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Home My WebLink About471 BROADWAY - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 471 BROADWAY Suite: Vicinity: REAR PROPERTY LINE Parcel Number: 11733115 App�icant: OWNER Address: Owner: SWANSON, MARCIA C Address 471 BROADWAY COSTA MESA, CA Contractor: Address: Zip: � , � � Arch : � Address: Phone: Zoning: Phone: Zip: Phone: 949-650-1639 Zip: 92627 Phone: License: Eng: Address: Status: ISSUED Applied: 03/15/2002 Issued: 03/15/2002 ISSUED BY: � Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCTfs-6 Ff HIGH CONCRETE BLOCK PILASTERS FOR WOOD FENCE AT REAR OF PROPERTY (6.5 FT OFF ALLEY) Plan Check: $45.01 Permit: $69.25 SMIP Res: $0.00 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $114.26 SETBACKS MAIN STRUCTURE Fronl 0- 0 ACCESSORY Front 0-0 PARKING Ex��: o NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEESUMMARY PLANNING & ZONING Left 0- 0 LeR 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 $z,000.00 $2,000.00 NOTICE: The work authorized by this permit shall comply with all applirable handicap access requirements under California statutes antl related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure lo obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 aawo law� WORKERS'COMPENSAnON DECLARAnON: � I hareby aHirm untler penalty of perjury one of ihe following declaretions: � � �' � ' • • ❑ I heve and will maintain a certificate of consent to self-Insure for workers' compensation, es providetl tor 6y section 3700 of the Labor Code, for the pertormence of ihe work fo� which this permit is issued. ❑ I �ave and will maintain workers' compensation insurance, es required by section 3700 of the Labor Code, for the perfortnance of Ihe work for which this permit is issuetl. My workere' compensetion Insurance carner antl policy number ere: Carrier: � Policy Number: (This section need nof be completed il the permit is velued et one hundred dollers ($100) or less.) [� I certity ihat in the peAortnance of the work tor which Ihis permit is issued, I shall not employ any person in any manner so as to become subject m the workers' =^" compansation lews of California, end agree ihat if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Cotla, I s�all forthwith comply with,ihese_provisions. . /�llca'nnS�gneiuie" � ' ��%i1C/o _ �//GZ<t2�? ete: � �� J "�2 WARNING: FAILURE TO SECURE WORKERS' �MPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOIXJE HUNDRED THOUSANO DOLLARE ($100,000�, IN ADDITION TO THE COST OF CAMPENSATIdJ, DAMAGES AS PROVIDED FOR IN SECTION 3]Ofi OF THE LABOR CODE, IN�EREST, AN� ATTORNEV'S FEES. LICENSED CONTRACTORS DECIARATION: I hereby aNirm ihat I am licensed unde� provisions of Chapter 9(commencing with Section 7000) of Division 3 ot the Business and Professions Code, and my license is in full force ana eHecL Lia N Class k Contractor's SignaNre: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm ihat Ihere is a consiruction lending agency for Ihe pedormance of ihe work for w�ich this permit is issued. (Sec. 3097, Civil Code). Lentler's Name: Lender's Adtlress: SigneNre: � Oate: OWNER-BUILDER DECLARATIONS: I hereby attirtn that under penalry of perjury that I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW tor �he Following reason (Sec. 7031.5, Businass antl Professions Code: Any city or county which requires e permit to consiruct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires ihe applicant for such permit to file a signed statement that he or she Is licensad pursuant to ihe provisions of tha Coniractors License Lew (Chepter 9(commencing wit� Section 7000) of Division 3 of the Business entl Professions Cotle) or that ha or sha is exempt therefrom antl the basis �or the alleged a:emption. Any violation of Section 7031.5 by any applicant for a permit subj s ihe applicant to a civil penalry ot not more ihan five hundred dollars ($500).): I, as owner of Ihe property, or my employees with wages as their soie compensation, WILL DO 7HE WORK, and Ihe siructure Is not intanded or oflered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner oi property who builds or improves thereon, and who does such work himself or hersetl or ihmugh his or her own employees, provitled that such improvements ere not Intended or oRered for sale. fl, however, ihe building or improvement is sold within one year of completion, ihe owner-builder will have ihe burden of proving Ihat he or she did not build or improve for purposa of sale.). ❑ I, as owner of ihe properry, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct ihe prolect (Sec. 7044, 8usiness and Professions Code: Tha contractors License Law tloes not epply to an owner of pmperty who builtls or Improves thereon, antl w�o contracis for such project with a contractor(s) license pursuant to ihe Contractors License Laws.). � sec. Business end Professions Code tor ihis reason: rOwne� ID venfied by drivers license. Yes 0 No Venfication ot Ownership by (rype of docu en , I.e. - properry tax bill or DIVISION OF INDUSTRIAL SAFETY PEflMIT CERTIFICATION: No: ❑ I hereby certity that no excavation five (5) or more feet in tlepth in�o which a person is required to descend, will 6e made in connection with work au�horizetl by ihis permit, and ihat no builtling slrucWre, scaHolding, falsework, or demoli�ion or dismanNing thereof, will he more ihan ihirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomia Atlministrative Cotle). ❑ As owner-buildar, I will not employ anyone m do work which would require a permit from the Division of Indusirial Safery, as noted above, unless such pereon hes e permit to do such work tram the division. Signature: Date: Division of Indusirial Safery Permit Number: CER7IFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRV: I certify under penalty of perjury ihat I have read ihis ap0lication and state that the information given is correct. I egree to comply with all state lews and city ordinances relating to building consiruction, and authorize representatives of the City of Costa Mesa to enter upon the ebove-descri6ed property for inspgction puryos s. 1 agree not to occupy or allow occupancy ot any building authorized by this permit until finel inspection. _7y,1?�c«�.�-t�� 3-15-02 � Sgn-� Of Legal Ovrner(s) ��Dare ` And/OrAuthorized Applicant Data CODEt, ixsvecnoxrne 1616 Fixed System Final Fire Pravention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Well 202 Final Factory Fira Place 203 Finel Sign 204 Final Demolition �: i ��ws . cooe. ixsvecnoHTvve 206 Final Mechanical 20B Final Plumhing 210 Final ElecMcal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final BuildinyOccupancy BAIE It�L� 95�i� - Gieen � � / � 4113A - WTi�i J �_ e� . r� / 0 � i / 6 9 0 ll i2 13 � � / � , � . 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Ban 3/8"Q at 32" O.C. � Fill Cells Solid With Grout W here Steel Occurs Rcinlnrting $tr.el Shall Conbrm to Sec.A�15�39 A.S.T.M. All $teel to be Lapped 24" or to Code NATURALGRAOE TWO 7/8"O BARS CONTINUOUS TOP 6 BOiTOM MOQ�ZSTEEL MUST BE TIED IN VLnCE AT TIME OF TRENCH INSVECTION. TYPICAL 6�� CONCRETE BLOCK FENCE � c i > z u f � W O u '- W r1 LL � u^ � e�f F►—KI �H p SEE CMt I � BE Ow 0 WIDTH THICNNESS . DEPTH OF EARTHTOOTH . SPACING OF EARTHTOOTH I4" I 0'� 24" 12' FOOTING REDUIREMENTSCHART 14 10" 20" 14� BUILDING DIVISION 12- 9" 16'� 16' GENERAL- NOTES MORTAR; p�e Part Plastic Cement, and T�ree Parts Sond GROUT: One Porl Cemenf Three ana One Holf Ports S�and COPING: One Part Cemenf, Three Parts Sand CONCRETE: Well M�ied 1:2-I/2:3-I/2 Ma� ol 7-I/2 Gollcns of Wafer Per $ack of Cemenl GROVT MAV BE VOUREO FROM THE TOV OF iNE FEN[E IN CELLS WMERE STEEI OCCURS. CELLSAND AREASOF MORIZONTAI REIN FORCEMENT SHALL BE CLEAR, CLEAN 6 FREE OF AlL MORTAR DEBRIS. ETC. H C�' C4PTHTCOTH VJ triE HE�GTH O� iENCE B�LOW BOTTOM OF �OGTiNG SCALE: I/2��= I' I 2�� 9" 12" I6� • TtDS SKEfai LS FOR INFORMAt70NAL PURP066 ONLY. APPUUNT 6 RFSPONSIBLE FOR PROVIDIIJG AN ACCURATE RFPRESQdIA770N OF 2}ffLt PROPER'IY RJ CASE Tt� SHAPE AND SIZE DO NOT O�RRESPOND N'17}1'fHE R`1FORMAl70N PROVIDID ON 7}DS SHEEI'. • SOLID WALLS/F�TI�S BEIWka12'b' h 6' QJ iQ�7GHT SHALC BE SE'IBAIX AT LFASf 10' FROM FROD7I PROPFRTY LINE. • SOI� WALIS/FENffS SFULL N07 SX� 2' 6' IN }�IG}iC WII}�I ]V OF 7HE FROM PROPERTY [IPIE (N07' CURB LWEj. • VQt�Y DS[AN� FROM NRB 7'D PROPEKIY LINE AND 9iOW ON PIAN. VERIF7GIION FROM TF{E QiYS ENGINf02INC DIV6ION S REQUIR�. GI.L (714) 7545343 POR INPORMATION. � xs RE90[w¢ II�pEMq � yz�m I 1 SF ' 1 � 1 � . � I S Y a i� � AE90ENCE 1 �`�______.'....._.._.. \ �___ RC90ENCE STREE M90ENQ �> F e �� RE9DENCE i ............... ', / / BLOCK WALL LAYOUT FOR BUILDING PERMIT PLANNING DIVISION 91�U'F�coSTA M�e1SA CONSTRUCTION PERMIT ProjectAddress 7 �� %2�%��G✓R%� �'�1�✓� Applicant's Mailing Address �� Owner's Name ��/9 ✓`-�/✓A1�S0 0� ,J� // Address � %� 'C?lz0/4—�J /�/H"%� CM Arch/Eng. License Na. Address Contractor's Name Phone Address ( mai I i n9) City License No. LICENSED CONTRACTOR D C R ION 1 he�eby affirm that I am licen d un r p v n5 0( Charter 9(commencing with section 7000) of Divisio 3 0� he Bus' ess antl Professions Cotle, antl my license is in full force anqreffe � License Class �icense No. Date � Si9nature WORKERS'COMPENSATION OECLARATION I hereby aifirm that I have a certificate of consent to self-insure or a certlficate of Workers' Compensation Insurance, or a ce�tifietl copy thereo( ($ection 3800, Lab. C.) Policy No, � Company BCertifietl copy is nereby �urnishetl. ' � Certifietl mpy 6 filetl with the city Builtling Division. � EXEMPTION FROM WORKEf35• COMPENSATION DECLARATION (This section neetl nat be wmpletetl if the permit is tor one huntlretl ($300J or less). I certify tltat in fhe pertormance o/ the work for wM1ich this permit is issuetl, I sM1all not employ any person in any manner so as to become su ct [o the Workers' Cprp�en�ion LawS of C li ' _ _ � \pplicant to fill in all spacez exceD� tnoze within heavY Dortler lines antl si9n all aov�opriate eeciarations. PER � ryp�� TRACT NO. LOT NO. UNIT NG. � i� TVPE OFCONSTRUCTION NEW %�D� ALTERATION REPAIR �� ❑ CONVERSION. ❑ DEMOLISH �❑ OTHER AP # DESCRIPTION OF WORK/USE OF BLDG. - S Main Buildi TYPEOFPERMIT GRADING ❑FOUNOATION STRucTURFl� T Front ❑ TENANT � ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear ❑ OTHER %+ PROJECT DESCRIPTION 5(l. F7. oCCUaarvcv C Right CONSTRUCTIONTVPE VALUATION$ g Left ZONE GRADING CU.YDS. ACRES Ping. Ref. # Remarks: Planning Notes: Workers' Compensatlon p�ovislon5 oi [he Labo� Cotle, you mus[ tort�wrt� comply with such p�ovisions o� this pe�mit'shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV I he�eby affirm tha[ [here is a mn5t�uctlon lentling a9enty for the per(ormance ot the work for w�ich this permit is issuetl (Section 3097 Civ. CJ LRntler's Name Lentler's Atltlress OWNER BUILDEN OECLARATION I hereby afti�m that I am exempt irom the Contractor'S License Law (or the followinq reason (Section 7031.5 Business and Protessional Cotle: Any city or county which requires a permit to const�uct, alte�, improve, tlemolish o� repair any sGucture, prior to its issuance, also requires the applicant for such permlt t0 file a signetl Slatement that he/she is IicenSetl pursuant to the prOvisions of the Contractor's License Law (Gnapler 9(mmmencing with Section 7000) o( Division 3 of the Busine55 antl P�o(essions Cotl¢) o� that he/She is ezempt the�efrom antl tne basi5 (o� the allegetl exemption. Any violation of Section 7031.5 by any applicant tor a permit subjects the applicant to a civil �enalty of not more than five huntlretl tlollars ($500). I, as owner of the properry o� my em0loyee5 with wa9e5 as their Sole com0eniation, will Eo the wo�k, antl the sVucture is not intentletl o� offe�etl tor sale (Section ]044, Business antl Professional Cotle: The Contractor'S License law tloes not apply to an owner of a property who builtls or Improves thereOn, antl who tloes such work himself/herself o� through his or her own ' employees, provitletl LM1at such improvements are not intentletl or ofteretl (or sale. It, howevet, the builtlinq or imp�Ovement i5 Soltl within one y¢ar of mm- pletion, tne owner wiil have tne burtlen ot proving he/she tlitl not bulltl or im- p�ove torthe pu�pose of sale). ❑ I, as owner of the property, am exclusively conVacting with Iicensetl con- � tractorsto mnstruct the project ($ection ]044, Business antl Professions Cotle: � 4ne Contractor's License Law tloes mt apply to an owner ot property who builtls or improves thereon, antl who contracts for such projects witn a con- tractor(51 license pursuant�to the Contractor'S LlcenSe Law). I am aware thaf proof of their WOrke�'s Compensation insurance shoultl �e pravitletl to me. ❑ I am exempt untler Section B. & P. C�for this reason Date (�J %!� Owner � I hereby certfi y[hat I hav¢ reatl this pplication antl state that the above information is correct. I agree to comply with all city antl county ortlinances antl state laws relating to builtling consVuction, antl hereby authorize repre- sentatives of thi5 city to enter upOn the abOve-mentionetl pro erty for IfISp¢CtIOO pu! / Siqnat �� Sa�57�G7Np�O-Ot— oate�o Driver5' Llcense or 55 � _/. �/—� Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Drinking Fountains Floor Orains � FlOor Sinks GasService OuUets Interceptors Kitchen Sink Lavatories P—Trap Roof Drains ReinspeMion Fee $15 Boiler Duct - Under Ground Duct-Structural ' Duct - Ventilating Exhaust $ystem ❑ Multiple Firepl/Fact Blt. ICBO # Heating System & Ducting ❑ ai oo,000 sTu O i oo,000 Reinspection Fee � $15 CMF 0865-46, rev. 10/84 White - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor PLUMBING Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Goset Water Heater Water Service Auto-Wash Issue Fae Hood or Typel ❑ Canopy Typell ❑ Refrigeretion System ❑0-100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registere Issue Fee FEES 4L24 6/07/B5 Zone Accessory Building: Parking Req./Provided ELECTRICAI � Automatic Washer Transformer 0 15-50 KW Construction Pole Su6. � 50 + KW Cooking Unit Dishwasher Dryers ❑Gas ❑Electric fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Dispoul Generator DO-5 KW 05-15 KW Meter LJup ro 100 amps Meter �er 100 amps Sub Panel Motors �0-1 HP �i'/:-8 Inc.Solar 09-15 HP �16�15+ Microwave Pole Light Range Sign ; Standing Sections - Trash Compactor $ 3 I �— Reinspection Fee $15 'Issue Fee FEES �DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approved By Building Approved By Appliwtion laued Bv $ 3 IQa5a TL Z O N . ' N G R E Q M T r $ FEES $ 3 SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ � ' �ISSUANCE $ , PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ ��%' SO GRADING $ PLANCHECK 50% $ MICROFILM 5 ^� MECHANICAL $ TOTAL FEE $ ��"S v PLAN CHECK 25% $ � • CONSTRUCTION AND PLANNING rOOL & SPA � APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole •. 52. Pool & Equipment Location " • �� 2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement 3.,Electrical.Conduit Utility-Undrgrnd. 54. Forms 4.�Elect[ical Conduit-Undrgrnd. � 55. Electrical Bonding 5: Steel Reinforcement � - 56. Rough Plumbing & Pressure Test 6.."Electrical UFER Grnd. �� 57. APPROVAL TO COVER-GUNITE ' h 7. Footings� � , � ' ' 58. Electrical Conduit-Undrgmd. � , 8.'Foundation � _- � 59. Gas Pipe, � Undrgmd., Test � 9..Wate�,Pipe-Undrgrnd. , ' 60. Backwash Lines, P-Trap, O Undrgrnd. . 10.�Structural Floor System 61. APPROVALTO DECK 1 t. 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 Electriral-Conduit 66. Solar System-Final 96. 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 � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑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 • 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 ..T � /j 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 & BUILDING � 48. Special Requirements Completed 49. Electric Release to Edison . 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No Date - , � (�L�Rd � PO R �- ruSPEcT ADolicant to fill in all zpaces ecceD< <�ese within heavy eortler lines anC sign al1 appropriate aeclarations. C�TY oF coSTA MEsa CONSTRUCTION PERMIT . �,�ct Address �� -��2�/�1� Lt/�i C-'M Applicant's Mailing Address �� ^/ / 5wner's Name M/+n�'�.a .J�//✓/�%�S�' �phoKE��9 Address �� !'�'�WAy �%�G�7 Arch/Eng. License No. Address Contractor's Nam Phone Address (mailing) � n City License No. LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensetl untler provisions of Charte 9(c� with section ]000) of Division 3 of tne Business antl�fe sio s Cotle, antl my license is in full force antl eftect. License Class Llcense Date Signature WORKERS' COMPENSATION DECLARATION I hereby atfirm that I nave a certlflcate of consent to sel/-insure or a<ertificate af Wo�kets' CompensatiOn Insurance, o� a ce�tltietl copy tne�eof (SeCtion 3800, l.ab. C.) Policy No. ' Company � BCer[ifietl mpy is hereby (urnishetl. Certifietl copy is file� with the city Builtling Division. Date APPlicant EXEMPTION FROM WORKEf15' COMPENSATION OECLARATION ' �(Thissection neetl not be completetl if the permit is for one huntlred ($300)'or less). I certi(y that in the performance oT tM1e wo�k for'wnich IM1is pe�mit is i55uetl, I shall not emplo any person in any manner so as to become subject to the Worke� ' o nsation� Laws ot Cali fo_;��')A fDate i9nature ��A��A^ �t— I'NOTIC : If, fter making this tleclaration, you shoWtl become subject lo the ' Workers' Compensation provisions of the Labor Cotle, you must forthwith comply with such provisions or this permit shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV ' ' 1 hereby affirm that the�e is a consVuction lentling agency for the perfo�mance of the work for whicM1 this permit is issuetl (Section 3097 Civ. CJ Lentler'S Name Lentler's Aatlress OWNER BUILDER �EGLARATION I hereby affirm that I am exempt from the Contractor's l.icense Law tor the following reason (Section 7031.5 Business antl Professional Cotle: Any city or munty wM1ich requi�es a permit to conSYruct, alte�, improve, tlemolish o� repair . any structure, prior to its issuance, also requires lhe applicant for such permit !%> to tile a signetl statement that he/she Is licens¢tl pursuant to the provisions of '+•..tihe contractor's License Law (Chapter 9(mmmenung with Section 7000) of Division 3 of the Business antl Professions Cotle) or that he/she is exempt theref�om antl the ba5i5 fOr the alle9etl exemption. Any violatlon ot Section 7031.5 by any applicant for a petmit subjects tne.ap0licant to a civil enalty of not more than five huntlretl tlollars (y500). I, as owner of the p�operty or my emPloyees with wa9es as their sole ompensation, will tlo Ihe work, antl the structure is not intendetl or offeretl e: he ContraCtor's in s an0 Professional COtl T tor sale (Section ]o4a, Bus es License Law tloes not appty to an owne� ot a prope�ty who builds o� imp�oves thereOn, antl w�o tlaes such work himself/herself or through his o� her own employees, provitletl that such improvements are not intentled or offeretl for sale. If, however, tne builtling or improvement is soltl within one year of com- pletion, the owner wlll have tne burtlen ot proving he/she tlitl mt build or im- prove for the purpose of sale). ' ❑ I, as owne� of the pwperty, am exclusively contracting with licensetl con- tractors to const�uct the project (Section 7044, Business antl PrOfession5 Cotle: The Contractor's License Law tloes not apply to an owner ot property who builtls o� improves the�eon, antl who contratts fo� such projEcts with a con- tractor(sl license pursuant�to the Contractoi's License Law). I am aware that proof of thei� Wo�ke�'s Compensation insurance shoultl be provitleG to me. ❑ I am exempt untler Section B. & P. C. tor this reason Date Owner � �'�� ` I hereby certl y that I have reatl this application antl state that tne above information is correct. I agree [o comply with all city antl county ordinances antl state laws relating lo builtling construction, antl hereby authorize repre- sentatives of this city to enter upon t�ie aUove-mentionetl OroDerty � or Signature �_� Drivers' License or 5_' CMF OB65-46, rev. 10/84 � ��i S � �- '�-- TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR — ❑ CONVERSION ❑ DEMOLISH ❑ OTHER qp # �ESCRIPTION OF WO(iK/USE OF BLDG. S Main Buildi E TYPE OF PERMIT GRAOING FOUNOATION S7RUCTURAL T Front ❑ry� TENANT ❑ ELECTRICAL ❑ PLUMBI G❑ MECHANICAL A q¢af �Lv�OTHER .�%��F'�../yJ��L�� PROJECT DESCRIPTION 5�. FT. OCCUPaNCv C Right K Left CONSTRUCTION TVPE VALUATION $ $ ZONE GRADINGCU.VDS. ACRES PIng.Ref.# rtemarks: � Planning Notes: Bar Sink Backflow Preventer Backflow Irrigation Bathmbs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Kitchen Sink Lavarories P—Trap Roof Drains Reinspaction Fee � $75 Boiler Duct - Under Ground Duct-S[ructural � Duct -_ Ventilating , � � Exhaust System O Multiple ❑ Firepl/Fact.6lt. ICBO # Heating System & Ducting ❑ 0-100,000 BTU O 100,000 BT Reinspection Fee �� $15 WhifE - Builtling; Canary - Applicanq Pink - ACCOUnting; Goltlen�otl - ASSe55or Showers Service Sink Sewer Cap Sewer Connection Solar Collectors $olar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Laundry Trays I�sue Fee Noodor Typel ❑ Canopy Type I I ❑ Refrigeration System �o-i oo,000 aTu ❑ i oo,000 System Repair/Alteration Fire Dampers iiegisters Issue Fee $ 3 FEES � $ 3 5367 G/24/8;� Zone Accessory Building: Parking Req./Provided ELECTRICAL Aummatic Washer Transformer ❑ 15-50 KW Construction PoleSub. ❑ 50+ KW Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator �0-5 KW �5-15 KW Meter LJup to 700 amps Meter ❑over100amps Sub Panel Motors�0-1 HP �1X-8 Inc.Solar �9-15 HP �16-15+ Microwave Pole Light Range ' Sign ; Standing Sections Trash Compactor Fee �$15 � � Issue Fea DEVELOPMENT SERVICES REQUIREMENTS: 2aning Approved By Building Approved By Aoolifatian luued Bv OaO�� TL FEES $ 3 Z O N I N G R E O' M T S SUMMARV OF FEES , � '. BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICP,L $ S� �DU GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ • � � PLAN CHECK 25h $ I' �N��RUCTION AND PLANNING ' �..JL & SPA PROVALS Permit# Date Inspector AppROVALS 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 � 5. Steel Reinforcement , 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnii: - 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, � Undrgrnd. - 70. Structural Floor System - ' - 61. APPROVAL TO DECK i 11. Property Sewer Line & House�Connection •- i�' 62. Backwash & Receptor-Final , -- � � 12. Sewer Cap 63. Heater & Vent-Final � 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.StorageTank OGas ❑Oil 25. Roof Sheathing - � � �� ' ' ' ' ' � 7q: 0've�fiead 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 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. FWALSTRUCTURE&BUILDING � , 48. Special Requirements Completed � � 49. Electric Release to Edison . ,, 50. Gas Release to Southern California Gas Co 51. CERTIFICATEOFOCCUPANCY '. � No. Date � � , � ORANGE COUNTY BUILDING DEPARTMENT 636 Noeh Broadwoy - ' ' SANTA ANA, CALIFORNIA FOR APPLICdFhT TO FILL I.,� qooREss 'N / � +!�'./�I-N-�[�(/��G(A SCHOOL DIST. /J �J �^A•� OR TOWN c.LW-(ec. rU! NEAREST � caoss sr. ,� OWNER � (J�v MAIL t,^ / y] , � ADDRESS 7 � /�Km arr (�,�,7'ii %i?1u-ss.. ��73 -G G S�h��G ARCHITECT OR LIC. ENGINEER NO. ADDRE55 LIC. CONTRACTOR �j��/ NO. ---t '/ nooRess � ' * .[�/C LEGAL LOT �� / '/ ]ESCRIPTION I NO. SJ BLOCK I TRACT �� T (ATTAGH METES & BOUNDSI � X �1��",�! I NO. OF BLDGS. SIZE OF LOT / ff X'�+--� :Y NOW ON LOT E% STING BLDG��'�^^^"1 I F MiOl9 � I ROOMS � SETBACK LINE FROM: %�y/�+�� REAR VARO .�� CENTER OF STREET /Z/ll SIOE YARD 4f / DESCRIPTION OF WORK S �-0" BUILDING � SIZE S EXTERIOR W/ COVERING USE OF NEW BUILDING Fl APPLICATION FOR PERMIT , �� ■�_��. FOR OFFICE USE ONLY RECEIPT NO. PERMIT NO. �. J !i, �Y _`->, � i`"% BUILDING AD�RESS � SCHOOL DIST. OR TOWN NEAREST CRO55 5T. PLAt15 � CORRECTIONS APPROVALS FOUNDATION: 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FORM5.1 APPLIGA710N AND STATE THAT THE ABOVE IS CORRECT UNDER-P AND AGREE TO COMPLV WITH ALL COUNTY ORDINANCES FRAME: FIRE BRACING ANO STATE LAWS REGULATING BUILDING CONSTRUCTION. LATN.INT. //p�/� t SIGNATURE OF! I/ �� ,� LATH, EXT. PERMITTE �y � � PLASTER,INT AUTHOfiIZED AGT. - PLASTER, EXT / N. 1� /� PERMIT FEE E 'J� � �^SONoRY REI VALUATION S �f� � p��N CHECK $ / " � 3' I o I z n z n r i � ' STREET PLOT PLAN Show location and distances from property line and between buildings. •< - � .