPICATE ISSUED 33. Final Electric Notes: �• .c � 34, Fina4 Heazing & Air Conditioning Z C � 35. Final Gas Pipe-Test � � J� --� ^�� - - - � 36. Hood or Canopy ' " . 37. Firal �actorY Fireplace � . . . -38. Final Plumbing � � ' . 39. 4Vater Service-final � . 40. Gas Service-Final � " 41. Solar pomesticFinal • ' � ' _ 42. Backflow Preventer � ' - 43. Backflow Irrigation 44. Landscape Irriqation SYstem 45. Sound Attenuation - , . , _' 46. Handicap Regulations � . 47. FINAL STRUCTURE & BUILDING . _ . 48, FINAL PIANNING 49. Etecttic Ralease to Edison 50. Gas Re�ease to Southern California Gas Co � a 51. CERTIFICATE OF OCCUPANCY . No. Date � � ADO�icant to fill in all spaces except enose within neavy borOer lines antl slgn all aoVropriate tleclarations. ClTV OF COSTA MESA CON U�TIOyN� PERMIT Project Address �n��/ �Q/ � ,f%r • Applicant's Mailing A ress Owner's Name Phone�c�%'�� Adtlress � � Arch/Eng. ' License No. Address Contractor's Nam Phone Address Imaiiing) — City Licen N �-.. LICENSED CONTRACTOR DECLARATION I M1ereby affirm Ihat I am licensetl untler provision5 of Charter 9(commencing with section 7000) ot Division 3 of the Business antl Prote551on5 Cotle, antl mY license is in fu fo antl etiect � ' Licenze as ic s �Date '" Si9nature WORKERS'COMPENSATION DECLARATION � I hereby atfirm that I have a certificate of consent to self-insure or a cerHficate ot Workers' Compensa[ion Insurance, or a certifi,tl copy thereof (Section 3800, �ab. �� /yp�/�^� Company Policy No. UJ(��T��T�� v,A._ __ I �(rt�ifietl copy is hereby tumishetl. pp �/ %p Date/T7ifi� roQ/ns tiled wAPPhcan'tY I/�f VA( n� • `T EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thissection neetl no[ be completetl if the pBrmit i5 for One huntlretl ($300) o� less). I ce�tify Nat in [he pertormance of the wo�k tor whi[h this permR is issuetl, I sM1all not employ any person in any mann¢r so as [o become subject to the Workers' Compen5ation Laws of Califomia. . Oate Signature 'NOTICE: IP; aiter makin9 this tleclaration, you shoultl become subject to tne Workers' Compensation provisions of Me Ldbor Cotle, you must forthwith comply with such prOvisions or tM1is permit shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV � 1 hereby affirm (hat [here is a construction lentling agency for the perPormance of the work for which tnis permit is issuetl (Section 3097, Civ. C.) Lentler's Name Lentler's AOtlress - - OWNER BUILDER DECLARATIOIJ I hereby affirm [hat I am ezempt from the Contractor's License�Law for the following reason (Section 7031.5 BuSiness antl Professional Cotle:'Any city or '.ounty which requires a permit to construct, alter, imorove, demolisn or repair my 5V ucture, ptior to it5 issuance, also requires tne applicant for Such permit to tile a signetl Statemen[ that he/she is licensed pursuant to the provisions ot tM1e Contractor'S License Law (Chapter 9(commencing with Section ]000) of Division 3 of the Business antl Profession5 Cotle) or that he/she is exempt therefrom antl [ne ba5i5 for [he allegetl exemption. Any violation ot Section ]031.5 by any appliCant tor a permit subjects [he applican[ to a civil �enalty o� not more Ihan five huntlretl tlollars ($5�0). tJ I, as�owner ot the property or my employees with wa9es as Meir sole compensation, will tlo the work, antl the structure is not Intentletl or offeretl lOY Sd�E ($2CSI00 i�44. BO51lIQ55 dOd PIO�CSSIOOdI Cotle: The Contractor's Li<ense Law tloes not apply to an owner ot a properry wno builtls or improves thereon, antl who tlo¢5 such work bimself/herself or tM1wu9h his or her own employees, provitletl ehat sucn improvementz are not intentletl or otferetl for sdle. If however, the builtling o� improvement is sold wi[hin one year o( Com- pietion, the owner will have tne burtlen oi proving he/she ditl not build or im- prove for the pu�pose ot sale�. ❑ I, as owne� of the proDerty, am exclusivery conlracting witM1 IlcenSetl Con- tractors to tonstruct the prolet[ (Section ]044, Business antl Profession5 Cotle: The Contractor's License Law tloes not apply to an owner of property who builtls or improves tbereon, antl who mntracts for such projecls with a mn- tractor(s1 license pursuant'to the ConVactor'S License Law�. I am aware [nat proof o( their Wo�ker'S Compensation insurance shoultl be provitletl to me ❑, I am exempt untler Section � B. & P. C. for this reason �ate Owner I nerebvi certifv tha[ I have rea 52IIIdiIV25 Of I115 C-fy inspectlan r s . 5iqnature Drivers' License or 55 � CMF OB65-46, rev. 10/84 ] tliis application antl state tnat the above compry with all city antl county ortlinances 9 con5truction, antl hereby autnorize repre- upon the above-mentionetl property /or �J,�� Date��. �°` �- White - Builtlin9; Canary TYPE OF CONSTRUCTION LJ NEW U ADD Ll ALTERATION ❑ CONVERSION ❑ �EMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. TVPE OF PERMIT IJ GRADINi ❑ TENANT ❑ ELECTRICAL ❑ OTHER PROJECT DESCRIPTION S�.FT._ CONSTRUCTION TVPE 20NE GR Remarks: � Sink <flowPreventer <flow Irrigation Drinking Fountains Floor Drains � Floor Sinks Gas Service OuUets Interceptors � Kitchen Sink � - . Lavatories P—Trap Roof Drains Heinspection Fee.� � $15 Duct- UnderGround Duct - Structural Duct - Ventilating Exhaust System ❑ Muliiple ❑ Firepl/Fact.61L IC80 # Heating System & Ducting ❑ o-i oo,000 aTu O i oa,000 en Reinspection Fee � $15 nt; Pink - Accounting; Goltlenrotl - Assessor �/FOUNDATION LJ STRUCTURAL PLVMBING ❑ MECHANICAI. OCCUPANCY VALUATION $ _ NGCU.VOS. ACRES_ 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 Issue Fee Hood or Typel ❑ Canopy Type I I ❑ A.P. # S Main Building: E T Front A Rear C Right K Left S Ping. Ref. # Planning Notes: FEES Automatic Washer � Construction Pole Sub. ' Cooking Unit Dishwasher �cyers ❑Gas ❑Electric Refrigeration Sys[em ❑0-100,OOOBTU ❑100,000 System Repair/Alteraiion Fire Dampers ' Registers laue Fee Fan ' . F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator �0.5 KW �5-75 0431 7/30/86 5.00 7L 2on8 - Bui Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Merer ❑over 100 amps � Sub Panel Motors DO-7 HP �1 %- 8 Inc.Solar �9-15 HP �i6-15+ Microwave Pole Light Range ' ', Standing Sections Trash Compactor $ 3 ' �- Reinspection Fee $15 Issue Fee FEES �DEVELOPMENTSERVICESREQUIREMENTS: 2oning Approved By Building Approved 8y Appliption Issued 8y $ 3 FEES $ 3 SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK � $ PERMIT . PLUMBING $ � ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL g GRADING $ PLAN CHECK 50% $ MICROFILM, $ MECHANICAL $ - TOTALFEE $ 8G0 PLAN CHECK 25% $ Z O N 1 N G R E Q M T S CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit # Date Inspector pppROVALS 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 � C " r 5. Steel Reinforcement 56. Rough Plumbing & Pre"ssure Test ' 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE s ' '- 7. Footings 58. Electrical Conduit-Undrgrnd. - 8. Foundation 59. Gas Pipe, O Undrgrnd.-`T'est 9. Water Pip�=Undrgrnd. � 60. Backwash Lines, P-Trap`, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK,._ 11. Property Sewer Line & House Connection 62. Backwash & Recepior-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Dreins 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 B�r 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 0 Gas ❑ Oil 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 7S. 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. FINALSTRUCTURE&BUILDtNG 48. Special Requirements Completed 49. Electrie Release to Edison 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY ' � No. Date � � '� C7i I � PP0.IECTPDDPESS: zOS6 BALEARIC DR OWNER'S NpME: STRONG WALTER R TR aooeess: 2016 B�fLEARIC DR COSTA MESA,CA 92626 � 557-7008 3� PflCN/ENGINEEB: BEG.NO.: r FODPESS: UNIT: UNIT: PENMITTEE: HOMESTAR ROOFING ( 714 ) 538-1878 aooeess: 1539 ORANGEGROVE B ORANGE CA 92665 UCENSEO CONTqpCTOfl OECLAflATION: I here�y allirm Inal I am licensen untlei pmvisions of Chapter 9(commencing wit� Seclion 7000� of Div;sion 3 oi Ihe Business and Pmlessians Cotle, anA my license is in full force anU eHect. cirvuc.:044971 STPTELIC.:SiGZOS cu('s's�:C-39 n , �ale'. S� �C� �C/7-- Signa�ure', `i1 C' 'C_' - �,.Q�%�A WOBKEBS' COMPENSpTION UECIABATION: I hereby affirm Ihat I have a cenificate ai consenl to self-insure ar a cenificate ai Warkers' Campensanon r i co ereoi (Sec�ion 3800, Lab. ) roucvNo.:��f'��`��—�� E%P.OPTE: 9IOLI9Z cornraxr: GOLDEN EAGLE ❑ Ce�ified capy is herehy Wmishetl. � Certifietl copy is �iletl with ��e ciry Builtling Oivision. Oate: � / �-C� � �i 2-- ppDlicanL �� <1� L-� p EXEMPiION FflOM WOHNENS'COM7ENSATION OECLAflATION: Qhisseclian neea notbe completetliithe permiiisforane hunare0�S100)arless�. I cetlify Ihat in I�e De�ormance af ihe work �or w�ich �his permit is i55ue0, I shall not employ any De�san in any manner so as lo becOme suble�� o Ihe Workers Compensation Laws ot Calibmia. Date: SignaWre: NO710E: If, afler making ihis Oeclaration, you s�oultl become su6ject to ehe Workers' Compensation provisions of ihe Labor Code, you musl forlhwiih comply with such pmvisions ar this permil shall be Oeemetl revoked. . CONSTBUCTION LENDING AGENLY: I hereby affirm Iha� there is a consimction lending aAency for Ue pehormance o� �he work �or which ��is permil i5 i55ue0 �Sec�ian 3W7. Civ. C�. LENUEP: noosEss: OWNEB BUILOEB DECLAflATION: I herehy afiirm �ha� I am exempt trom �he Contractoa' S�ale License Law tor �he �allowing reason (Seclion 7031.5 Business antl Professional Cotle: Any ciry oi caunry which requires a permit to conslmct, alter, improve, Oemolisn, or repalr any simcture. prior to its issuance. atso requires ine apP�icant for such permit to tile a signe0 slalement lhat he/she is licensed pursuam m the pmvisions oi Ihe Comracmrs' S�ate License Law (Chap�er 9(commencing with Section 7000) a� Division 3 0� �he Business anA Pmf¢ssions Cotle) or Iha� he/she is ecempl Iherefmm antl �he basis lor �he alleged exemption- pny violation o� Section 7031.5 6y any applicant lor a permil 5u6jec�5 �he aOPlicanl to a civil p¢naliy ot no� mare Ihan �ive huntlred tlolla�s (5500�. I. as owner o� �he D�opetly or my employees wi�h wages as their sole compen5aiion, will do �he work, antl Ihe ❑ s�mclure is no� imended or oflered �or sale (Section 7044. Businew antl Professional CoOe: The Coniractors' State License Law Ooes no� apPly io an owner of a pmpeny who builas or imD�oves t�ereon, antl who does such wod himseli/herself or ihroug� his or her own employees, provitletl Ihat such impmvements are no� in�enUetl or oileretl �or sale. I�, however ��e �uil0ing or impmvemen� is so10 wi�hin one year ol comple�ion. �he owner will have �he burtlen o� pmving he/she did no� builU ar improve for the Durpose ol sale). I, as owner o� the propeny, am exclusively conUacting wi�h licensetl comracmrs to cons�mct the D�ole�� (Seclion 7044, Business ❑ and Pmlessions Code: The Coniractors' S�a�e License Law tloes no� apply to an owner o� pmperty who Um105 o� improves �hereon antl who coniracis lor such pwjects riilh a conlraciar�s) license Oursuanl to �he Contractors' $�ate �icense Law). I am awa�e ��a� pwol ot ��eir WOBei's Compensation inmrance s�oNA be pmvieetl to me. � I am e�emp� untler Sec�ion'. B. 8 P. C. lor ��is reason: �ate: Ownec I do nereby renily Ihat I am aware of ane untlersland tne requirements ol Califomia Healih anA Safery Caee Sections 255Q5, 25533, antl 25534 antl �hal I or any W�ure builtling occupan� will/will not (circle one) neetl �o comply wilh saiA s�a�e codes antl �he requiremenis for a permi� lor cons�mclion or motli�ica�ion �mm Ihe Air Ouali�y Management �iSVict Fesiden�ial cons�mction applica�ions are enempi �mm Ihese pmvisions. Oa�e'. Applicanl: I hereby cetlity �bat I �ave reatl ihis applicaiion an0 slale �hat ��e a�ave in�ormation i5 correcL I agr¢e �o comply w�h all tity ana counry or�inances antl siatelawsrelalingto bmltling constmclion and hereDy aN�orize representatives o��Ais citylo enter upon the aUove-men�ione0 pmperly ylor inSDeciion pur005e5. /� Daie: U /�-��`12 Signalure: � �� ` n� oriver's�icenseo�SociaiSecurirya: $ 164i-46 Wniie—ButlOing�, Green—Gotle Enlorcemem: Canary—Appl¢an�; Pink—Revenue', Goltlenrotl—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B� PERMIT NO; H 058687 PLAN CfiECK NO: N GOVT; N SUPP; CONSTRUCTION TYPE; 5—N PERMIT TYPE: STR PURPOSE; ALT JOH DESCRIPTION ; TEAR—OFF SHAKE, SHEATH, REROOF W/COMP SH SQ FT: 6,950 CLAIM VALUE; 6,950,00 CALC—VALUE; 6,950,00 GROUP OCC; R-3 /M-1 COMMENTS: REROOF 28005F RESID 6 GAAAGE ��*��*��*«.*��*��*��*��*��«.��TE �� Z O N I N GS ERTEB AUCIxRSE M E N T S CTOR ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILa�f��-Ct�--- 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 REQ• PROV; PARCEL; 13945319 ZNE: REF NO; PLANNING NZS7'ES> � i �-; . ik ik iE if ikiF if iEif if iE kiE if iF if ik iE iF iF ik iF iE 3E if if ik k iE iF Ik iE iF iF iE iE iE IF it iF 3f if �FlE iE iE If iE3E iE 3f iE iEdF IFiE�F k if iE 1F iF �1F if iE�E �F if jE �F�E iFlEiF if iE iF iF iF D E V E�L O P M E N T S E R V I C E S R E Q U I R E M E N;T' S ZONING APPROVED HY DATE; BUILDING APPROVED BY : DATE; APPLICATZON ISS'UED BY• � DATE• �,�� ifiEifiFiElEiFifiFikififiEi4,IFifiFikiFlkikiF7Fif'iF�FiFiF'�f'iFiF�iFii�"iFiF'iFiFii�7FiFikiEiEifik�t�Fi(�iF ifjF ff if 3f ik if �f iklf �F ik iE iFif ik iF if if iF iF iF if iEif ik 1E �E if iE iF if 1E if �f �f ik if 1flf iE if if if iF k �f iF it ik1F iF if iFff iF iF �f iF �f iF 1Elf iElE k if �E if 1E iFif iF 1f �F i(� ff 3F iE k 3f LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y : a: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 90.00 ,70 i PL� SMIP/NON—RES��' ISSUE FEE HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID � DUE TOTALS----> 90,70 0.00 0.00 90.70 90,70 �,00 REVENUE DIVISION TOTALS--> COLLECTED: 90,70 OVER/SHORT: ;00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 90,00 ,70 '�� r iF �f if iE iE iE iE it �F iF iE iElk if 1F 3f �E if if if iF iF if k �F 1F iF ik iF �f if �EiE if �E �F iF ii iE if iEdE ik iE 1E if iE iEiE �F1E �liEiE iE iF if 1FlFiE iF 1E if �E iF iE iE IElf 1f k�F iE iF k iE 1F 1E iF Z N D I V I D U A L F E E B 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 SFR 6950 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 6,950,00 END OF FEES 'N . � n �,f � : _ � 7 , �i � t• _ ': -.. . _ ... . . i, I CONSTF# CTION AND PLANNING POOL & SPA APPROVALS Permit # Date Inspector pppROVALS Permit # Date Inspector t. Temporary Etectrical Service or Pole 52. Pool & Equipmen[ Location 2. Soil Pipe-Undrgrnd. ' ' 53. Steel Reinforcement r. , 3. Erectrital Conduit Utility-Undrgrnd, �' ' 54. Porms 4. Electrical Condu'rt.FJndrgrnd. - 55. Electrical Bonding � 5. Steel ReinfO�cement 56. Rough Piumbing & Pressure 7est F�-.Etectrical UFER Gmd. � 57. APPROVAL TO COVER-GUNITE . ' i.,.Fqotings . ' 58. Electrical Cond�it-Undrgmd. - 8. Foundation � �� 59. Gas Pipe, � Undrgrnd., Test � 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. ?0. Svucturei Floor System � 61. APPROVAL TO DECK t t. Pcoperty Sewer Line & House Connection 62. Backwash & Receptor�Final �2. Sem'e� CaP . - � fi3. Heacee & Vent•Final S3. Roof DrainS 64. Plum�ing System - Finai t4. Rough Plumbing 65. Electrical-Final ' 15. Rough Electrical-Condu�t , 66. Sofar SYstem�Finai i 6. Rough Electric Wiring 67. Fencing & Access Approvai 77. Rovgh Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Eleccrical-T Bar Ceiling 69. POOLlSPA SYSTEMS FINAL 19. Rough Heating & Air Cond�tioning FIRE DEPT. REQUIREMENT - - _r..... z . 20.�Rotigh Factocy F�?eplace � _ � t �-� _ _ r X APPROVA�.Sj - -Perinit # - � . . 27 �.Duc�s, in=St�uctupe� � .. . - � x -� - _ . .� -`7p, Undergraimd Hydro 22. Ducfs, Ventilatirig : �� _ � � � �7�, producfPiping C'-Gas ❑Oil 23. Gas Pipe'Rough & �est ;� �"� 72, Underground Flusti I�. � 24.'RotSf Framing _ � ^ � '� � �� . i '% .73: -Undergrnd: StorB�ge-Tank T,7 Gas ❑ Oil 25. Roqf Sheathin9 < ; � � � - ` " '` ., ' ` ZG_q: 6e,�_; •�a„Overhead Hydro_ 26. _T�Bar Ceilin9 (Structural) & Monocoat -�� '' � 75: Ory Chemical - -� - � . ' y- 27. Frame and PlashiPg� x ,`„ ,,.; ._ 76:. Dry Standp(pe .� � ' - -28. Latbing�$� 5iding.. : �t: . . : . � � 77: FIXED 3Y3TENef�INAL` y . ' r `�29. Insulation �� " .� �� ;� ` � c 7B: FIRE PREV. FINAL � . � � 30. Drywallrtdaitfig .ti � ' �� HEALTH'OEPTSREQUIFEMENT '-31. Plaster @ovyn Coat� , � Y I ..79:�FINAL IttISPECTION � " - ; � 32.. Electricil Power MeterFinai _ � �, �SO.�FOOD CERTIFI�ATE ISSUED 33. Final Electri@ '�" _ ' � �� "Notes: " ' . '� , � 34. Finel He�tinq & Air Conditionipg, ,^ � ; ;�.�_. . � - - � 35. Final Ga"s PiPe-Test� . - , r - • � ' � � � � . 36. Hood or Canopy ' � . � � � s . : , �� ' � � r 37. Final Factory Fireplace_ �- 1 t " ,� ' 38. Final Plumbing ` _ � I I'� ' � • .' r '39. WatEr ServiCe=Final- l - � I< • � ' ' � „4p. Gas Service•Final ` _ = � , � , � � �: � , y: x 141. Solar pomes[ioFinal � ' � � � I � � a . c` < t - 42. Backflocv Preventer " , . � ' � c = 43. Backflow Irr[gatiorn.,� • • - � � -- ' � �44. �andscape Irripatian:5ystem, ; . ,r - �t.� . � .. - •45.-Sound Atteouatio,r�..-�. '�: - - � ' � ' .. _ ' . -_ . a ^• '-46. �HandiwR Regulatio7fs ; ' ' {' _ - . . ^ , � . '- - � . `47. FINAL STRUCTURE�� BA�j:�DING �3�� ,.4 �,:� = ' � _ � .48. fINAL PLANNING`�: ` j --�-� �- I I . 49_ Electric Release to �E'dj"sbn"',7 � K`(� G��' �- /_� : � F-. n 7f'S.ZF'r �Z- �-�-v� �� e� - 50. Gas.Release to South4er�i Ca(�omia Gas Co : � i ;�` - '. �� '51. CERTIFICATEOFQCfUPANC . . r . ., _ . No. .�Bate d COSTA MESA BUILDING.SAFEIY DEPARTMENT P. O. BOX 91f C06Tq M68A, CALIPORNIA For A'p/pllcanf ►o Fill' In Comple�ely , �{� �y,y TYPE OR pRINT �i/% ,r:. COSTA MESA. CALIFORNIA � MAIL ■ ARCHITECT NO. OP BLO09. EXISTIN6 6LOG. /� 6ETBACK LINE FPOM �I� DESCRIPTION OF WORK OR WALL �F E RECEIU�D MAR 2 2 1963 APPLICATION ��PP�� DEPl BUIL��NG � ��STA McSA f01' �fflG@ {�59 Dllry/ aeceirr no. � rertppyno. _� necerye�/ v G BUILDING ADDR6S9 FIRH s ZONE — APPROVHD � BY 1 HEREBY ACKNOWLEO08 TMAT I Hpyg R2AO Tl119 APPLICATION AND eTAT¢ THAT TXE 18 COPR6CT AND AOpEE TO COM- PLY WITH �1LL CITY O INA CE8 ANO 9TAT6 W9 R80UUTINO eU1LO�N0 CONeTRUCT ON. SIGNATUREOF �'l �`j PERMITTE - AUTHORIZED qGENT NOTE: NO ZONING � NO. OP uae or rve PLANe �� BUILO�NO � l� ti-G Sz��T�R. � �( 3 4 �E OVERHAN6 BHALL BE LESB THAN YARO9APPROVED MAIN BUILDING eer. VAR. # YAR�SAPPROVED ACCESSORYBUILOING DATB —6 � � a y�'�a. �. 6 06 Y m TH8 AMOUNT BHOWN I1ND8R V�LU�TION 19 FON THE E PURP058 OF EBTABLIBHINO /� PERMIT PE8 ONLY, p VALUATION �n// / m PERMIT FEE $ o � � � �� a�� s m s E i v ¢ . / LL JOB ADDR.ESS 2016 $ GENERAL CONTRACTOR DATE FIRE 'LONE DESCRIPTION OF WORK �ROUP �J TYPE � � SUBCONTRACTOR nePER.N A' r �