HomeMy WebLinkAbout2336 BUNKER HILL WAY - Building Permits��p��B���� !���J Af1NK£.R HII�L WX
avnexsnu�e�v�wam: R.T.VAS, �TOSE
�o�� RIVAS, ROSARLO
7.336 BUNKERHIT,i, WV
COSTA MESA,CA 92626
MVL. WJLWG I�DDFE55:
/ipCNRECTORFNtlNFFA:
ACH.OP EIRi.'S AODRE55:
LIC. NO_
UMT:
UNT:
cor+rn�cTararuMe: STOUT ROOFING INC ( 310 ) 923-6'775
cwrn�cTorcs�uw�o P O AOX 4309
,�ooxess: DOWN.F,Y CA ��,�,; 402536
90241. uxr:
LICENSED COHfPACTOHS DECLARATION: 1 hereEy eRim under penaly rjury Nal I em licmaed uMx pvriaane d Chepx 9
(mmme�winB �h Seciion ]WO) of Diviaion � d �M Buai�u eM PMeae' a C e, eM my licenae ia in full brce aHed.
cmuc.No.:05,9377 _uacuss: C 39 uc. . Q25�6 E . 10/�r5
OWNEN BUILUEA OECL,4RATON: I hareby etfiim uMer pqfielly W perjury IMI I em exemq Irom tM Convenae Liunae w Iw tM
lelbwing reawn (Seaion ]W 1.5 Busviees eM Proleeeime Gode: Any cily a munty wfiich reyuires e parmA lo mneVuct, r, improve.
Eemd'mh, m repei eny Nruc�ure, pia b ib oweMe, ebo repuirm tM epplivni lor auch pamin �o file e apmd eiqement tlw M a ehe
ia licenaed W��1 to tM 0�� a Ihe Coniredan Liceme Law ICheqx 9(canmena�p xilh Satlion ]0001 d Oiviion J d iha
Bueineas end Profeseuns Cade� ar �hu M or ehe is eaemq t�ereham end Ihe becis for IM ellepeE avemption. My vblelun of Saclian
)031.5 by enY eDWiunt tor e parmtl wbjea+the nppl'ram to a dvil perially d rw1 more Ihen (ve huMred dd4es �550011.
� I.esoxiwrd�Mpropenyormyempbyeaewehwepeam�heiadecpnpaneetian,vrilldoihexo�k,andiMeUucNnonUinleMed
or Mered lor eele (Secion ]OC6, Bua�nea eM Prdessiona Coda: TM Conirerlors lironsa Lew doea �at eppy Io en ownerd propeily
wM EuiEe n inprovo iMreon, end xM doea euM wwk IimmX a MeaM a NrouOh he «har oxn mmpbrroe, provided thm eueh
impmvemenb ere ml inlmEeE a dlered lor aeb. X. fwwerer. tM WiNirp a'vnqwemam u edd wnhin me Y� d wmpblian. �M
/ owner-0uiker will heve the buMen M provinp he ar aha did nm build w imD�e Iw Ihe puryroa d eda).
❑ 1. m axmr d �M popeily. em ud�My conlreclip xilh IioenxE wnVslas io conatrua tM qqetl (`�� �. �i�s eM
Prdmaiom COCe: The Conirmon licenx law Eoes ml eppty lo en ovrtbr M qopeily who Wike or imqwro iheroon eM who
?� conVatle la ewh prol�e wilh e mntrenor(n) liceneed Wnuem lo tha Conlredon Licenae Lew�.
� I em exempl uMer Seciion: B. 8 P.G., la �hb reawn:
Dale: Owewr:
I do hereby cMi/y �het I em eware d uM uMenteM the requiiementa d Cdfomu Heellh eM Selery Code Sediaa 25505. 2553J, vk
2553C, end Ihet I a eny iNure buiWiep arwpent vnll / will rwl (drele one) need lo eanON w�h aek elete mAea eM IM repuiremanh br
e permM1 Iw mvlrvelion a moEifre�qnhantM A'r-6Ty .l�e,apa�mnt Diaiia. Rxideruid wnmewion eppiraiiomere examq ImmNse
wo.�.�,..
Dme: ApplicenL
WOAKEA'S COMPENSATION OECL�FATION: I Mretr/ elfi�m uMar penetly ot peQury aro d ihe /dbvnrp Jetluetom:
� I he�a vM xi1 meinlen e cenifrate N ooneant 10 eellimun br wake� oompanwion. m praiJeE far by 5erlim �)OO W tM lebar
Gode, la tM pertame�we d iM wark la which Ihia permG ie uaued.
I heve and wil meintein workaii ewnpeme�bn insurarce. m repuinE by SeUim �)00 d I�e lebor Code. br IM pertormanm M tM
work la which iM1ie partnn is eeueE. MY worl�en' cwnpemmion inwrenca urrier vM pdiry n�m Wr are:
c��: S'CATF F..XPTRF,S
aeiry n�mn�,: l. 0/ 19 / 9 5
(This section rreed rrot be comG�e.1 ]llieG�k is Ia om hunC,eEGdlers�le.n.)
� I cenAy thet in Ihe perloimence d the work (or whbh �M1ie permil ia i eE, shell �at employ vry penon i mennar w es to
�.�,d� w me �e�.� �ro�� m.,. a cdn«„�. eu mm a.nwa n�o� io us
���sd� o�.aaoos m s<a� 3iaa d m. �ee, cad.. �.ndi �..,i on �.f{ � o � . ��/
ro
antl �NII �W/�c! �n smp/oy�rlo crlMn�l6en�lll�� �ntl
M. ewt o/ nmv�iu�tron, tlem�yu u frnNWtl ro.ln
CONSTNUCTON LENDINO �OENCY: I Mreby eifiim wAer penelry o� petlury Ihet �here if e conel�udqn bMinp epency b� �M
�no�� a m<.on ia .n�, me wm,� a o�d �sena, aos�. c;.. c�.
LENOEN'S NAME:
LENDEH'S ADDflESS:
I cerliy tl�el I have reed Ihia epplcetim end sfele �I�e� the ebove iniwmetim is co�ree. l epree lo compy wnh ell aiy uM county ordirencaa
eM e�e lewa rNe�inB �o WiW' conalrudion ard hereby autMr¢e repreaentetives W Ihia dly b anler upon Ihe above�meniioned pio, e�ly
taimDedbnW�Wxa. �. .+...+ ....e�r..�r�e�.� A
(5�St-K.WP) Whne-Buikvp 8 Selery: GreerFie: Cenery-AOP�^�� Rnk-Pevenue: Goldenmd-Avan.w �
CTTY OF COSTA ME.SA — BUT.T,p.T.NG PF.RMIT
pF,HM Nn: B 072635
PHRM.T.T NO: R 077.635 PLAN CHF.CK NO: N GOV'C: N Sf)PP: N
CONSTRUCTION TYPF: VN PF.RMIT TYPF.: S'CR PIIRPqSE; OTN
,70A DESCR.T.PTION ;'C/bFF, SHfiATH & kEROOF W/COMP SHINGT,RS SQ F'P; 2,924
CT.�ASM VAL,OF.; 7.,97.4,00 CAL�C—VAI,UE; 7.,924.00 GROUP OCC: R-3 /
CQMMENTS: SMOKF.. DETF.CTORS RRQ�7.T.RED PBR 91 UAC
�����r��r�r**��e�x x*��r*��r�x��e�r��e�e�r�r****���r-xx*x�� �r��c x��x�z��#***�c�c�**�r�e**x��r��*��c���r��x*�rt*
7. Q N I N G R E Q f7 T. R R M F. N T S
S F T Fi A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FiR NT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REO: PROV: PARCEL: 41916476 ZNE: REF NO:
PLANNING NOTES>'
i
if IF if'k )E iF'k if iElE �%if iE'1F'If jE fE �]f iF ff iE'1E �IE dE �E'1E'If 1E ff 7E iF ik �lE 1F if%1f if',Elf i41f jF �FiE if )f iE iE lE iE lE 3F iF � iE #!k iE # 1(' iE'7E i(� � X IE # IF 3P 7F * jE iE IE #�)E if iE
1� 6 V F. I� n P M E N T S E R V L C E S R F.. � i) .T. R F M F: N T Si
7.ONTNG APPROVEA� BY . DATE: '
BUII,DZNG APPROVED AY ; DATF; /
APPT,ICATION ISSOF_D AY: DATE; �,�///j// �/J�J-(j�
3EiE'M1EIEjE3E7E9FiFiEif�7E7F�k')I"lEiElFiEiE9EihjfiFlEifiE'If jti4ifihifif3FiF�lhi('1f#�IEjfiElfiFIFX�3P7F��%�7FiFiE1f3E34iE36#�% 1f7E N�IF`i6�K�iE
I�FGALI7,ATT.ON:N F E S O M M A R V STRUCTfJRA?, SE �MF,NT: V
BI�DG PMT PT.,TIMAING FI,FCTRIC MECHANIC F:f.RE SMT.P/RES GRADiNG
pFRMIT 54,00 .SQ
SMiP/NnN—RF.S
PLAN
ISSUE FEE
AUTZ,DING—DiV—> PERMZT ISSUF. P7�AN—CHF.CK TO'CAT, pAT.n DUE
TOTAL.S---> 54 . 50 0. OQ 0. 00 54 , 50 54 . SO , 00
RF.VF..NOF', DIViSION 'COTAI,S--> COI,I�F.CTF..O; 54.50 OVF.R/SHORT: ,00
HI�DG PMT PLOMHING BI�ECTR7C MECHANIC FiRF. SM.T.P/TO'C GRAD:LNG P7,AN—CHFCK
59,00 ,SO
I*at******at***�r��**�t�c*K�t*at*��t*�rat3t��r�t�*x*�t*�t****-�*�w*�c+t�**�c+a�t**�t��t*�tit*�t*�t�t#x�**���t�t*�t
I N A.T. V I D U A L F E F. H R F A K D O W N
T�(PE QTY D F S C R I P T I O N UNIT CnST TQ'CAL COST
SFR 2924 REROOF BY VAI,UF. RF..SiA6NTIAT� Nn7,ONE i, 00 2, 929 .00
FND OP FF.ES
2! 041E34 dQ--0013341 Z T+J �f 54.50
UATE: U6/Q5lS` TZ15E: iD:03
/�
CONSTRUCTIpN AND PLANNING - . � PQOI & SPA ..,
l d t•.��
Date F� irispector - Date Inspec2or �
�APPROVALS Permit # , APPROVAIS Permit #
i. Temporary Eiectrical Se�vice or Pohe 52. Pool & Equipment Location �
2. Soii Pipe�Undrgrnd. �- � 53. Sieel Reinforcement ,. •
, 3. Electrical Conduit UtilitY�Undrgmd. 54. forms �
4. Electrical Conduit-Undrgmd. � 55. Electrical Bonding � I
5. $teel Reinforcement 56. Rough Piumbing & Pressure Test �
i
6. Electricai UFER Gmd. 57. APPROVAL TO COVER�GUNITE �
i
7. ,footings �. 58. Electricai Conduit-Undrgmd. �
S. Foundation � - 59. Gas Pipe, O Undrgrnd., Test� •
9. Water Pipe-Undrgrnd. ,, 60. Backwash �ines, P�Trap, O Urdrgmd. ,
10_ Structural Ploor Svstem � 61. APPROVAL TO-DECK
17. Property Sewer �ine & House Connectio� 62. Backwash & Receptor�Fin`al
�
72 Sewer Cap � 63. Heater & Vent-Final �
13. Roof Drains 64. Piumbing Sysxem - Final ''
I
14. Rough Plumbing . 65. Electrical-Pinal � �,
15. Rough Electrical�Co�duit 66. Solar SVstem-Finai '
76. Rou9h ElectricLViring 67. Fencing & Access Approval
iJ. Rough Wiring Sign ' 68. APPftOVED FOR PLASTERING
18. Rough Electrica6T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREIVIENT
20. Rough Factory FirepiaCe '�� i , APPROVAL$ �' Permit # ' �
21. Ducts, in Struciure ' ` 70: Underground HYdro �
22. Ducts,Ventilating ' . 71. Product.PipingOGas ❑Oii
23. Gas Pipe-Aough & Test 72. Underground Flush
24. Roof Framing ' . ;, 73. Undergmd. Storage Tank O Gas ❑ 011
25. Roof Sheathing �j ��(-R�j` �(�6L 74. Overhead HYdro �
26. T�Bar Ceiling iStructura�i & Monocoat 75. Dry Chemical � ��
27. Frame and Fiashing �,. . 76. Dry Standpipe
28. Lathing & Siding� '-� � � 77. PIXED SYSTEM FINAL
29. Insulation � �• �� � 78. FIRE PREV. FINAL ' �
30. Drywall.Nailing � HEALTH DEPT, REQUIRER4ENT
31. Ptaster Brown Coat - 79. FINAL'INSPECTION
32. Electricai Power Meterfi�al ' �_ 80. FOOD CERTIFICATE fSSUED
33. Finai Electric�. Notes:
34. Final He;ting & 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-Pinal � � �
47. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irriqation, .. � .
� 44. Landscape Irrigation System " - � �� � .
45. Sound Attenuation � .
46. Handicap Regulations -
47. FINAL STRUCTURE !� BUILDING l 1,��.r ,
48. FINALPLANNING
49.'Electric flelease to Edison
50. Gas Release to Southem California Gas Co .
51. CERTIFiCATE OF OCCUPANCY
No. Date _
�
�nonEuaem�ar�c: Z336 BUNKER HILL WY uxr:
an*+EaswuEiFaawx:RIVAS, JOSE
�o�u RIVAS ROSARIO
2336 �UNKERHILL WY
OSTA MESA,CA 92626(714)540-6479
�rai. Ymuxc �ooxess:
AflCNRECTOX�NEFX:
i11CN. ON ENfI.'S AUUNES:
uc. wo.:
UNT:
cartn�crarsru�:GEORG6 HRAZIL PLUMHING ( 714 ) 535-7905
carx�croas�uuw 3022 N. HESPERIAN WY
moness:SANTA ANA CA ucra.: 622214
927U6 u�r: 1Q1
IJCENSED COMPRCTOqS OECLANR�ON: I Mreby eflim uMx pewYy q perjuy tlrel I am IrenaaE uMm pm�iaima d Cheqer 9
(mmme�w'q wnh SeeYon ]000) d pivis�m � d iM Busie�eas aM Prdeseiony CoEe, erd my I're�ae ia in 1�II foree eM ellxa.
cmuc.no.: 6 5'q68 uc.cuss:C-36 ���c.+"Go.:..62/2��^21/�4/�� EXP: 08/98
Deta: � ! ConUeaa: �-l+--ViLyY- (7/(y{ y�L
OW NEfl BUILUEN DECLIFATION: I hn�eby eifirm under peneYy d perjury Ihet I em exemq irom ihe ComMon Lioeree lew lor Ihe
-'bwin9 reeson (Sedion )031.5 Bueiwee enE Pro/xsions Code: Any cty or munly whM iequiree e permil to mnnruq, eM1m, imprwe,
iolivh, a repei eny at�unura, prnr ta ns vauence, elso reQuirea �he eppliran� br such peimn �o fib e eqnaC eletemenl ihm he a eM
�enxd w���,� m me ao.;a�. a ma com,ae«a ucaose �ew Icnew� e lon,�ma�m wnn saao� �000l a a.u� a a�b
)OJ1�a eritl Prdessiona Cotle� or uw M a s�e c eaemp thaelmn enE IM Eas'v la Na ellepeE examqion. My violetion ol Setlion
5 Ey enY eVW�t la e partnn wbjeee tha epplira�t to a dvY penely d ml maa then liva hurMmJ Edlen 13�1)�
❑ i.�ow„a.ainerownr«mv«�dm�,,.n.�.,,ma:.dew���nm�.�;uaoma�.�eub�,�..e„am�a�eae
«oneree w seb lsenion �ou. ew�rox e�a rwmsimscada: me com.moreuoen:e �aweoea m� epWr�o ��».d nooaM
who Wlda a inqovea IM1ereon, end � doea auch x«k Nmsetl a Miae! or Ihraph h'a a her oxn empbyeas, provkeE �het wM
impovameMe ara not iniaMeE n d�eied �a sale. tl, howa�er, �he EuiNi�p w mqovemani is add wnhin me yeer d compblion, the
owerer-0uiNer will have �ha WNm d pranng M or she Ek rw� buik w improve Iw the puryoea d eale�.
� I. ea owner d ihe papeny. em eRdueiveH �Ired'm9 �h IicenaeE convecron W conaWp IM pol� (`�� )�. Bueinma eM
Pmleeeiona Cade: TM Contrepon �ense Law doas m� eppy lo en owror d qopaily vAw WiNe w impovec iheraon uM wlw
conirecb iw such prol�e wilh e a��eaor(s) I'censed punuenl lo Ihe ComreMn Licensa lew).
❑ I em exemq under Senion: B, d P C., br Ihie neeon:
Deie: Owner:
I do Mreby cenity tFiet I em awere d vM unAersierM Hre rx�uiremenb d Celiamu Fbellh erd Sefey Code Seqiom 255p5, 255�3, end
2553a, eM ihet 1 a eny luture Wikirp o�+pem xi�l / wdl nd (drele one) mad to mmply xvh aeid Ye�e oodes eM ihe repuiremame tor
eParmnlac«umictionumodifrationhd��twAi e�y aaOe��Datnd.fieaidentelwMiutlioneWF'�iomusexemqimmNme
pamian.
Dete' APd�:
WONKEH'S COMPENSATION DECL�F�T�ON: I hereby alfirm uMx peneMy ol perjury me d iM1e bllowiip detlermorm:
❑ I heve end xiA mantan e cenJictle d coneent lo aeM-inwre hr xaken' aompenwion, m povitleE lor by Seaion 3)00 d �he lebor
Coda, ta IM pallortnenca ol ihe xark Iw wMch �his parmit ie iasued.
�i ne� �e me mdm�:, �n�n �omre���, ��s���. ��w�u<e er sm�, aiao d me �m, coae. i« ina wno,m�� d me
wwk Iw whicM1 ihie permX is ipueE, My wakere' cwnpensa�ion inaurence caniar e�M pdiry number ere:
c�a.: STATE FUND EXPIRES
Pdicy Number: 4 f� � O'I —�l H O 1/ O S/ 9 9
'�...,s s«r� �e.e �or ea �obrea r ma ro�. � ro. � n��e�e dd�.,, Ricn/ w�.�
❑ I cMly Nm in iM pMormaMe d Ihe wak lor whch thia parmn ia iauetl. I ahaA rw� empby erry penon in eiry manr�x so es Io
n«ome eubjea �o �na wonan� mmw�� mwe d cetitamu. ene ro,� mm i� ��nww exome wdm iu �ne .wh .�
COT[IBIIS I plp �9k1f18 O/ $BCiqfl 31C0 O� ��IB �dbOf i�iOjB� � 9�18�� �M mlll � /4�1�1/0r PIONfIOIIH.
Data: � Applcenl: / ' Y'�
WeminO: Fellun ro ascun worksri co�qM�etlen rovwsys Is unl�wlu{ siW �M1 II sub/ecr en smpleyx ro cilmml perwlMx ene
clvll flMa up ro ons hundrsr/ fhouurd �lera (5/00,000). M atldltlon ro Ms caf o/ compenutbn, demepu u pov/dW br /n
SxHon 3106 0/ Ms Lebor COW, InferM4 end ettomsya /sew
CONSTNUCTION LENDINO A�ENCY: I MrebY �� uMer pereM1y d parNy thm �here ia e mnst�ud'wn IeMiip epezy la tM
perlormeMe M ihe �wrlc Ia whidi ine pe�� is'sauM (Saeun 309], Crv. C).
LENDER'S NRME:
LENOEp'S AODNE55:
I cenily ihel I hew reaE Nv epplceiion e�A deb IM1aI �he abova iMorme�ion i� corree. I prae ia canply xilh ell rny erd ooumy adiriv�a
e�M s�ata lewa ralel'rg la W ikvp conelruq� end hereby ei�hwixe repreaeNslivea W this dly lo enlar upon IM ebwa-men�oneE poperly
lorinspection purposea.
RICHARD LEWIS
�� ��mt Nema �1
oe�e: !
eluro d OwnOr/AppnVAOPlicenVGonlraclw
(5151<B.WP) Whne-Builtliq b Selery: GreerFle: Cenery-pppicen�; p�M-Rewnue; (ioldenm�Asxeaor
CITY OF COSTA MESA - bUILDING PERMIT
PERMIT NO: P 087652 PLAN CHECI: NO:
CONSTRUCTSON TYPE: V-N PERMIT TYPE: PLU
JOB DESCRIPTION : INSTALL NEW 40 GAL WATER HEATER
CLAIM VALUE;
CALC-VALUE:
�
' � --poZ6
PERM NO: P 08765"l
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT:
GROUP OCC: R-3 /
COMMENTS: REPLACE WATER HEATER ONLY
*�t�t�e***�***��*��r��e�**�r�r**�*�r�*+�����*�r*�*�r*�r*���r���r*��t�r**�r**���*�r*� �r**�***�r*�r*��
Z O N I N G R E Q U Z R E M E N T S
S E T B 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
PARKZNG REQ: PROV: PARCEL: 91916476 ZNE: REF NO:
PLANNING NOTES>
i
���**�*+�*�**��***�**+�***+�+�*����***��*+�*���***���**+r*�+����x***�*��**���**�*�**�rx
D E V E L O P M E N T 5 E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY .
BUILDING APPROVED BY :
APPLICATION ISSUED BY: �i� � /
iEaf-1EjEiElEit1E�E�1E�1EiFfFikifiEiF3kdfiEjf3E iE iEi[- �IE : Ff F F k F . E E1 F
LEGALIZATION;N F E E S U M M R Y
BLDG PMT PLUMHING ELECTRIC MECHANIC
PERMIT 11.00
25�
DATE:
DATE:
DATE: L — p
�*�x-******* e�r� e#"i�1�F�t�
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON-RES
PLAN
IS5UE FEE 22.00
bUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 11.OU 22.00 0.00 33.00 33.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 33.00 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
33.00
* iE aF jE iE iE iE iE iE iF iE i' it 3E If iE iE 9E jF 3E if �c iE iE if if iF df !t if iE iF �E jE �E jE iP 1E �F iE jE � aE iE iE if iE iF iE jF iE 3F jf iE iE iE %3E �E iE jElE iE iE 3F �F �lE 3F 3E iE 1E �E-)F �ElE if i4 iF 3E
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 1 WATER HEATER AND/OR VENT 11.00 11.00
END OF FEES
04-09-1938/12:28 F'N/833.�'9
kCRTH:Fil-2022167
�'EkMIT:08765�
CONSTRUCTION AND PLANNING POOi °: SPA
APPROVALS Permit # Date Inspector pppROVALS . .�it # Date Inspector
t. Temporary Electrical Service or Pole 52. Pool & Equipment Location, � '
2. Soil Pipe-Undrgrnd. � � 53. Steel fieinforcement ,. �
3. Electrical Conduit Utility-Undrgmd. 54. Forms - •�
4. E�ectrical ConduioUndr9rnd. 55. Electrical Bonding
5. Steei Reinforcement 56. Rough Plumbing & Pressure Test
6. Eiectrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58.� Electrical Conduit�Undrgrnd. �
8. Foundation 59. Gas Pipe, O Undrgmd., Test
9. Water Pipe-Undrgmd. 60. Backwash Lines, P�Trap, � Undrgmd.
10. Sttuctural Floor Svstam 67. APPROVAL TO DECK �
7 t. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Finai '
73. Foof Drains 64. Plumbing SYstem - Final '
14. ftough Plumbing 65. Electrical•Final
15. Rough Electrical•Conduit 66. Solar System�Finai .
16. Rough E�ectric Wiring 67. Fencing & Access ApProval '
17. Rough Wiring Siyn 68. APPROVED FOR PLASTERING �
18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. ftEQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit,$
21. Ducts, in Structure � 70. Underground Hydro
22. Qucts, Ventilating 77. Product Piping CI Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing - 73. Undergrnd.StorageTank OGas ❑Oii .
25. Roof Sheathing , ]4. Overhead Hydro
26. T-Bar Ceiling (Structurel) & Monocoat 75. Ory Chemical
27. Frame and Flashing 76. Ory Standpipe �
28. Lathing & Siding 77. FIXED SYS7EM FiNAL
29. Insu�ation . 78. FIRE PREV. FINAL
30. Dryevall Nailing HEAITH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final • 80. FQOO CERTIFICATE ISSUED
33. Finai Electric Notes:
34. Fi�al Heating & Air Conditioning
35. Fi�al Gas Pipe•Test
36. Hood or Canopy �
37. Final Factory Fireplace .
38. Final Plumbing �-�.q n/ .
39. Water Service�Finai . .
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backf�ow irrigation
44. 1_andscape Irrigation System
' 45. Sound Attenuation ��
� 46. Handicap Regulations
�� 47. FiNAL STRUCTURE & BUIIDING
� � 48. FINAL P�ANNING
49. Electric Release to Edison
5Q. Gas Release to Southern California Gas Co
51. CERTIFICATE OP OCGUPANCY
No� Date
�
�� �
AOOlicant to fill in all spaces ezceDt those wit�in heavy Cortler lines anE sign all app�opriate Ceclarations. ��` �/�,/��%
� < � i� Ja
CIT�70FCOSTAMESA CON TRU TION P�IMIT PERMIT �,,�„� TRACTNO. LOTNO. UNITNO. J �
� Z
�
' Preject Address
Applicant's Maili Address �
�7
Owner's Name ����� �}. �// Phon �
Address �u.(Cf'�� �
Arch/Eng. License No.
Address /
Contracror's Na e � �c�{,,`� _Phone �
Addresslme'I"nal ��� i7��
City Licenae No � �� �
�ICENSED CONTRACTOR DECLARATION
I hereby aftirm that I am licensetl untler provi5ions of Charte� 9(tommencinq
with Section ]000) of Divislon 3 of the Busine55 antl Professions Cotle, antl
' my license is i�ntl effect. � �
� Licenze af Uce e o.
� Date Signature
\ WORKERS'COMPENSATION DECLARAT�ON
� I nereby aHirm that I nave a ceriiticate of consent to selt-insure or a certificate
` of Workers' Co/m�/peyncsa�tijo�n/ 1Insurance, or a certifietl �co7p�y thereof (Section
3800. Lab. �/ U/)N'//l� .ON� �i'� .
Policy No. yT,_�T�_o_o— Company
erHtietl copy is hereby furnisbetl.
Cer(if,ioQ�qqy i�f�etl witn the city Baptly�]�,QiyjSiqT.//e_ l
Date // ri�r/ rn APPlicant�o��'���(ol f' //l�/9� ,
EXEMPTION FROM WORKERS' COMPENSATION DECLHRATION
(Thissection neetl not be rompletetl if the pe�mit is for One huntlretl ($300) or
less).
1 certity thal in Ihe performance of the work�fo� which Ihis perm�t is issuetl, I
shall not emplay any pe�son in any manne� so as [o become subject to the
Workers' Compensation Laws of California.
Date Signature
NOTICE: If, after making this tleclaration, you shoultl become subject to the
Wo�ke�s' Compensation provi5ion5 ot the Labot Cotle, you muzt fo�thwith
comply with suth provisions ot this permit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
1 he�eby aftirm that the�e is a const�uction lentling a9en[y fo� the perto�mance
of the wark 'for which this permit is issuetl� (Section 309] Civ. C.)
Lentler's Name
Lentler's AtlrJress �
OWNER BUILDER OECLARATION
I hereby affi�m that 1 am exempt trom the Cont�aclor'S License law to� tne
followinq reason (Section 7031.5 Buziness antl Profe5si0nal Cotle: Any cily or
counly whi[h requi�es a perml[ to const�uct, al[er, improve, tlemolish or repai�
any Structure, p�ro� [o its issuance, also requires the aDO��cant for such Oe�mit
to tile a siqnetl Statement tha( he/she is licensetl pur5udnt to the provision5 of
tne Contractor's License Law (Cbapter 9(commencinq with Section �000) of
Division-3 of the Business antl Professions Code) or tM1at he/she is exempt
, theretrom antl the basis for the allegetl exemption. Any violation ot Section
7031.5 by any appllcant fo� a permit subjects the applicant to .a civil
� penalty of not more than five huntlretl tlollars ($500). �
❑ I, as�owner ot tM1e:property o� my employees with wages as their sola
com0ensation, will tlo'the work, antl the structu�e is not intentletl or oife�etl
tor sale (Section ]044, Business antl Prote55iondl Cotle: The Contractor's
License Law tloesmot appty to an owner of a property who builtls or improves
thereon, ana wno tloes such work himself/herself,or thraugh his or her own
¢mployees, p�ovitletl that such improvemen[s a�e no[ intentletl or offeretl fo�
sale. It, however,_the builtling'or improvement is soltl within one year of com-
pletion, the owner will have the burtlen of proving ne/she tlid not builtl or im-
p�ova for the purpose of sale).
❑ 1, as owne� of the property, am exclusivety cont�acting with licensetl con-
tractorsto wnstruct the project (Section ]044, Business antl Prolessions Cotle:
The Contracror's �icense Law tloes not appty to an owner of property who
builtls or improves thereon, and who contracts for such projects witn a con-
tractor(5) license pu�suant to the Contractor's License LawJ. I am aware that
proof of their Worker� Compen5ation insurance shoultl be provitletl to me.
❑ 1 am exemDt untler Section B. & P. C. to� this reason
Date � Owner
'I hereby certi(y that I have reatl this application antl state that the above
information is correct. I agree to comPry with all city antl county ortlinances
antl state laws relating fo builtling cons[ruction, antl he�eby autho�iie repre-
sentatives o/ this- city to eAter u000 ine above-menlionea property for
I Drivers' License or 55 � .�
CMF 0865-46, rev. 10/84 White
TYPE OF CONSTRUCTION IJ NEW IJ ADD LJ ALTERATION � REPAI R '
❑ CONVERSION ❑ DEMOLISH ❑ OTHER � A P #
DESCRIPTION OF WORK/USE OF BLDG.
. � S Main Building:
TVPE OF PERMIT GRADING C�.FOUNDATION ❑ STRUCTURAL T Front
'O OTHERT ❑ ELECTRICAL ��"PLUMBING ❑ MECHANICAL A Rear
PROJECT DESCRIPTION 5[]. FT. ' oCCUPANCY C Right
K Left
CONSTRUCTIONTVPE VALUATION$ $
ZONE GRADING CU. VDS. ACRES Ping. Ref. #
Remarks: • � Planning N'otes:
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers '
Dishuvasher '
Drinking Fountains
Floor Orains
Floor Sinks
GasService ' Outlets
Kitchen Sink .
Lavatories
P—Trap
Roof Drains
ReinspeMio� Fee ;� $15
Boiler
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
FirepVFact, BIL ICBO #
Heating System & Ducting
❑0.100,000 BTU � 100,000 BT
Reinspection Fee
Canary - Applicanh Pink - Accounting; Goltlenrod - Assessor
$15
Showers
Service Sink
Sewef Cap _
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet �
Water Heater
Water Service ' '
AUlO-Wd5I1
Laundry Travs
Issue Fee
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑0�100,OOOBTU ❑100,000
System Repair/AI[eration-
Fire Dampers
Registers
Issue Fee
FEES
Automatic Washer '
Construction Pole Su6.
' ' Cooking Unit �
D ishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures ,
' Device Bozes �
Outlets
Switches -
Garbage Dispoui
Generator 00.5 KW �5-15
8226 12/04/66
Zone
Accessory Buildinq:
ELECTRICAL - �
Transformer O 75-50KW
❑ SO+KW
Meter LJup to 100 amps
Meter � �over 100 amps
Sub Panel
Momrs O47 HP O1'/: - 8�
Inc.Solar 09-15 HP �16-15+
Microwave
Pole Light ' �
Range
Sign
Standing Sections
Trash Compacior
5.00 TL
F E'
2
O
N
I
N
G
R
E
Q
M
T
S
$ 3 i ,
Reinspeciidn Fee $15 Issue Fee '$ 3
FEES
DEVELOPMENTSERVICESREQUIREMENTS: �
Zaning Approved By Date
Building Approved 8y /� Date—,__��._
Applintion lauad By / � Date 2� �� ��O
SUMMARV OF FEES -
. BUILDING PERMIT $ SMIP , $ �
PLAN.CHECK $ "�� PERMIT '
PLUMBING $ _�_� �SL ISSUANCE $ '
PLAN CHECK 25% $ ENERGV P.C. S
, ELECTRICAL $ GRADING � $
- PLAN CHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $ ���
$ 3 PLAN CHECK 25% $ � �
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit # Date Inspector qppROVALS .iit # Date Inspector
7. 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�
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER;G,UNITE
7. Footings 58. Electrical ConduiriUndrgr4nd,.
>
8. Foundation 59. Gas Pipe, O Undrgrnd., fi�st
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, C57.Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK ;},}
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final i
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 8ar 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. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structurap & 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: J-;Z�_�l -�/.�y�� /ySPeG��. ! C.�l'i�e'
34. Final Heating & Air Conditioning �_3��� � --f� �
�/
35. Final Gas Pipe-Test � I
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
57. CERTIFICATE OF OCCUPANCY � _
No. Date �
�-
JOB ADDRESS
BUILDING PERMIT N0.
GROUP I&J TYPE
SUBCONTRACfOR
� ����2
COSTA MESA BUILDING-SAFEfY DEPARTMENT
P. O. BO% 919 COS`�p MBBA. CALIPONNIA '
For Applicant to Fill In Completely
TYPE OF2 PRINT
COSTA MESA, CALIFORNIA
o�..-. �1�'a �1.�-U�CQa �
��� S�'tq s�
TEL. �
n NO.
, /R"a�V'� TEL.
RY N .
'�{ 3Z IJ.�:.._�x$o n'`'"C
R So�.� l� �'t�, t�� (
f 1_ I_ � L^ C' Z�i G�'
STATE
LIG. NO. Zi•
SIZE
OF LOT
USE OF
EXISTIN6 BLD6.
6ETBACK IINE PROM
DESCRIPTION OF WORK
). OP
JOM9 v�!
pOOF
J
� HEHEBY ACKNOWLEDOE THAT 1 HAVE PGD TN18 APPLICATION
AHD BTATE T E ABOVH 18 COqqECT AND AOqEH TO COM•
PLY WITH A1.L CIT OHDINANCHe AND BT�T[ LAWB qeOUTATINa
BUILDIN� CO TRU ION.
SIGNATUREOF . . , . _ . .. r t � _
FEE RECEII�ED
�NNY 1 8 1�R
fINANCE DEPT.
pC1�it9Nc�OST� M€�rc
BUILDING
For Ofiica Use Only
NO.
ZONING
NO.OF UB80F
runa em�nv
.NO. �' "
fE: NOHAVEOVERHAN68HALL LE89THAN �
' TO SIDE 8 REAR P. L
'E6
.OWED �U. B. C. REQUIREMENT
YARDSAPPROVED YARDSAPPROVED
MAINBUILDING ACCESSORYBUILDING
tOMGLBTREET� ��
_
�
VAR. SF
�1 �.3fop sc. Fr.
TXE �MOUNT BHOWI
PUflP09E OF 88TA1
VALUATION
$ ��3s-
Fr. �V
BET. MAIN @ z'
ACCESS. BLDG9. �y;
DATE W
APPROVED (e
DATE � I J � 6 p
li
C
..7
�
�� �, o LLl
a
I VAWATION 19 POq THE F N
� A PEFMIT FEH ONLY. p �
AIT FEE S ��� � O
J
'/ m
� cHecK S o� �` � F '�
4 � _ �7 % � �