HomeMy WebLinkAbout423 BROADWAY - Building Permits�D�NESSOFBUILpNO: Qz3 BROADWAY
a^'aEas�+^i"EiFa�w'":HUMPFIREYS, HRADLEY T� .
' - mopEu:HUMPHREYS, WENDY L '
423 BROADWAY
OSTA MESA,CA 92627642-1049
AVPL. N�I11N0 �ODPE55:
urcxrtEcr on �mw�x:
ACN.OP F1M.'S AUURE55:
UNT:
�—V
uc. xo.:
UM:
CONIpACT01Y5 NAYE:
coxrx�croxs�uw�o
,wonEss: uc. xo.:
uHr:
UCENSED COMflACTOqS DECLAflAT10N: I hereby elfvm uMer panetly d pepury ihel I em IicenseE uMer proviaiona d Cheper 9
(commenorq wnh Sxlbn ]000) d Divisun 3 W Na Busima vM Prdeaeions COEe, eM my 4certve b in lull laca end ellea.
cmuc.r+o.: uc.cuss: uc.No.: EXP:
oe�e: com,eao,:
OWNEH BUILDEP DECLpHATION: I hereby etfi�m uMar pene�y d perjury �hel I em a�amq Imm �ha Con�ropas Lironae law (or Ma
Idbwmg ieesan (�ion ]W 1.5 Busiims eM Prdmzorra CoGe: AnY <iY a coun7 �� roVuiias e pemin io mcebuct, ells. impove.
demalsh, a repei any siruclure, prior w na'vaueze, s6o �puirea tha epdimnl la wc� pa1mX lo fib e tiB� s�ement OW M a aM
ie I'rensad Oursuentlothe proviaiona d ihe Comrenars Licenae Lew �Cheplm 9(commendip wilh Sed'un )000) d Diveion 3 Wlhe
Business anE PrWemons Cade� or �he� ha a ahe is eKempt thxahom eM �M besis for Ihe allepetl eaempton. My volelbn d Sed'an
)031.5 by eny epplirent la e permA subjede Ihe epplicanl �o e cHil penelly M iwt mare �hen fne huMred dollen j5500��.
� I.esawrerdtMqopenY�mY�dW��^'�hwapmeslheimbmmpaeuetion.xilldo�haxwk.eMiMsVucn�mo�wlinteMeC
a oflereE la sab (Section>Oas, B�ma arM Prdessiona Cade: Tha Conlredon liunse LewEoea iwl epply lo en ownerd poperry
wlw buJda ar'vnprovae ihereon, enE who Eoes such wak NmseM a MnaX w ihrouph he a her own ampbyeea, provided iM1at auch
' improvemente are mi imeMad a oilered lor sele. H, howevec Ihe buikin8 or improvemem ia eaN wnhin me yeer W mmplmoq the
�ownarbuitlar MII heve IM1e burden W prwin0 he or ehe Eid nd buik w improve for ihe puryose W aele�.
I, ea owmr d iM popeM. em axdirsrveFy conirmiq xnh liceread conlrectars to cortHeua Ihe pmjeu (Seaion )OM. &ni�wa erd
PMmeiom Cade: The CaNradas Liceme law doee m� � ow�� a qw�r wno w�w « nw�o�,� me.� �d wno
COIIVBCb IOf eYf�l pfO�Btl9 WIIII 9 Cq11RC0l�9) IIC0119BC P119UdlII � I�1B Ci011�1BtlIXH �Im119B �d �.
❑ i� a.amm �oae� s«i�: a. a v.c., ro, m�a ,o <'
o�<: S-�L1- �l l-� o.�,:
�
I do Mreby ceniry Ihat I em eware d vd wdentad iM repuiremew d Callomie FbeXh a E e/ery Code Sedions P5505, 5533. enE
zssx, a,d m� � m�v nn��a w�ie�oc «c,o�i �ii i w�i � �dtib o�l �«e �o �dr.�n ..�a s�a �de. �d m. �oa���mew m.
epermitiwconnVuctionnmadiliraiionhwntheRi ua-OTnyl.renegameniDimna.ReaidaniielconatNclioneppFcelionseraexempiiromlheee
provisiona.
Deta: AvW��
W OHKEfl'S COMPENSATION DECLINATION: 1 Mreby elfirm uMer penally d pe�ury me d the Idlowirp dedarefona:
� I have enE wil meintein e cenJicete d mnxnl lo aeH-ineuro br wakas' campenaeiion, ea provked lar by Sedion �]0p o/ the Lebor
Gotle, f« iM perlortnenca d the v.M tor wlJch thia permii ie iseued.
� I Mve eM wil manien woeken' mmperoelion inwrairoe. m repuired by Seqion 3)OD d Ma L+bor Cods. b �M paAwmenm d �M
work la whiM Ihc permil ia �ued. My worken' compammion i�xurence rariier enE pdiry number ere:
ce„�a,:
Policy Numbar.
(]M1is section need rrot 6e complered I �he perm/ is Ia one huMreE dollers /St001 or lasv.)
� I wIN �� in IM pMormerce d IM work ta wM1ch Ihh permil i(ia��u�eE. I shell m� employ eny pemn in vry ew ao m �o
become wbpa to tM warkera' canpenaetion lawe d Celiloma.�¢rM epree ih il I ehouM e come wbptl IM workere'
compenalian pmviaiona a/ Seeion 3]00 W Ihe Lebor Coda, I e I loi with mmD �h IMse r[I iiaions.
o�,: � ' �K —G l., aoa��,�:
I Wammg: Falluis ro ucun wortna' c�mpnutlon rowrap� h �n/ewN( mrl �lull udN an iq« ro cnm�u� o.rvro anC
�/M
CIYII XMf 1p 10 MO IIMA/M:M4LMlIOIIi/l �S10OOLVJ. I/1IWIHO/1 b(M CO)( 0I CO Nlfi� lll� 41/MQ/) IJ p/OY�41'� i0/ �/1
SxHon 3106 0l Ms La4or CoOs, Intws�t, en0 emrnsy i ls�i. .
CONSTNIICTON LEN�INO AGENCY: I hemby ��m unEer qnelry ol perlury the� ihare ie e mn�mdion brdinp eperwy fw Ua
p,n��ce a m. wo,w �« wn�w me re�� m m�ad lsw�, aoa�. ca. q.
LENUEH'S NRME:
LEN�EF'S AOORE55:
I caniy �hat � neve reed �nia epqketion ene me�. thei �ne ebove int«metion is m�red. I epiee �o comoN ��n el� cny end wuniy «dinencea
eM swe lewe relq(g io buiWvp wnsvudion eM heraby eNhorrza reproaeme�ivea M ��ia tlty lo enter upon Ihe aDwe-mentioned propeM
��� �M°� � �WENDY �UMPHR^��5
a
o�a: �' ��i � �l L�
(5151d6 WP) Whno-Building 8 Selery: Greao- ile: Cenary-AppYfant; Nnk-Revenue; GOIEenrod-Rsxamr
�
CITY OF C05TA MESA - BUILDING PERMIT
PERMIT NO: M 077822 PLAN CHECK NO: �
CONSTRUCTION TYPE: V-N PERMIT TYPE: MEC�
JOB DESCRIPTION : ADD 1584 SQ FT LIVING/ 484 GARAGE
W
�PERM NO: M 077822
GOVT; N SUPP: N
PURPOSE: ADD
SQ FT;
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /U-1
COMMENTS: ADD MAST BDRM, BDRM/BATH, ENTRY FAM RM, GARAGE REF 8-77819
***��+�+�**x+t�*�+t*�*�t�r*�x��t�r�*�rxxx�t*�r�t�x�*�+tk*+�*�t�xx*+k�tx�*�**x�*�*����t*�t�r���**�***�t�
Z O N I N G R E Q U I R E M E N T S
S E T H A C K 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
pqR�rNp �J
PliA�[�INGR�O'�ES> PROV: PAACEL: 11733105 ZNE; REF NO;
j .
1E 1E iE iE iF iE iE it iF iE it it it it iE iE if iE 1E 1E 1E 1f iE iE iE iE iE iE iE 1E fE 1E 1E iE iE iE iF ik iE iE 1E iE iE fE iE iE iF IP iE IE iE �IF.If iE iE iE it iF IE iE iE iE iE �F 1E iE iE it if iE �E IE iE iE iE 9k iE iE 1E
". 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 .
B,UILDING APPROVED BY ;
I
LEGALIZATION:N
BLDG PMT PLUMBING
PERMIT
PLAN
F E E S U M: M A R Y
.
ELECTRIC MECHANIC
� . ��i23,�0
',7 . z5i
DATE:
DATE:
DATE: ��
* * * �t * * i� ic�'��3Fi�-+t
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON—RES
ISSUE FEE � L5.00 �
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK' . TOTAL PAID DUE
TOTALS----> 23,00 15.00 "'0.00 ' 38.00 38.00 .�00
REVENUE DIVISION TOTALS--> COLLECTED:, / 38.00 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC i� �FIFFE SMIP/TOT GRADING PLAN—CHECK
38!'�00• =—
' l - .
TYPE
MEC
MEC
MEC
I N D I V I D U A L'
QTY D E S C R I P T I O N
E E�'
; n
i
1E if iE 1E iE IE 1E 1E 1E IE 1f if iE IklE if� 3ElE �E 1E iE'lE �If IE'lE iE 1E iE if iF iE 1k 1E 1E
,B R E A K D O W N
1 REPAIR/ALT HEATING ';Uj43�T/53f�S. W/,CNTLS
1 GAS PIPING SYS i- 4 OUTLETS •
1 INST HOOD W/DUCTS FED,BY MEC EXHAUST
1 VENTILATION FAN CONN TO SINGliE DUCT
END ':OF FEES _
, ��'��� ' .
! 1�
, �r
�•
UNIT COST
9.00
3.00
6.50
4.50
TOTAL COST
9.00
J.00
6.50
4.50
��
•C�JNSTRUGTION AIJD PLANNING POOI & SPA
APPROVA4S Permit # Date Inspector qppROVALS Permit # Date Inspector
1. T:mporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe�Undrgr�d. 53. Steel Reintorcement
3. Electrical Conduit Utility-Undrgrnd. _ 54. forms
- 4. Electrital Conduit�Undrgrnd. . 55. Electrical Bondiny
5. Steel Reinforcement 56. Rough P�umbing & Pressure Test _
6. Electr�cal UFER Gr�d. 57. APPROVAL TO COVEfl GUNITE
7.- Pootings 58. Electrical Cooduit�Undr9rnd.
$. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, L� Ondrgrnd.
10. Structurel Floor SYstem 61. APPROVAL TO DECK �
11. Property Sewer �ine & House Connection 62. Backwash & Receptor-Finai
12. Sewer Cap -63, Heater & Vent-final
13. Rooi Drains 64. Plumbin� System � Finai
14. Rough Plumbing 65. Electrical-Final . .
15, flough Electrica6Conduit 66. Solar SYstem�Finai •
16. Rough Electric Wiring 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electriral�T Bar Ceiling 69. POOUSPA SYSTEMS PINAI
19. Rough Heating & Air Conditioning „� Z� �� � , FIRE pEPT. REQUIREME�fT -
20. Rough Factorq Fireplace .. �� � APPROVALS Permit #
. r
21. Ducts, in $tructura . �� . 70. �U�dergrou�d KYdro
22.Oucts,Ventilafing�' - -71.ProductP�PingOGas �Oii
23. Gas Pipe-Rough &, Test � 72. Underground Flush . _
24. Roof Framin9 ' 73. Undergrnd. Storage Tank L� Gas D Oii
w rr
25. Roof Sheathtng 74. Overhead HYdro, -,- .
26. T�Bar Cei{inG {StructusatS & Monacoat -• 7�, Dry Chemlcal '
27. Frame and Flashing _, 76. Dry Standpipe . �- -
28. Lathing & Siding • 77. FIXED SY-STE0.A FINAL
29. Insulation = . 7$: FIRE PREV. F{NRL ��
30. Drywall Nailing � � , * -� HEALTH DEPT. REQUIREMENT
.
37. Plaszer Brown..Coat ` _ „ ,. ` 79. FINAL INSPECTION � .- .
32. Electrical-Fower Meter�F;nal � � - 80: FOOD CFRTIFICATE ISSUED- -
i '
33. Finat Elecjric� ; � Notes: "`
-- I'?`Z-�-E :�tfz��c_-� _
34. FinafHeating & Air Conditioning- � . � '`
, - l�l s_�-�_ '�_z3=��-G? �;�� - - - �..��
35. Finai Gas PiPe-Te{ ' �+ �7 n�L J Vr�^c7,�2S�
' . - . I-c)-�G-• �/! /L' _C �'� --
36. Hood or C�nopy _ .
` j% / 3- "j-� Gan jL.�r,?/_
37. Finai FactPN �ireplac2 " - � , 9 �+�
. . / �_`� 'Ci 'f- ���.- '
38. FinaFPiumbing . . , � .���7� ?� ��
39. Water Service-Finai � � � •
. e
. 40. Gas Servic¢'Final ' . ' _ '_ , • . . .
41. Solar pomestio-FiFlal� � • - �� � .
42. Backfiow Preventef , , - �� .� �-
43. Backflow Irrigation � '� ' _
r - y �
44. Landscape IrrigatiorySystem -- t- � � � - �Y � . � - � ��
45. Sound Attenuation � " - � �
46. Handicap Regulations . � - .
47. FINAL S7RUCTURE & BUILDING '
48. FINfaL P�ANNING , � � �
49. Electrie ftelease to Edison �
50. Gas fleiease to Southern California Gas Cn
51. CERTIFlCf+TE OF OCCUPANCY
No Date
'
i,00nEssaem�oixc: q23 BROADWAY
� avxexs.w.Meir�wowr+:HUMPHAEYS, BRADLEY T
:,;f �oonEss:HUMPHREYS, WENDY L
4 2 3 BFbADFIAY
,� OSTA MESA,CA 92627642-1049
�vr�. wu�ac woncw:
J
1 .�NCXIfECT OX E.Nf�lFEP: UC. NO.:
RRCXAFl ENG.'S AOOXE55:
.
�
CONIFACTdI'S NAME:
ca+mncTo�s Muuxo
,mux[ss: uc. ra.:
uHT:
UNT:
UMT:
4CENSED CONfPACTOflS OECLAFRTION: I Mreby ellim uMx parely d perjury WI I em Icemetl uMaz proviebne d Chaqx 9
�mmmenong wilh Saction ]000) N Diviaun 3 d �he Businaw end Profeaepna Cade, vM my licenm is in lull foru enA eMm.
cmuc.r+o.: uc.cuss: uc.No.: EXP:
oma: comreaor:
OWNEH BUILDEN DECIARRTION: I Mreby elfirtn uMer penely d perjury ihm I am exemq from IM Con�redae Licema lew /a IM
I011owinB meaon (Seclion ]W 1.5 Busineea eM Pmfeaeione Code: Arry cAy a caunly whirh requiree a peimn m oonevun, allm. imqove,
lamd'oh, a ropei eny elriwYure, pw to na oauence, eho repuiree the epplicent br such pertnA to file e eipned eletamenl I�et he a eM
o licenaed punueM lo Ihe prwieiona d �M ConVmora Ixenas law ICheplm B(mmme�a�p wilh Setlion ]OW) d DNuion 3 d the
Businaw enE PrWeaeone Code� m the� M or ahe is exemq ihselmm end iha besia �a �he dbped uemqian. My voletion d Sedion
]031.5 by eny applirenl br e permit eubpde iM epplkaN b e civil pendy W nM more Ihen fHe hwEretl dollen �5500�).
❑ I, av owrier d t�e qopaMy or my mmplryeae vnlh wepea m �Mi ade campevelion, will do IM wA, eM tM ebunure e�w inteMed
or oflered br aeb (Seciion ]066, Bueinm end Probesioro Coda: The Contrepore Licenea Lew doea nM xpplyb en uwnerd propary
wM10 WiEs a inpovw Ihereon, end x1w doee euch wwk IimeaH or henep a ihrouph hb ar her own emDloyase, D�� �� �h
impwemema ere nd iMentled a aHerad la wb. M, howe�ar, the buiNirp a inqwemeM b edd wilhin ms yeer d oomplation, tM
�ow�wrbuiMar xill heve �ha buNen W qovi�p M or eM diC not builE or improra lor the W�e d eeb).
I, u owner d IM propeM. em eadumMy mnvm'up wnh IionwE canvec�ps ro conqrwf Iha piojetl (Setlion 10aI, Bwinme enE
Prdeseiona COEe: The ConVeqon L"cenu law Eoea nal epply t en oxnp d propeely who buitla a impwee �liaaon enE who
convaae lar auch prqMs wilh e mMretlor(a) Icemed punuent to I�e Con ae Lice ae lew).
� I em aaemq uMer Seciion: � B. 8 P.C..1 n
oe�e: 5- Z�l - 9(e w�,,,.
i eo n.��v �enM �nm i� ewaa a�e �oaa.i�e m, �.a����u w c�a«om �e sman . sm�. , zss�u, .�d
25534. enE ihel I or eny Mure buiMinp oxupent vnll / will nM (drcM one) need io wih eeid etma codee anE iM reyuimmenb br
epermnlwoomvunbnormodifiretbnhwn�heA'v u�6 eCiyF.rerepamemDimriq.RmiEeMielmnsirudionepplratimeereexemptiromihesa
a�,�..
oma: Aoo�bem:
W ORKEX'S COMPENS�TION DECLRN�TION: I hareby etFrm uMer penelly d pe�jury am d tha IODoxiiq dadera�uen:
� I heve arM wJ maiMen e cMMiwa d oonront to esM�irouro br workeri compenWon, v povidad lor by Sepion 3]00 d Ihe Lebar
ccee. �n ine oen«mv�c. d �n. wak �« whicn mia o�tl ia esuee.
� I heva end witl meinlein workeee' wmpenee�on insurence, ea rx�uirad by $eclion 3]00 d ihe Lebor Coda, la Ihe perbrmenee d Ihe
work tor wM1i A ihie peimn ia iuued. My workan' mmpeneetbn inaurence remer eM pdiq numEer are:
c�.:
Polky Number.
�!mm cea�o�, neee �or as mma�ee r rn. ro�x o�o. orro nuneme eabrs Is�ool w b...�
� I ceniy ihet in ihe perlormenca M iM vroA br whbh ihia parmil ia issueE. I ahell na empby y perean in y menner ao u io
paewne wbjeq b tM woiken' eampeneelion kwa W Celitanie. d peee el il I aho become e I� b IM vroilrors
compenwbn povisiona d Sedion 3)00 0l �he lehar Cade, I I/a hxilh m N� �h e qoviaiau.
o�a: S- 7�1- R l n nvdK���
WeminP F�llun b ncurs woAsn'rompxueHon coverap� 4 unhwNl, mJ Mell n /o r fo etlMn�l p� Itlu and
c/vn Nwi up ro on� hunarad tlromrd dwMn (Stao,oao). In eee/Hon ro th� rost ol c �,.no�, a�.... p.o�mw ro� i�
Sxtlon !)06 0l Ms feGorCOW, Intwes4 enC ettormy's Isq.
CONSTHUCTION LENOINO RGENCY: I hereby eifrm uMer penelry d perjury ihm �here ia e mnamqion lendinp epency br Ne
perfortnenro d the wak M whitl� ihb permi i� ewed (Sed'un 309]. CH. C).
LENOEH'S NRM
LENDEH'S ADDNES �
I<eNly tl�et I heve read Ihia epplicelion eM beta Ihe� the ebove inlame�ion is wriect. I epree to comply wnh all vry erd muMy ordiru�e
end etme levn releiinp lo builCinB consrvdion eM Mreby emhorue repreaentelivea W Ihie dty to enlar upon iha ebova-menibnetl pioperry
IainaDedion W_rD�a._"_."� .. ............ �.�..
Dete: �- z,�'( — 1 (�
(5151d8.WP) WhAe-Buildvq 8 Sefely; Greeo-Fle: Canery-ADpucenl: Pink-Revanue:Ooldenrod-Aeveawr
CITY OF COSTA MESA - BUILDING FERMIT
PERMIT NO: B 077819 PLAN CHECK NO: 00917-96 L
CONSTRUCTION TYPE: V-N PERMIT TYPE: STR
PERM NO: B 077819
GOVT: N SUPP: N
PURPOSE: ADD
JOB DESCRIPTION : ADD 1584 SQ FT LIVING/ 484 GARAGE SQ FT: 175,000
CLAIM VALUE: 175,000.00 CALC-VALUE; 135,000.00 GROUP OCC: R-3 /U-1
COMMENTS: ADD MAST BDAM, BDRM/BATH, ENTRY, E'AM RM,
*at��x�**�*�*x��at********� �ie*+Ex *it*itit*at��**iF+��t� iEit�*it*�****x ****x ��t*t�iEieit*****+eet�*ie��t
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUZLDING ---------
FRNT: 38 FT IN REAR: S FT IN FRNT: FT IN REAR: FT IN
LEFT: S FT IN RGHT: 5 FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: 2 PROV: 2 PARCEL: 11733105 ZNE: R1 REF NO;
PLANNING NOTES> ADD MASTER BEDROOM; ENTRY; FAMILY ROOM; BEDROOM/BATH/OF,FICE
> AT THE REAR OF AN EXISTING SFD, ON BOTH SIDES OF THE HOUSE.
iE i! if 1E k 1F if 1E 1E 1ElElFlf iE # 1E iE 1F 1E iElE iE 1E 1(� 1E 1E iE 1E 1E iE 1E iE 1E iE 1E 1f 1E iE 1f 1E iE iElE 1h IE iE fE iF k 1E 1E 1Flf 1E 1f 1E 7E 1E iE iF 1F if 1E iF 1E iF iE 1E jE 1E ik 1k iE fE 1E 1h 1E 3E 1E
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 : W�JK�/K�g DATE: Jr� 2"�%
BUILDZNG APPROVED HY ; V� DATE: �J`�•%"%(�
APPLICATION ISSUED HY; � DATE: �J� %%F'�%�
******�x�***�*x�x�ititat****'if��f��F'iF�t�F�t�F7F�F�iF�F�t�F�F"iFi'FiFiF3F�3F3F�F�F �F�FiF**it*itiEiEitiE*�3F7F'�F"iFat*
LEGALIZATION:N F E E 5 U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 762,00 13.50
- SMIP/NON-RES
PLAN 495.30
ISSUE FEE �
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 775.50 0.00 495.30
REVENUE DIVISION TOTALS--> COLLECTED:
HLDG PMT PLUMBING ELECTRIC MECHP.NIC
762.00
TOTAL PAID DUE
1270,80 1361.80 -91.00
775.50 OVER/SHORT: ,00
FIRE SMIP/TOT GRADING PLAN-CHECK
13.50
�E 1E 1E 1F 1k 1E iE if 1E 1f 1E if-iF 1E ik if !f if 1Elf 1(� iE 1h �IE if iElE iE'IE 1E 1E 1E iE iE iF iklE iF 1E 3ElE 1E 1ElE 1ElE 3E iE iE if iE 3k 1E iE 1E iE aElE 1E 1E iF 16 if if iE �E iE if iE iF iF 3E 1ElE �E'IElE')E 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. UNIT COST TOTAL COST
SFR 135000 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 135,000.00
END •OF FEES
I
� CONSTRUC710N AND PLANNING PO�_ . 5PA
•_,�.PPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
t. Temporary Electrical Service or Pole 52. Pooi & Equipment Location
2. Soil Pipe-Undryrnd. 53. Steel Reinforcement
3. Electrical Conduit UtilitY-Undr9rnd. 54. Forms
4. �lectrical Conduit-Undrgrnd. 55. Electrical Bonding . (
5, Steel Reinforcement f�� 56. Rough Plumbing & Pressure Test "� � I
"� f "
6� !'lectrical UFER Grnd. 57. APPROVAL TO COVER�GUNtT£ �;
. 7.; Fofltings �A��j �7/JfS�- 58. Electrical ConduirUndrgmd. -���' �
�' F iF' i
8. Foundation � • 59. Gas Pipe, O Undrgmd., Test j�;
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd. � �
10. Structural Fioor Sys2em 67. APPROVAL TO DECK �" � �
.•'
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final � .
12. Sewer Cap • - 63. Neater & Vent-Finai � .
13. Roof Orains 64. Plumbing Sysiem - Final •
14. Rough Plumbing : 65. Electricai-Pinai '
75. Rough Electrical-Conduit ��� 66. Solar SYstem-Final
16. Rough Electric Wiring '67. Fencing & Access Approval , �
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
t8. Rough Etectrical-T Bar Ceiling 69. POOL{SPA SYSTEMS FVNAL
79. Rough Heating & Air Condrtioning - . � PtRE'D£PT.-flEQU1REMENT
20. Rough Facto�Y Fireplace - ; ' -' �• AppROVALS. ' Permit# ' _
21. Oucts, in-5tructure ' ^ 70. -Undergrourid Hydro
22. Oucts. Ventilating� . . �: � • � 71 . Product Piping � f�as u' Oii
23. Gas Pipe-Rou9� &:Jest . . - _ � 72. Underground F.lush_�. - ��
i
24. Roof Framing ' , �_ � - . 73. Undergmd. Stctr,ype;Zank O Gas G Oil
25. Roof�Sheathing - � � � � C(� � - 74. ,Overhead Hydro �
26. T-Bar Ceiling-fStructural? & tvio�ocoat / / �� - 75, �Dry Che�ical - _
27. Frame and Flashing _ �� � 76. Dry Staadpipe�� - � �
28. Lathing & Siding - _-. - 77. FIXED SYSTEM FINA�� '
29. Insulation - � 78. FIRE PREV. F�INAL
30.DrywallNailing - �' _ - ' _ -;HEA�THpEPT_�iEQU1R.EMENT
- , .
31. Plaster Brown.Coat . - 79. FINAL INSPECTION
32. Electrical Power Mecer-Finai ..� ' '{ 8(3:; FOOD CERTIFICf;TE �55UED"
33. Finai Electrie � - �� . Notes: � �
34. Final�Heating & air Coaditioni�g � � � � ���� �
_ _ ' � "1 '����„ __ + �%�t�/ .
35. Finai Gas Pipe-Test ��, � �,. _ f
36. Hood or.Canopy � ' !
37. Final Factorv Fireplace " - � - . .
38. Final Plumbing � . � • ' ' �
�
39. Waces Service•Fi�al - . ,
40. Gas Service-Finai -
41. Solar pomestic-Final � ' ' - � r '
a
42. Backflow Preventer - � . -
43. 8ackflow irrigation ; ' -
44. L.andscape Irri9ation SYscem � �� '� r. � . ; - - _ -
� _
45. Sound Attenuation , _, � ,: ', � , ' •"
46. Handicap Regulations _ � � ia-.: _ '
47. FINAL STRUCTI�Rf & BUILDING �� _ . `'.
48. FINAL PLANNING - �
49. Electric Release to Edison - ' ' � ; . ,-
50. Gas Release 2o Southern California Gas Co . � '
51. CERTIFICATE OF OCCUPANCY
No Date
�
I
ADoxess a emiara:
� OWNEFS NPYE IF qNTYN:
�ooxEss:
�cr�. wuura,�ooxesa
GRCNRECT OP FNtlNEEP:
urcx on �c.•s woness:
, 1I
u
uc. no.:
CONfHACTORS NAYE:
ca+macroxsxuura
/iUUPESS uc. r�o.:
UNT:
PERMIT NO: P 077821 PLAN CHECK NO: 02037-96 N
�**�*iEie*� itieie+t�**it*iE*�*iFiF+r*****ie�***��**at*iF� iEat��at��**at**ie*atx *it**�tieet**at�*iF*�*****
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
urn: PLU
PLU
PLU
PLU
uNr:
LICENSEU COIRflACTORS OECLARATION: I Mreby aRirm urdar penally d perjury Nel I em IceneeE urMer provieione W Cheqer B
(mmmerianp v.ilh Section 9000) d Divia'vn 3 d ihe Bueirbae uM PMndona Code, eM my licenee ie in full bice eM e/ied.
CRY LIC. NO.: LIQ CW55: 11C. NO.:
OWNEN BUILDEN OECLAPATION: I hereby elfrtn under peneXy d perlury ��e� I em exemq Irom Ihe Contreaae Lieeeae l.ew lor tha
Idbxiq raeeon (�� ]0.'11.5 Bua'uwee eM Pmimabne Coda: Rfry cYY w muny whidi rpuiree e permil lo mmWcl. eller. imProve.
demd'uh, a repei vry ev�ture, prior to m eeueMe, ebo �uirae tln epplimnt la euch pemin io fib a egrwd eblement Ihtl M a oM
b IicenseE punuenl lo Ihe pomiom W IM Conlreclae License lew �Chep�er 9(Oommend�q wilh Sed'ron ]000) d Divebn 3 d iM
veinese eM PrWea�ions Code� or IIW he w�he ia examq �herehom end ihe Eub lor IM ellepeE examption. My vble�un W Satlion
,qt.5 by elry eppliunl Iw a permn wbpaa �M eppliceni to e tivil penelry d ml mwe Ihen fve huMred ddlen �5500j).
� I, ea owner oliM proparly or my empbyeae wRh weges m IM'r ede mmpemelion. vrill do Ma wak. end IM elrucNn o nd iMeMeE
w oNered br seb (Seclbn )044. Businea and Prolnaione Cotle: The CoMreclore Liceros lewEoas ral eppyto en owner W propeM
who WiAa a inpovee Iherean, erd wM Eoea auch wak Nmaeq ar Mrmer a �hrouph he a her own ampbyw, pwided Ihe� wch
improvementa era rol imeMed or o11e,eE la sele. tl, however, t�e WiMiip a inprwemem o eok xnhin orre yaer ot mmpletion, tM
owner�buiMer will heve ihe buNen d pmvinp ha or ehe did nm build or improve lor ihe puryoee W eele�.
� I. a� oMner d IM popery. em extlusiveF� cmVeqiq xiih licenaed cmVeclon ro mutrutl IM pmjetl (Saeion ]OM. &»'ura eM
ProM1eeiom Coda: The ContraGas Licenw Lew dwe rwi apply b en ox+wr M prope�y w}w Wiltls a impovu IMreon eM wM
commna for euch pml�e wdh a mnvaUor�a) Ikeneed pureuent to iha Comreaon Licenee Lew�.
� I em uemq urder Sec�bn: B. 8 P.C.. br thia �eeaon:
Dete�. Umx:
I Eo hereby carlity Ihel I em aware d vd uManterM IM iaquiremenn d Cd'domu HeeM1h erd Sefery Gode Sopiom 25505, 25533, vk
25534, entl ihm I ar eny lulure buildirq acwpent xiil / will nm (a�cb one) neeE to wmply wil� eeiE etete mEea eM the nquiromanM far
apeminlacansVuclionwmod'ifirai'wnhomiMAi u3e�Tyl.��epemenlDielnd.ReeidemaloonavutlbnepD4'�IaruweumqlmmNssa
yoviabne.
Oele: AGNicem:
WORKEfl'S COYPENSRTION DKL�P�TON: I Mreby tlfirm uMer panMy d pe�jury aw W tlro Idbwiip EerWtliom:
� I hew eM xitl mdmein a cMHcele of mneant io veH�ineuro br woMe�e wmpneelion, m p�ovideE lo� by SeGion 3]W o/ ��a Leba
Cods. la iM pa�lameMe d IM xwk Iw which Nis pmnu n iausd.
� I heva eM xill meimen wwkert oompenetlon inaurerke, m rpuireE by Seaion 3)00 d IM Lebar CaEa, br IM pa�amence d tM
work la which Ihis parmit ia ipued. My wnNere companmlion ineurence cemsr end policy number era:
Cemer:
PdkyNumbm:
iis section neeC na be compbfeE %(M pormk ia br we hvndred ddlen (SI00) w baeJ
J 1 cenfY � in �ha pAortne�e d �M wpk for whch t�ia permn ia ueuad. I ehell ml empby erry paaon in anY men�ror eo n to
bacama euEl� io ihs workers' canpenee�ion lawe al Cdibmie, end proe Ihet X I ehouk bxoma eubjea �o iM xwken'
mmpsnwion proviabne d Seaion 3]00 W Ihe LeEor CoEs, I ehdl loMhwilh mmp�y wi�h Nroe v���e.
Dele'. Applcenl:
W�mlrp: F�llun ro�xun woAsn'rompxwtlon roverep� I� unNwlul, end �MII �ubf�cl an xnploy�r ro eAMnel pen�ltls� �nd
C/H/ flMa up b on1 hinOrM fMYMnO tldlln (510q00p/, In ad7/tlon N tl�/ cwf OI rompawfbM1 Jarrrpu u poHtlM bI In
9�c0an J�OS o/ M� LWo� COW, InNn�q mtl ettomry'� /w�.
CONSTPUCf10N LENDINO �GENCY: I Mroby elfi�m undar paneM1y W perjury �hei Ihwe b e aonqriWion bMirp epsnry b iM
peAormenm N Ihe vmrk for which ihe paimY ia oaued (Seqcn 308), CH. C).
LENDEN'9 NAME:
LENOEN'S RDDflE94:
I ceniy Ihe� I heve read thie epplicelbn and etms thel tha ebove iniwmelion ia correU. I aproe Io comply w�h all dry and coun�y adinanoee
eM ste�a kws nlelnp to Wildvp wnprWian eM hereby eNhor'vs mpeseMetiv» d t�ia ary lo entar upon tM ebws�menlioneE popeMy
fa insped'wn Wrpowa.
Dete:
SpneNre d OwnedAWnVAON��ntreea
WhNe-Build'uq 8 Safery; OrserrFle; Cenery-Appiwnl; Pink-Reronue; Oddenrod-A¢seeor
i SEWER CAP / DEMOLITION EACH 7,00
1 SEWER, CONNECTION TO BUILDING EACH 15.00
1 REPAIR/ALTER DRAINAGE/VENT PIPING 7.00
2 VACUUM HRKR/HACKFLOW PROT. 1 TO 4 5.00
1 WATER RE—PIPE 7,00
END OF FEES
7.00
15.00
7.00
10.00
7.00
e
CONSTRUCTION AND PLANNING
APPROVALS Permit#
1. TemporarY Electrical Service or Pole
2. Soil Pipe�Undrgrnd.
3. Electrical Conduit UtiGty-Undrgrnd.
4. Electrical Conduit-Undrgmd.
5. Steei fleinforcement
6. Electrical UFER Grnd.
7. Footin9s
8. Foundation
9. Water Pipe-Undrgmd.
70. Structural Floor System
1 i. Property 5ewer line & House Connection
72. Sewer Cap
13. Roof Drains
74. Ro�gh Plumbing
15. Rough Elecvical�Conduit
76. Rough Eltctric Wiring
17. Rough Wiring Sign
18. Rou9h Electrical�T Bar Ceiting
19. Rough Heafing & Ai� Conditioning
- � -- -
20�. Raugh� Facfo'ry Fi�eplace
21. Ducts, in Structure
22�. Ducts, Ventilating
23. Gas Pipe-Rough & Test
24. Roof Franting
25. Roof Sheathing
26: T•Bar Ceifng�(3trifc�Ural) & Monowat
27. Frame and F.lashing _
28. I athing & Siding �
29. Insulation ��
30. Drywall Naiting=
37. Plaster� Brown Coai
32.- Electrical PotvBr Meter�final
33: Final Electric-'- '�
34. Pinal Heating & Air Condiiioning
35. Final Gas P�pe-Test
36. Hood or Canopy
37. Final Faciory Fireplace
38. Final Plumbing �
39. Water Service-Final
40: Gas Servite-Final
41. Solar pomestic-Finai
42. Backflow Prevanter
43. Backflow Urigat�on _
44. Landscape Irrigation Syscem
45. Sound Attenuation
46. Handicap Regulationt
47- FINA�-STRUCTURE & BUILOING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release_to Southern Califomia Gas Q
51. CERTIFICATE OF OCCUPANCY
No. Date
Date
,
U
POOL. A
inspector qppROVALS Permit# Date inspector
52. Pooi & Equipment Location
53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER�GUNITE
58. Eiectrica� Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash lines, P-Trap, G Undrgmd.
61. APPROVALTODECK
62, Backwash & Receptor-Final
63. Heater & Vent-Final
64. Plumbing System - Fina�
65. Electrical-Final
66. Solar SYstem�Final
67. Fenciny & Access ApProval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEhASFINAL
FIRE OEPT. REQUIREMENT
APPROVALS Permit #
70. Underground Hydro
71 . Produci Pipiny G' Gas ❑ Oii
72. Underground Flush
73. Undergrnd.StorageTank C�Gas ❑OiI
74. Overhead Hvdro
J5. Dry Chemicai
76. Dry Sta�dpipe
77. FIXED SYSTEN7 PINAL
78, FIRE PREY. FINAI.
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
Notes:
T
.
_J
�oon�ssaem�awc: q Z 3 BROADWAY
"""ERs"u'E'F�u�ow":HUMPHREYS, BRADLEY T -
�op�HUMPHREYS, WENDY L
� 423 BAOADWAY
�STA MESA_CA 92627642-1049
ANCXRECT Ofl FNtlNFEH:
31CN. Ofl FNO.'S 100NE55:
uc. No.:
CONIIiAtTqf3N/J�:
CWIHACTONS MYIPlG
1DDRESS: llC.NO.:
UNi:
UNi:
uxr.
LICENSEO CONTNACTONS DECLAflATION: I �araEy eflkm unEer penetly W perjury thet 1 em I'renaed under provieiorre ot Chepter 9
(mmmenenp vnlh Section ]OW) W DNision 3 W I�a Busineaa end Profeaeiona Code, vM my licenae ie in /ull bme end aHec1.
cm uc. No.: uc. cuss: uc. No.: EXP :
Deta: CaNreUor.
OW NEH BUILDER OEClAF4TI0N: I hereby effi�m uMer penelly d parN�Y �� I em exemq from �M ConVeqas Licenae lew la Me
idbw'vq rueon (�� )�1.5 &n'vime uM Prdaseiona Cada: AnY ciy a countY �� �Quires e peimil io omebun. Mer, imyova.
damdsh, a repei eny svuclure. prior io es 6aueMe, ebo requirea �he eppl'rant la euch permil b fib e egiwE alelemeM ihet M a sM
licansed Wn��l lo IM povisions d iM Coniredora liceme law ICheqm 9(�me�anp wilh Setlion )OW) d Oirobn 3 ot Ihe
uineea eM Roleaeona Code� «thm he a ehe ia examq IMrehom enE tha baeu fa the dbped azamqion. My videtion d Sedion
.03t.5 by eny eppliranl lor a permil subpds Ihe epdtien� �o a civil panelry d iat mae ihen iNa hurdred dollen �5500�).
� I,eaoxnarNihepropenywmyampbyeeewlhwapeaavlheiredecompeneeiion,willdoNewoA,endthaei�unureaewtintendad
or ollareE for ule (Seclion 10aa, Bueimv end PMeasiona Coda: The Conlreclon licensa lewtloee wl epplyto en oxner oi propery
who buida a mprovea theeaon, enE who Eoes aucli waM Mmmtl or herseM or ihrwOh h6 w her own employeee, pmnded rtw euch
imo�menia ue rot imended or oilered for aela. II. Mwever, �M buitli'p or improvemem ia sotl wilhin ona yeer M mmvletion, the
�owr�erbuikar will hava Ihe EuNen M provinB � or she did nw build w improve /a �ha WT�e d aele�.
�. m own., d �n. v�v. ��auaivety w�vmuw wnn fxanaea wn�renon �o conrrua �ne woise (seaon )wa. eusmavs end
Profaviona Code: Tha COMrepae Licenae Lew daes mi epph� to en oxmr d pope�ly w}w Witls or impv.•m t�e,eon eid who
contrecb Iw euW pqees wnh a mniretla�a) IcenmE Wrs to iM Conireeon lice ae lax�.
� I em exemq urdx Sectiocn�:� B. 8 P.C.. ih' r wn:
Dam: �' �� � -V � e Obner: � .
I do na�any cen�ry me� i em eware a a�e �oda��,d ma rey��remema oi caieomie �e sar�y coa< s«aoos u s, zss3a. �,a
zssx, em me� i w�y tm�re nwmnq occupeni wiii i w�n oa (dmb one) need �o com wnn �d s�a�e codee e�e m. ���.eme�m i«
e peimil lamnslruclbn or motlificetionhwniha �r�y . enepamem Dis�na. Reeitlenliel mnsirud'on y�p4W ione ue eaempt irom Iheae
prmisiona.
Deta: ADG����
WONKEN'S COMGENSATON DECL/�flAT10N: I hareby alfirm �Mx penelly d perjury «n d tM IMbxinp detlereiiom:
� IheveeMwilmeinleFecenAiutedooruenitoaeMinwreMworkericanpmWion,npwNedf«bySecun�)OOdtMLebor
coee. i« ma v«�om� d m. wa i« w:�n ma ro�n a�we.
❑ � nave m,d �:e meimen worken' wmw�� ����,�. ��a��,ad br s«rian 3�0o a ub lab« coee. �or mn osnormaMe a me
work Iw which i�ie pertnn is issued. My wakers mmpanution inwraMe famm eM pdicy number ere:
c�e�:
Policy Number:
his sMian neeC na be cwnpleteE / the prmn is lw one huMreE dollars (StPO) or bsa.)
� I ranAy thm in tha pMwmerce M ihe wark br which t�ia permX A ieeued. I e1W1 � amdW �Y V� in eny mennar m av to
becoma wElatl lo IM xwken' canVemetion le�n of CalAanie�&M e9rea liq E I shoul become e'ed b �M xveken'
mmpensaibn D�sions d Sedion 3]00 W Ihe lebor Code. I ell /m hvrilh ew y' Iho e rovisions.
oete: .� - .�`-l'�Clb nwi�wn:
Weminp: F�llun ro�xun wohxi mmpxwtlon rover�ye L �nbwNl, �ntl ilull •/xf employn ro cdMrol p u an0
c/vll flrisi up ro om huntlretl tMua�rM Collan (5100,000), In aGL/tlon ro M� cost ol t/on, Oamep� as pv etl br In
SscHon J103 0l Ms lebor Catle, Infwsip �nd �ttomsy i/sea.
CONSTNUCTION LENDING AGENCY: I hereby elfim unEer penelry d perlury Ihm there ia e wns�mnion landi�p egermy fa IM
paAormence W I�e wak br whicli ih's peime is esued (Sed'an 3091, Civ. C).
LENDEP'S NAME:
LENDEH'S �DOflE55:
1 eenity Ihei I heve reeE Nis eppl'ration eik peta Ihel Ne above intamelbn is eortea. I epeae ta ewnply wnh dl ory arW ooumy adineMea
e�e.�e�. mws nlet�e w wib:,e consn,aion ena na,aW ewi«iza reva.m�divea a mc mr m eme, uro� �ne mwa-mm�in,ad o�rem
/IX 1119PBCplI
�4iENDY HUMPHR�ES Q,��
o�a: `� — oL�'�'1(n
(5151<6 WP) Whna-Buildiiq b Seley:OreemFle: Ganary-Appticenl; %nk-Ravenue: Gddenrob-Asaaaer
CITY OF COSTA MESA — BUILDING PERMIT
IT NO: P 077821 PLAN CHECK NO: N
TRUCTION TYPE: V—N PERMIT TYPE: PLU
DESCRIPTION : ADD 1584 SQ FT LIVING/ 484 GARAGE
PERM NO: P 077821
/
GOVT: N SUPP: N
PURPOSE: ADD
SQ FT:
M VALUE: CALC—VALUE: GROUP OCC: R-3 /U-1
****i�*���**�**BD**+t�rB����H��+Ht�*+Et****+�**�**xit*****��x�****Bx�*****��r*�***�**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: ET 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: 11733105 ZNE: REF NO:
PLANNING NOTES>
�
iE iE iE iE IE iE IE If 1E 1E 1F ik 1E iF iE if fE iF 1E if ik iF IElf 1E 1E 1I� 1! ik 1E iElE 1E iE IE �E �! iE 1E iF 1E iE dE iE'14 ff !f if �k1Elflk iE �ElhlE iE iE fElF if if iF if� iE IE iE iE IE iE iE')f 1E �E 1f 1E 1E iElE
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:
I:li��lf �7�i�R�1C1a1�iliL�I��p3'1
DATE;
APPLICATION ISSUED BY: � � DATE: � 2`f�'9�!/
IE 1E iElE �E iF iF'1E �E 1(� 1E 1E 1E iE fE iE IE'lE 1E fE'lE iE if� If 1E iE �E 3E fE'IE IE'1E��7F3E iE
LEGALIZATION:N F E E S U M,M A R Y STRUCTURAL SEGMENT:N
v t. • -
BLDG PMT PLUMBING ELECTRIC MECHIINIC �� '%F,IRE� • SMIP�/RES GRADING
PERMIT 137.00 - i�- �- �� '� ���; ' - •
25& ✓ ` �, ' � ,� � ,`SMIP/NON—RES
PLAN • , ✓ . . 1 .._. _,
ISSUE FEE 20.00 ' '
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK T.OTAL ', � PAID DUE
TOTALS----> 137,00 20.00 0.00 ��157.�00 •. 157.00-: .00
�. j "
REVENUE DIVISION TOTALS--> COLLECTED: 157,00, OVHR/SHORT:� .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE 'SM3P/TQT -:GRADING PLAN—CAECK
15%.�� �" � � _� � '' y - �. .
jE 1E 16IE 1E iF if 1E 1E �E fE 1F 1E iE 1E 1E iF 3f jf iE 1f 1E 1E 1E iF 1E iE iE iE if if If 1E iE iE 1FlE fE iE * jE'if iE 1E 1E iE iE IE iE iF,1f iE if 3E iF iE iE iE IE 1ElE.lE IE,dE iE if iE iE if !E if 1E iF iE 1f IE iE iE iE
I N D I V I D U A L' F E E H.: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
PLU 2 BATHTUH . . `� . ?7.00 14.00
PLU 1 DISAWASHEA , ��` - �7,00 7.00
PLU 1 LAUNDRY TUB OR WASHER , . 7.00� �',� 7.00
PLU 1 SHOWER ✓y. � a �� � . 7,0,0 , 7.00
PLU 1 SINR, KITCHEN �� 7,00•--' 7.00
PLU 1 WASH BASIN ' 7,00 �'"', 7,00
PLU 1 WASH BASIN (SET) � ,� 7.00"1 , 7,00
PLU 2 WATER CLOSET (TOILET) :' � 7.00 14,00
PLU 1 WATER HEATER AND/OR�VENT ��� 7.00 7,00
PLU 1 BACKFLOW PREVENTER �•, �, 7.00 7,00
PLU 1 GAS RE—PIPE � 7:00 7,00
� . �
,\
r'
CONSTRUCTION AND PLANNING
APPROVALS Permit #
1. T,emporery Electrical Service or Pole
2. Soi� Pipe-Undrgmd.
_3,. €lectrical Conduii Utility-Undrgrnd,
_4:. Electrical Conduit�Undrgrnd.
5. Steel Reinforcement
6.•,Electrical UPER Grnd.
' -7: Footings
8. Foundation
�9. Water Pipe�Undrgrnd.
30. St�uctural Floo� SYstem
11. Property Sewer line & House Connection
72. Sewer Cap
13. Roof Drains
14. Rough Plumbing •
15. fiough Electrical�Conduit
76. Rough Electric4Viring
77. flough Wiring $�gn
18, Rough Electricsl-7 Bar Ceiling
19. Rough Heating & Air Conditioning ,
20. Rougd Factory Fiieplace " .
27. Ducts, in Structure- , � -
22. Ducts, Ventilai��4
23. Gas Pipe-,Rough & Test -
24. Roof Framing '
25. Roof Sheathing . ' °
26. �T-8ar Ceiting (5tsuccura4l & Monocoat
27. Frame and Fiaghing,: - . .
. 28. Lathing & Sid;ng - , � - _
29. Insulation -........�.. - �
30. Drywali Naiiing
31. Plaster Browr t,oat . � '
32. Electrical Powar Meter-Final
� 33. Final Electnc- ; � � . -
- 34. Final Heating-& Air, Cqnditioning � -
35. Final Gas•Pipe-Tes��
36. Hood or CanopY
� 37. Finai�Factory Firepla"ce ° "
38. Final Plumbing - + �
39. Water Service�Finai
A0. Gas Servi ce-Final �- � , . �. .
41. Solar Oomestic�F�nal
42. Backflow Preventer , , -
h G ..
43. Backflow Irrigation
44. Landscape Irrlgatiqn15ystem - .
45. Sound Attenuation � � •
46. Handicap Regulations .-
47. FINAL STRUCTURE & BUI�DING
48. fINALPLANNING
49. Elec[rie Refease to Editon
50. Gas Release to Southern Califor�ia Gas Cu
51. CEiiTIPiCATE OF OCCUPANCY
Date
�
POOL !A
Date lnspector qppROVALS Permit�# Date Inspector
52. Pool & Equipment Location . '
53. Steel Reinforcement
54. Forms
55. Electrical8onding '
56. Rough Plum6ing & Pressure Test
57. APPROVA� TO COVEft-GUNITE
58. Electricai Conduit-Undrgrnd.
59. Gas Pipe, � Undrgrnd., Test �
60. 8ackwash Lines, P�7rap, �7 Undrgrnd. -
61. APPROVAL TO DECK
&2. 6ackwash & Receptor-Final
63. Heater & Vent-Finai
64. Plumbin� System � Finai -
65. Electrical�Final , .
66. Solar SVstem-Final •
67. Fencing & Access Approval
68. APPROVED FOR PLASTEiiING �
69. POOLlSPASYSTEMSFINAL �
- .. FfRE��6PT. REQUIREMENT
. - . -• APPf{OVA;�S - Permit# - . _ - .
a �
' � 70. �fl�derground Hydro �
- � 71. ProduCt,PipingOGas �'Oil
� 72. Underground Flush r�
:�_ 73. Undergrnd. Storage TaniP G Gas rJ Oil
74. Overhead Hydro •_
� ' 7�j: Dry Chern7cat - -
� 76. Dry StanclPiPe ,.. � .. �� _ �
77: FIXEDSYSTEM'FINAL '
7� PIRE PREV. Fif�AL �
' �HEALTH DEPT. REQUIREMENT "
79. FINAL INSPEC7lON �
SP- FOQD CERTIFICATE ISSUED
, .� Noces:�-Ii-�// � �.rv)n»15�.
�r%y/_�_7 � /!
��/_i� 6 �i ^
. Y/ L. 1 Y �� / -
* ' -�i�%
- (' �_'' _-'��
� . !�-e . _ ._
T
0
�
s
�_�� SHowc.?-
� l � .: . C �/_L:b7�G
�� ��
/
- • �
\ F
0
- ��su��qN6 423 BROADWAY
: ` aE�Fw+ov^+:HUMPHREYS, BRADLEY T
� nooxess:HUMPHREYS, WENDY L
423 HROADWAY
�OSTA MESA,CA 92627642-1049
�avi. uuuxc �noxess:
�''
�
NMHRECTOPFNtlNFEN:
u�cx. on enc.•s �oonEa:
CONIF�CTOR'SNIJIE:
CQAqACT0115 YYIPlG
ADDXESS
UNT:
uc. no.:
UNT:
uc xo.:
UNT:
UCENSEU COMHRCTOHS DECLAPATION: I hereby eXim unCer peneXy o/ pe,jvry Ilul I em licen»d urker pwiaiona d Cheqx 9
(ewnmendrp wnh Seclbn ]000) d Oiviaion 9 d Na Buai�s vM PMesa'are GOEe. eM mY lioenu ia in lull lace ud eilaa.
cm uc. No.: uc. cuss: uc. No.: EXP ;
oma: cn,veeo,:
OW NEH BUILDEN OECLANATION: I hereby elfimi uMer parely d perNrv �� � em eRemq Irom iM Contreaas Licenae lew /a tM
lollowing reeson (Seclion ]091.5 Businese anE Professions COEe: Any cily a coun�y nfiich rxryiref e permX lo consimcl, elleq improve,
Aemolnh. ar reper eny svucWre, priw io da vauaree, ebo repuirsa Ihe applirent Iw auch permn to fib e aprod ataemant �hel M or aM
is IicenseC pursuanl lo Ihe povisiom d Iha Conlredon Limnae Lew �Cheplm 9(comme�rp wnh $aqion ]000) d DiJmion � d iha
Busineas end PrMessbna Coda� or ihet M w eha is exemq therehom arM Ihe basia fw IM allepeE eMamption. My videton ol Sequn
)031.5 Ey eiry epqicent tw e parmil subpds IM epplicen� to e dvil qwlry d m� mara Ihen ive huMred ddbn �S50pj).
❑ I, es oxmer o/the properly or my emDbYeae xNh wepea as �hev eole compensaiion, xill do the wwk, enC IM Mruclura b nd inleMeE
or dlereE for aele (`�tion ]OId. B�ress end PMessbna Cada: Tha Cantradors License lewEoes not epply�o en owner d paparry
wno waea «mao�, ine„o�; �a.mo e�.��n.� �:ma,tt «n<nen o, m,a,an n� «n�, o�„� amviw�a, w%+dee inm wcn
�mo�amame �< �oi m�e�eed «��d m, seia. n, nowa,ec ma b��a�nq «mv,o„�,em n aoa wan�� �. ya., m�vi��, m,
�o�mer-0uikbr will heva iM W Nen d poviip M w aM d'M ml buik a impwe tor tM puryoae d eele).
I, ea ox�r d ihe propaM. em eRdutively conlredip wi�� lieensed mnVeclon b conArud IM prola= (Setlun )OCG, Buainra eed
Vm/essiona Cade: Tha Comreaare Ixenae law Aoes M eppy 1 en owner d qope1ty w1w WiNs ar impovee IMrson eM wla
WnllBcl810! BUdI projBp9 W11h a l I�atlor�9) lianse! W�u9n1 �o M ConlRdon Ll[enae w).
� I em exemp uMer Sec�mn: B. d P.C., fa ihu re aon:
Dete: �- 2H'R�J . Ownee
I Ao �emW cenRy Ihet I em ewere d vM uMermteM ihe rea�iremanla ot CelLomie Heelih d Selary Code Sedions 25 5, 255�3, erM
25530, end ihe� I or eny lumra buildi�q oocupenl will / will nd (drcM one) need m wmply �' eeid slale oodm eM Ihe requimmenb far
IeCermnlnmuWtlionwmotlifreiianhan�heAi ue�iy are9amantUmrie.ReeiEemWmim�udioneDP�iorowewemqlmmihesa
waAsbm.
IDma: ApqiceM:
WOFKEN'S COMPENSATION DECLRP�TION: I hereby aifiim uMer peneXy tl pmjury wr M iha lolbxi�p Eetlaraliwu:
� I heve arM xil meimen e cendima d mneant lo eetlinwre br warkan �,o,�bo, � p,o„e.a m� a sea�, a�ao w me �n«
Code, la iha pertormence ol the v.ak for which Ihis permit ia isued.
� 1 new erW xil mainlein wnM1en' mmpenee�ion inwreMe, o reQuirad by Seclqn 3]00 of Me Lebor Code. in iM peAormence d �M
woA for whiM Ihis permn is iaeued. My wakars wmpenae�bn insu�en<e rimer ud pdiry number are:
� Camer.
Polky Numbec
�(T�h(is aecian r�eed rwt ha candared i �he VB�m1 is Ia mre hundred ddlars Rtool d bsa.l
e( I CBfIIIY�M1B� I� II1B Po�Q��CB WIFG WOMIO! VAIl0I1 IM1IB pBflllll 19 � 911lE� I BI10II d BTpO% elly Bf9011 IIIB11 81111l� 80 6910
becmie wbjep to iM xwkna' canpeneetion lews d CelXaniq d aprea �h 1 il I ehwW conn wbje lo IM woMers'
cwnpensaiion pm�5siam W S(e+d�ion1 3-]00 al the lebar Cada, I forl vrilh compl wilh ihoee isione.
Dma: S '�.� — R V� ApqiceM:
Wem/np: F�llun ro�xun wohxi rompawUon roverp� h unbwN( uW �N/I �W f en loyx roWMNI p u ene
elvll flnu i.q ro an� ��wrdrW tlp�aar�d dall+n (S10q000A �� ��tlon ro tln ro�f ol ro �ron e,m.o., ., p.o�mee ro. ��
SxHon 9108 0l Ns LMor CoOa, Intxsst, end atromsy'c /na.
CONSTflUCT10N LENDINO RGENCY: I hereby elfi�m under penelry W parjury �liel Ihem is e canelrutlion kMirp epanry lor iM
pena�e��e a ina.wn� iw wn��n �n� ro�+ �= es�ad �seaian xs�, cN. cl.
LENOER'S NANE:
LENOEF1'S AODPESS:
� CBlllh/ ��1BI ��IBVB R04 �h18 9�ICaILG�1M BIId pe1B I� IhB 9bWB IfI�Cf1IIB�p1118 WRBC1. � BQIBB ID COTpF/ W11�10�� On' BIIQ [qlfl�% ONIIIBlICB9
entl ete�e Iavn releting m building conavunian aM hereby authorae re0resantelivee d �hb dry ia enter upon Ih<ebove�mentoneE propeny
�UlIf19pGCl1011pfm0!!9'________ ____�________
o�a: -��- ��l' el Cn
(515td6.W ) Whna-Build'np 8 Selmy; Graeo-Fla; Cenary-ADPlicenl: Rnk-Revenae:OolEenrod-Asussor
PERMIT NO: E 077820
-Er^ COSTA MESA - BUILDING PERMIT
PLAN CHECK NO:
N
PERM NO: E 077870
GOVT: N SUPP: N
CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE PURPOSE: ADD
JOB DESCRIPTION : ADD 1584 SQ FT LIC�ING/ 484 GARAGE SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /U-1
*�********��*+�t***�tBD**��-BD***B***��ri�r****4**�*�*��r****+�t-***�*�B***8**�r*******x-�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN RBAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 11733105 ZNE: REF NO;
PLANNING NOTES>
i
1F 1E 1E 1E 1E iE 1E if 1f 1f iE iE 1E 1E �F 1E iE iE iE i! if 1E �lE 1E fE iE 1E fE 1E iE 1E 1E iE �E'lE 1E iE 1E 1f 1E 1E 1E iE iE 1F fF 1f !E!f fF if 1f iF ik fE fE iE 3E 1Elf 1E 1F 1E 1F iE iE fE iE iE iE iE 1f iF 1F 1f 1E 1E 1klE
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 : DATE:
APPLICATION ISSUED HY: :/ DATE; S�ZI�
'lE'N")E1E'IE1f1EiEiF1F1E1E1E1EiEiElEiEiElf�kif 1EiEiE1ElfiFlf3EfE1h�3 lkiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 82,25
50$ SMIP/NON-RES
PLAN
ISSUE FEE 15.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 82.25 15.00 0.00 97,25 97,25 .00
REVENUE DIVISION TOTALS--> COLLECTED: 97.25 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
97.25 •
iE jE jE iE iE iF 1Elf iF ik �F iE 1f� if If if if iElE if iE iF if IE iE ik * 1f !F �E iE jE 1E iE IE 1E'�E 1E iE iE'IF 1E 1E 1E 1E iE IE dE 1ElE 3E 9E iE 1E fE 1E iE'1F iE iE iE iE 1E iE if 1E dE iE IE �F iE if 1E �IF iE iE 1E 1E 1E
I N D Z V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C A I P T I O N UNIT COST TOTAL COST
ELE 20 FIXTURES, LIGHTING 1.ST 20 EA. .75 15.00
ELE 3 FIXTURES, LIGHTING 'ADDITIONAL EA. .45 1.35
ELE 20 RECEPT/OUTLET 1 ST 20 EA. .75 15.00
ELE 14 RECEPT/OUTLET ADDITIONAL EA. ,45 6.30
ELE 20 RECEPT/SWITCH 1 ST 20 EA. ,75 15.00
ELE 8 RECEPT/SWITCH ADDITIONAL EA. .45 3.60
ELE 1 SUB-PANEL 11.00 11.00
ELE 1 TEMP SERV PWR POLE W/OUTLETS EA. 15.00 15.00
END OF FEES
- - - ----�_ _ -- -- ----
_ ,;
/ o�;ONSTRUCTION AND PI.ANNING
,PPROVALS Permit#
' l. T�r!nporary Electrical Service or Pole
2. Soil Pipe�Undrgrnd.
3. ElectricaV Condn+t Ucitity-Undrgrnd.
-4. EleciricaiCondu�t-Undrgmd.��'
5. Steal Re�nforcement
6. Electricai UFER Grnd.
7,; Footings
8. Foundation
'9. Water Pipe�Undrgsnd.
.70. Structural Floor System
\, t t. Preperty Sewer Line & House Connection
'12. Sewer Cap
13. Roof Drains
74. Rough Piumbing
� 15: Rough Electricai-Conduit
POOi & SRA
Date inspector Date i�spector
7/
i6. RoughElectricW�ring
17. Rough Wiring Si9n �_
� 78. Rough Electrical-T Bar Ceiling
� 19. Ro�gh Neating � Air Conditiorting
20. Rough Factor� Fireplace � � ' '
_ �
,� 2L Oucts, in.St�ucture ,� . .
22. Ducts: Ventiiating
23. Gas Pipe•Rough & T{
24. Roof Framing `
a
25. Roof ShAathing �
�26. T�Bar�Cei4ing (S.�uccural) & Monocoat
�27. frame and �lashing . '
i
28. �athing h Siding ' `
29. Irsula:io� -� - -
30. Drywall Nailing ' �
31. Plaster Brown C��t�'� �" _.
32. Electrical Power (v}eter-F;nal
33. Fina.l Electric, �
33. final Neating & Aic Conditioning _
35. F�nal Gas Pipe-Test ; '
36. Hoodor Canopy �� .
37. Finai'Factory Firepi�ce ,
38. Final Plumbing ' "
39. Water Service-Finai'�
4Q. Gas Service-Final � � . .:
41. Solar pomestic-Finat ` �
42. Backfiow Preventer �
43. Backfiow Irrigat�on
44. Landscape Irrigacion-Syseem .
45. Sound A#tenuatio�
46. Handicap�fiegul8tions _ �
47. FINAL STRUC7URf & BU��DING
48. FINAL PLANNING
49. Electrio ReleSse to Edison
50. Gas Release to 5outhem Califor�ia Gas Co
51. CERTIFICATE OF OCCUPANCY
�ate
i
�,
APPROVALS Permrt #
� 52. Pooi & Equipment Location
, 53. Steel Reinforcement �
54. Forms '
b ��C 55. Electrical Bondiny '
56. Rough Plumbing & Pressure 7est
57. APPROVAL TO COVER�GUNtTE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, � Undrgrnd., Test
' 60. 8ackwash Li�es, P-Trap, C U�drgrnd.
67. APPROVAL TO DECK
62. Backwash & Receptor-Final
, 63. Heater & VenbFinal '
64. Piumbing Sysiem - Fina� �
65. Electrical-Final '
� 66. Solar System-Final
� � �67. Fencing & Access Approval
�' - -
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
- � F�RE DEPT. REQUIREMENT '� � 'r�
- i.
' '- ' � APPROVALS Permit #
--r-
' 70. Undergrcund Hydro
�, 71. Product Piping C_Gas �Oil
� r 72. Underground Flush �
�' ' 73. Undergrnd. Stqtage Tank �� Gas ❑ Oil
- - 74. Overhead Hydro
75. Dry Chemical ' - � �' ''� �.
- < 76. Dry Staodpipe .
71: FIXED SYSTEM FINAL
78. FIRE PREV. FINAL �
HEALTH DEPfi. RERUIR-EMENT ^
� 79. FINALINSPECTION ��
80: FOOD CERTIFICATE 155UED
� 1 �
C 2_��
Notes: �,[l -!%� ��%4: l/2I`i�
� t/3/�� c�..c.k,..� - Cr,�,ce . _ .�
. 1 -
�
w
rs
9
� �I •