HomeMy WebLinkAbout2348 BUNKER HILL WAY - Building PermitsADDflES50FBU1LpNG: �J4t3 tll1NR6K tIJ.J.�I.� WY
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,�noxess: 734$ Bi7NK6R HT.I�I� W\'
COSTA MF.SA,CA 97.6?.6
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MCNIfECT ON FNtlNFEP:
JMN. OH FlMi.'S �OOPE55:
uc. ao.:
UNT:
UNT:
caim�cTarsrvwe STOUT ROOFING INC ( 310 ) 923-6'775
carmucroxswuia�a P O AOX 4 309
�ooxess nOWNF.Y CA uc.xo: 402536
90741 urar:
LICENSED CONTN�CTOHS �ECIAN�TION: I heroby ellkm unEer penely d p u thm I em licenaad urder prwiaiom ol Chepx 9
(commem np wnh Sec1ion 1000� ol Divisun 3 d iM Bumr�ess eM Prdmeion de, tl my loma ia in lull lorce Hm.
cmuc.No.:059377 uacuss: C 39 uc.No.9*}0.536 EXP 10/ 5
Dme: Contratl� � '�fa��
OWNEfi BUILOEN OEC RATIOI : I hereby elfirtn under paneMy d perlury Ihel I em uampt Iran iM Conlredaa Licanee w la ihe
Idbvrvm8 ��� (��on )031.5 Bueiness arW Prdesabne Code: Any ciy a couMy xfiidi repuirae e pormil to mnewct. ar, improve.
demWs�, w ropei e�ry sM1uclure, qia b!a meuerice, e6o reyuiros iM epplireM la euch po�mil lo Rb e eq�d ale�emenl Ihet M w aM
�. i��e w�� m ma aowa�: a ub c�vma. �� �.. Icnev� s lw�,me�re .Mn seao� �aao) a ome� a or �b
Busirieae e�M Rdesabns Godel or Ihei he or she is uemq �Mrehom eM Ihe b�a lor Ihe albgeE exemqian. My videtion M Sedian
)031.5 by eny eppliceni lar e permn aubjMs the epd�� �o a aril perelry d M mae Ihen fxe huMrad dd4n �5500�).
� I, es owner ol lha Oropeny or my empbyeen wuh wegea ea �he'v eole wmpame�ion, will do �he work, end the evucture u nd'mieMed
a oMered lar aele (Section )pal. Bua�wss end Prolessbns Cotle: The Conlretlae Lice�e lew Eaee iat epply lo en owrwr ol pmpeM
who bu1Ea a vnpmvea ihereon, eM x1w dms sud� xak IimeeM or MneC a Mraph ho ar her avm employree, pavidad �he� such
impovemmu ere ea imaMeE « Wared 1« ceb. H, howarer. �M W itliip a inpaanem u.old wnhin om yaer d ownpleiion, Me
owmrbuildar will heva IM burden d qovi�p he a d» d'd m� buiW or impev.e la IM puryma d eabl.
� I, as axmror d the propem/. em extlmvaly conlreaip wilh IioeneeE coMreMae io conrrua Ne prqetl (Seaion ]DII. Bueinma aM
Proleasione Cade: The Conlredwa �anse lew Eoes �wl eppty lo en owmr d qopaM �o buitle a impraves iMrean eM who
conlrecle lor wM prol�a wi�h e mnlreear�e) Iceneed pursueni io the Convnqae Licenae law).
� I em axempt under Sectim. B. 8 P.C..1« thie remon:
P
Dele: On+ier
I da hereby cenity tlu� I em eware d ud uMen�vM ��e requimmenta d Cal/omu Heellh eM SefNy Code Seqiwre 25505, 2553J, ad
2553a, end ihei I«eny tutura buiWi�p rcwpem will / will nd (dreb orw) neeE lo wmply wYh saiE dele mEes eM IM raQuiremeMs br
apermAlormneiruction«modRfetbnhan�MRe u�iiy.lreregemantDiatnd.ResidaniWconmivaionepp4ra�ioneareexamqfromthesa
p��s�a.
Dma: AppicaM:
W OPKEP'S COMPEN5ITON OECLAPATION: I Mreby eiNm under penMy W perjury one d Ne Idbr.irq Eetlersiom:
� heve end xil meinlan e cenilce�e d mnxnl io aell-inwrt la wAars compeneetbn, m pwkeE fa by Sedion 9100 d Ihe labar
Cale, br iM pertorme�we of IM xak Ia whi<h I�is permn ie IeaueE.
� �10V! BII� WI� IIIBIf11BN WOf�(N9� COIIIV��qll 111911I0M.9. B9 RQWIBd q' $BCIC1131U0 O� I�IB �db0! COQB. �Of I�1B pG1�OfT011LM Oi ��18
wark /a whiM ihis pamin ia iaueE. MY wuken' rompensetion imu�arice urtror ud pdiry number ue:
c�,: STATF. EXPIRE.S
rw� N�m�,: 1. 0/ l 9/ 9 5
�rn;s saaro� �e.d �or i» �Weree r rna re�a n ro� o�a n�m.ae aon� Isi r�.�
� I cen'Ay ihet in IM perlamenu d the vroM la xi�kh t�ia permN ie i etl, I n� empoy a�ry penon m enrer eo o to
become nuM� ta �M worken' wmpenaeiion lewa d CelMana. apr Nea M I/¢ W becane to IM xorken'
compenulion OT�Ana �/ Seapn 31y0 d ihe Lebor Cade. I�hdl I hv.'rh py wnJytM qmiaiore. . /
Wem/n0� F�llun (o ax�rl woilr�r�' compuueHon caverpils �n/awNl, antl iMll ub/�ct �n xrrp/oy�r ro cNMryl p�Mp �M
clvll flias up ro ons hwdrM fhouseM tlWlen (S10q000A In aJtl/Hon ro(h� coq ol romps�uefbq demyps u; �&w.e ro. �n
Sxtlon 31W ol Me Le6or COM, lnnrosf, nW ettomey's /w.
CONSTRUCTION LENDINO R6ENC�: I hereby effi�m uMer paneliy d perjiry thm iMn a a mnaivaion Mnding epency M iM
penormar¢e d �ne �k �« wnkh ma pennt is eauee (sea:n ao9l, cb. cl.
LEN�ER'S NAME:
LENOEP'S ADDflE55:
I canity tAel I heva re� Ihia epolcetbn erd mela tl�el iM ebove inipmmion is corted. I eprea �o mnply xvlh dl ary ard aounry oNiriencea
eM swe levn Meimp to WiWvq eonstrudion erd haeeby einhor¢a reprasemetium d �he tlly to entar upon iM ebae.menlianeE P�opery
�����0�p�0��0� DA�ENE BURFORD ��I
(St5i<fi.WP� Whna-BuilEiq85efery;OrearFb:Cenery-AOG���:A�k-Fevenue;GOlEenroFMaeamr
C.T.TY OF COSTA MFSA – BfJif.,DT.NG P.F.2MiT
PERM NQ: A 077.64]
PF,RMIT NO; 8 072641 PLAN CHF.CK Nn: N GQVT: N Sf1pP; N
CONSTRUCTION TYPF,; VN PERMI'C TYPR; STR PORPI>Sf.: nTH
.TOB DF.SCRIPTT.ON ; T/OFF, SHF,ATH 6 RF..ROQF W/CQMP SHINGT,F,S SQ FT: ?.,97.4
Ci�AZM VALUE; 7.,97.4,00 CAT.�C–VAI�UE; 2,924,00 GROTIP OCC; R-3 /
COMMENTS: SMOKF.. DF:TFCTORS RF..QT7IREn PF.R 9]. UHC
*�e��it�*�**�rit*��r**x*x����x�eit�*x**�*x��r�r*x�xx�x*+e*x�**�e�e�»*+e�x���x��+�*xx*�*�c-�r��r�*xx��e
7. O N I N G R F Q 0 T. R 6 M 6 N'C S
S F. T A A C K S
H----------- MAIN BOILDING ---------- --------- ACCESSORY BDILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN ACHT; FT IN LEFT: FT IN RGHT; FT IN
PARKING REO: PROV; PARCEL: 919164$2 ZNE: REF NO;
PLANNING NOTES>.
� ',
�(' jk 7E if IE 3f 3E 7f iE ik i!'k IE ff 1E 3E'1E iF 1E 1f if 7E 1f' �f 3E if 1f 1E if IF'If k it 1E �X� 3f lF �)t dE iI' if if- iE-)E I(-%i4lf iE 1h 1!'k iE *'lE !E lE'lE iF iF if %af' #!E-If 3E 7f i4')f'K�lF iE j(' K'%'1F 3F 3f
D 6 V 3.� L O P M R N'C S R R V T. C F: S R R p O I R F. M F. N T� S
20NING APPROVF,D AY , DA'CE; -,
BUILDING APPRQVF.D BX ; DATF..; -
APPLICATTON TSSOBD AX; ���} ��1..�— DA"TE: �/�j�j(�
it+�ltir�lr*ieit�atttlt�ie**�c�itx�c�c�itit�ltiritit�it #x�e�r�x���**�*��*��x*xx*�*���*��x***�* jr * * x
I�F.GAL�IZATION;N F F. F.. ��S [7 M M A R V STf2I7CTt7RAT, SRGMRNT:Y
HJ.�AG PM'f PLOMHING RT.,F..C'CRTC MBCHANT.0 FiRF. SMT.P/RES GRADING
pBRMIT 54,00 ,SO
SM7P/N()N–RES
PLAN
ISSUE FEE
BU.T.I�DING–DIV–> PERM.T.T ISS[]E P7�AN–CI�F,CK TO'CAT, pp.T,A D(7F;
TOTAI�S----> 54.50 0.00 0,00 54.50 54.50 .00
RF.VENUE DIVT.SION 'PO'CAT,S--> COL�I�ECTF..D: 54.50 OVF;R/SHORT: 00
yT�59p00 P�'��MHT.NG RJ�ECTRIC M.F.CHAN.f.0 FTRR SMTP/Tp�T GRAnT.NG PT,AN–CHECK
i E l E i} iE iE jE iE jf if jE lE 1E �IE �%� i! iE iE iF iP 3! iE 3F iE iE 1E lE iE jE 1E 1E if if 3f JE iE iE k 7f iF 9E If iE iF i4 iE aE iE iE 3E-lE it 3F if �%�E K� iF 1E if � iE if IE �%�F 3f 3E iE �1F j( iE jE iE 1E iE iE 3E 1E �k
/ I N D I V.T. D U A I, F E E N R F. A K D O W N
TVPE QTV D}'. S C R I P T I O N 17NT.T COST Tq'1'Ai, COST
SF.R 297.4 REROOF AV VAT,T7�: RFSZAF.N1'.T.AT, NQ'I,ONF. 1.,00 2,924.00
F.Nn nF FEF.S
JI OOI�3�:2-0�133s23 �"r�T ;4.50
DATE: Qb/US/d` TT{7F: IQ:12
�-'
CONSTRUCT�ON AND PLANNING ' POOL & SPA -
APPRpVALS Permit # � Date Inspector.' APPROVA�LS Permit # Rate lospector
1. Temporary Electrical Service or Pole 52. Pooi & Equipment Locatian .
2. Soil Pipe-Undrgrnd. , i 53. Steel Reinforcemcn: . '
3. Electrical Conduit Utility�Undrgrnii. 54. Forms •
4. Electrical Conduit�Undrgmd. . 55. Electrical Bonding .
� 5.-Sieel Reinforcemeni � 56. Rough Piumbing & Pressure 7est "
' 6. ElecVical UFER Gmd. 57. APPRQVAI TO COVER�GUN�TE
7. Pootings 58. Electrical Conduit�Undrgrnd. �
� 8. Poundation �� 59. Gas Pipe, �7 Undr.grnd., Test
9. Water Pipe-Undrgrnd, . 60. Backwash Lines, P-Trap, O Undrgmd.
' 70. Suucturai Floor System . 61. APPROVAL TO DECK
71. Property Sevaer Line & Ho�se Connection 62. Backwash & Receptor-Final
� 12. Sewer Cap � 63. Heater & Vent•Pinai - � - ��
13. Roof Orains � 64. Plumbing System - Finai
14. Rough Plumbing 65. Electrica!-Final '
1
75. Rough Electrical�Conduit ;` 66. Solar SVstem-Finai � � �
16. Rou9h Electric Wiring � � 67. Fencing & Access Approval '
17. Rough Wiring Sign 68. APPROVEO FOR PIASTERING
18. Rough Electrica6T Bar Ceiling � 69. POOUSPA SYSTEPAS FINAL �
19. Rough Heating & Air Conditior(mg FIRE DEPT. REQUIR�M�NT
20. Rough Factory Fireplace . � ' APPROVALS Permix # �
21. Ducts, in Structure � � • 70: Underground Hydro
22. Ducts, Ventilating � 71. Product Pipin� O Gas ❑ Oil
23. Gas Pipe-Rough & Test • � � - 72. Underground Plush '
24. Roof Framing : � � ' 73. Undergmd.StorageTank OGas ❑Oil
25. Roof Sheathing � !_L�G" ��� 74. Overhead Hyclro .
J
26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Fiashing , - 76. Dry Standpipe
28. Lathing & Siding' �- ' ' ' 77. FIXED SYSTEM FINAL
29. Insulation � •� - � 7$. FIRE PREV. FINAL � �
30. Drywali Nail"tng - ; ' HEALTH DEPT. REQUIREMENT
31. Piaster Bro�vn Coat 79. FINAL INSP[CT.16N
32. Electrical Power MeterFinal '' 80. FOOD GERTIFiCATE ISSUED
33. Final Electric . � � Notes: � - �
34. Final Heating & Air Conditioning ,. � � '
35. Final Gas Pipe-Test . � - �
36. Hood or Canopy � ,
37.'Finai Factory Pireplace
38. Final Plumbing
39. Wate� Service�Fi�al ' .
40. Gas Service-Final � �
i
47. Solar pomesticFinal - � �
42. Backflow Preventer � ' � �
43. Backfiow Irriqation , .
�44. Landscape irrigation System ' " . . -
45. Sound Attenuation .. � � � •
46. Handicap Ragulations � �
47. FINALSTRUCTURE&BUILDING ..` ��� �y6[
4&. FINAL PLANNING
49. Electric Release to Edison �
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY
N0. Oate
AOD��cant to fill in all ipaces exceDt those within heavy borOer lines anE siqn all aPProOriate Oeclarations.
- CITY OP COSTA MESA ONSTRUCTION ERMIT PER NO. TRACT NO. LOT NO. UNIT NU. 525� 2/ I%�8�1 5c�" TI
Project Address
3aao �
P�ppliCant'S Mailing Address •� TVPE OF CONSTRUCTION NEW ADD ALTERATION PAIR
7 ❑ CONVERSION ❑ �EMOLISH ❑ OTHER A p # Zone
Owner's Name Phon
,DESCRIPTION OF WORK/USE.OF BLDG.
Address � — S Main Building: Accessory Building:
E Z
ArchlEng. LicenseNo. TYPEOF.PEHMIT GRAOING ouNDATIO�v STRVCTUR/>L T Front O
.❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL 6 N
Address A Rear
Contracior'S Name Pho �� � OTHER' N
PROJECT DESCRIPTION 5q. F7'. oCCUaANcv K Ri9ht G
Add�¢Ss�mailing) .CONSTRUCTIONTVPE VA�UATION$ g Left R
City License No. _ZpryE� GRADING CU. VDS. ACRES E
LICENSED CONTRACTOR DECLARATION Ping. Ref. # Parking ReqJProvided
Q
I hereby affirm that I am licensetl untlet provisions af Charter 9(commencing Remarks: r Pldnni�g NOtES: M
with section �000) oi �ivision 3 of the Busine55 antl Protessions Cotle, antl T
my license is in ful ntl effect, c ,. S
Licens CI Li ns o.
�Date — ' Signature ,' PLUMeING FEES
WORKERS' COMPENSATION DEGLARATION
1 I hereby affirm that I have a certiticate of consent to self-insure or a certiiicate Bar Sink Showers ELECTRICAL FEES -
� of Workers' Compensation Insurance, or a certitietl copy tnereof (5ection ackflow Preventer Service Sink Auromatic Washer Transformer ❑ 15-50 KW
� 3800, Lab. �^/�� � `�� y�� /Q (�� ❑ 50+KW
\ Policy No. �'J Company �?��c � � Backflpw Irri9ation Sewer Cap Construction PoleSub.
ertifietl copy is hereby furnishetl.
Cer iti o �? filetl with the city /�'{`yy'tli 1 i D�j/ Bathtu6s Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date j ��[S APPlicant (����A�'� �/ - � ,
EXEMPTION FROM WORKERS' GOMPENSATION DECLARATION CI3�iFi¢f5 SOldf COII¢CtO�S' Dishwash¢� M¢Le� ❑Ov2� 100amps
(TM1is section neetl not be complete0 if the permit is for one huntlretl ($100 or �
less). � Dishv✓asher Solar Pipin9 Dryers ❑Gas ❑Electtic Suh Panel
1 certity that in the perto�mance of the work far which this Oe�mit is issuetl I
snail noi employ any person in any manner so as to become subject to t{�e Drinking Fountains SolarTank Fan Motors �0-1 HP 01'/x-8
Worke�s' Compensation Laws o( Califomia.
Date SignaWre � ., �' � Floor Drains . Swimming Pool w/Spa F.A.U. InaSolar 09-15 HP �16-15+
NOTICE: If, atte� makinq this tletlarution, you shoultl become zubject to the —
Workers' COmpensation O�ovislons of the Labor Cotle, you must forthwith - FIpO�SinkS
comply with such provisions o� this pe�mit shall be tleemeC revoketl. U�ipol Fixtu�25 Mic�owdv¢
CONSTRUCTION LEN�ING AGENCV Gd55ervic¢ Outl¢tS WatC�Cl05¢L DeviceBoxes Po12Light
I hereby afFlrm that the�e is a construction lentling agency for the perto�mance
of the work for which tM1is Oermi[ is issuetl (Sectlon 309] Civ. CJ
Lende�'s Name �nterceptors Water Heater � putlets Range
�entler's Atltlress Kitchen Sink Water Service Switches Sign
OWNER BUILDEN DECLARATION
I hereby af�itm that I am ezempt from the Cont�acto�'s License Law to� the LavatO�i¢s AutO-Wash Gd�bdge Di5p0531 Standing Sections
foilowing reason (Section 7031.5 Business antl Protessionai Cotle: Any city or
county which requires a permit to construct, alter, impwve, tlemolish or reoair P—Trap Laundry Trays Generator 065 KW �5-15 KW Trash Compactor
any sVucture, prior to its issuance, alzo requires the applican[ for such permlt
to fiie a si9netl statement tnat ne/she is licensetl oursuant to the provisions ot Roof Drains
the COMractor'S License Law (Chapter 9(commencing with Section ]000) of '
Divlsion 3 of the Business antl Protessions Cotle) or that he/she i5 exempt
therefrom antl [he basis for Ne alleqetl exemption. Any violation of Section �
]031.5 by any appliwnt for a permit subjects the applicant to a civll
�enalty ot not more than five hundretl tlollars ($500). $ 3
LJ 1, as owner of tfte p�operty or my employees with wages a5 [heir sole RBinSpBctian F¢¢ $15 IssuO Fee
tompensation, will tlo the work, antl the slructu�e is not intentled o� of(e�etl ReinSpeCtion F¢B $75 ISSU¢ Pee $ 3
for sale (Section 7044, Business antl Professional Cotle: The Contractor's MECHANICAL FEES
License l.aw tloes not appry to an owne� of a pro0erty who builtls o� improves
thereon, antl who tloes such work hlmself/hersel( or throu9h his or her own DEVELOVMENT SERVICES REQUIREMENTS:
employees, provitletl tha[ such improvements ate not intendetl or offeretl to� BOil2� HOOd O� Typ¢ I ❑ Zpp�n A roved 8 Date
5ale. If, M1owever, tne builainq or improvement is soltl witnin onc year ot com- Canopy Type II ❑ g PP Y
pletion, the owner will have Ihe bu�tlen of proving he/sM1e tlitl not builtl or im- DuCt - Und¢� GrouOd guilding Approved By Date
p�ova to� tM1e purpose of sale). .
❑ I, as owner ot the oroperty, am exUusively contracting with licensetl com �uct-Structural Refrigeration System Appliration Issuad By / Dat
t�actorsto construct the project (Section 7044, Business antl Professions Cotle:
The Contractor's License L.aw tloes mt apply to an owner oi property who Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU SUMMARV OF FEES
builtls or improves thereon, antl who contracts for such pmjects with a con-
tractor(s) license pursuant to the Contractor's �icense Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compenzation insurance shoultl be provitletl to me. PLAN CHECK $ � PERMIT
❑ I am exempt untler Section e. & P. C. /or this reason FirepVFacG BIC ICBO # Fire Dampers P WMBING $ �• i%� ISSUANCE $
oate owner Heating System & Ducting Registers PLqN CHECK 25% $ ENERG� P.C. $
i hereby certify that I have read this appiication and state that the above ❑0.100,OOOBTU 0100,OOOBT ELECTRICAL § GRADING S
information Is correct. I a9ree to comply wifh all city antl county ortlinances
antl sta[e laws relatinq ta builtling con5truction, antl hereby authorize �epre- $ MICR�FILM $
sentatives of this c' o enter on the above-mentionetl property tor PLAN CHECK 50% �
inspection p se MECHANICAL $ TOTAL FEE $
Signature Date / /� �4 F
Drivers' License or 55 � '� Heinspec[ion fee $15 Issue Fee $ 3 PLAN CHECK 25% $
CMh OtlfiS-46, rev, tu/tl4 Wnrte - BWltling; Canary - AppllcanY; Pink - Accountin9: Goltlenrotl - ASsessor
.CONSTRUCTION AND PLANNING POl . SPA
Date Inspector Date Inspector
APPROVALS Permit # APPROVALS Permit #
1t Temporary ElectricBF 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 Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings ' 58. Electrical Conduit-Undrgrndt,'
8. Foundation. �--� 59. Gas Pipe, O Undrgmd., Tesfi�
i i
9. Water Pipe-Undrgrnd�� 60. Backwash Lines, P-Trap, ��ndrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK ''�
11. Property Sewer Line & House Connection 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
78. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS F1NAL
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 0 Gas ❑ Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing .,_. 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry ChemPcal
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 �
i;
2 L�f7' c-oQ2G . t.F�D �
33. Final Electric Notes: �2�1"88
34. FinalHeating&AirConditioning �_ZZ-�57 �m����R� �6 OF '�
35. Final Gas Pipe-Test � " Zp.3 , V.(?G (.,,�. D
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&BUILDWG � ' ' � �.
48. Special Fequirements Completed ,
49. Eleciric Release to Edison .
50. Gas Release to Southern California Gas Co . r
51. CERTIFICATE OF OCCUPANCY . .
No. Date , ,
PN0.IELTAOOPE55: 2'�48 BUNKER H1LL WY
OWNEH'SNAME: `LAVALA, V—RGINIA ELSIE TR
aooeess: 2348 BUNKER H��L WY
� ' COSTA MESA,CA 92626
RBCM/ENGINEEfl: S 4�— 5 9 7 7
AOOflES$:
flEG.NU.:
uxiT: ��7 �� �jTY OF' COS'iA NESA — BUILDTNG PERMIT PERN: NO: N. OSo32'
PERMIT NU; ;^. 056321 PLAh CHECK NO; N GOVT: N SliPP; N
CONSTRUCTION TYI'E: V—N PEkMIT TYPE: MEC PURPOS�: OTH
UNIT:
PEXMITTEE: MCB HEATTNU & ATP. ( 714 ) 639-8781
noosess: g60 N, M.AIN ST
ORANGE CA 92667
�ICENSEO CONTPACTON OECLANATION: I hereGy a�lirm ihai I am licensed unaer pwvkions oi Chaple� 9 �cammencinq wi�� Stttian
7000� ol �ivision 3 0l i�e Business antl Pmlessions Code. an0 mylicense isin lull lorte and elleci.
cirruc.:049406 srnreuc.:568131/��," �`"SS C—��7/0 �� /�,� �
ave: � ^.� y�5 i— sienamre: �efi�.Wtlli'�-/=fV-U—`�'/—u
WONNEHS' COMPENSRiION OELlAl1ATI0N: I nereby affum Uw1 I have a ceniliwte of wnsenl to selLinsure or a certiliwte ai Workers'
Comce�sation Insurance, or a cenilieU caDY �hereof (Seclion JBW. laG. C�.
Paucvxo.:p 600477.9 E%P.ORTE: O1�iSI93
COMPANY: CA S ND EM
❑ Ceriitietl [opy is M1ereOy lurnished. � Cehifie0 coDY /is IileO wit� ihe ciiy Builtlinp Oivisi .
OZR: 2 —�� �� AODIiCani: ` Q/�.Fi1A (� ��__)
EIIEMP710N iflOM WOPKEN$' COMPENSATION OECIAXRT10N: (Tlns seciqn nee0 nol he wmpete0 i� Ure pMmil is �m one hunOreO (5100) a less�.
I t¢rti�y Iha� in I�e petlormanCe aI Ihe work Ior w�ith I�is permii is i55uBG, I Stwll nol ¢mploy any persan in any mann¢r w as �o b¢came
sublecl lo lhe Worker5' Comp¢nsation Laws ol Calilamia.
Oa�e: Signature:
NO710E: II, after making �his tleUaration. you s�ou10 become subject to Ihe Workers Campensation pwvisions ol I�e LaGor
fAUe. y0u must Iofi�with comply wilh suc� O�m'�sions or iNs p¢rmi stWll be Ceemed r¢vOkeO.
CONSTflUCTION LENOINC RGENCY: I �ereby allirm Ihai Inere is a consimction lentlinp agency for Ihe Oerlarmance oi Ihe vrork for
which inis permii is issuetl 15eaion 3W7. Civ. C).
lENOEfl:
aooxess:
OWNEfl BUIL�EP OECtAMTION: I �ereby affirm �ha� I am eeemp� imm Ihe ConVaclors' State License law for t�e followinp reamn
(Section 7037.5 Business anG Pmlessional COGe: Any ciiy al counry whicA requires a permit to construct, alter. impmve. Uemolis4 or
repair any slNtlure. prior to its issuance, also reQuires I�e applicant lor such permil to lile a sipneE statement that he/slle 4license4
pursuam to the Omdsions ol �he Comracmrs' Staie License Law (Chap�er 9lcommenunp with Section 7000) at Division 3 0l �ne Business
an0 Prol¢55ion5 Cotl¢� or Ihal �e/5�¢ is exem0� Ih¢relrom antl lhe OaSiS lor t�e all¢q¢E ¢Memplion. Bny violalion o� Seclian 7031.5 Uy
any apDlicant �or a permit su�lecls IAe applicant Io a aWl penaliy o� noi more Ihan live hundrea Aollars (5500�.
I, as owner of t�e DmDerty or my employees wiih wapes as iheir sole compensation, will Oo the wark, anU the
❑ s�mcWre is not inlenGeG or ollereG for sale (Secuon 70aa, Business anG Professional Coae: The Comractors State License Law
Aoes nol apply to an owner ol a propeny who builEs or improves t�ereon, antl w�o Gaes such work himself/herseli or ihmugh
�is or �¢r own employees, O�oviGeE Ihat Such impmvements are not inlenGetl or ofl¢r¢E fOr Sal¢. II, however t�e builUinA or
imD�ovemenl is saltl within one year of comolelion, ine owner vnll have ihe OurOen of provinq ne/she aid nat EuilA or imD�ove
�or ine pWpose ol salel.
I, as owner ol ihe pmp¢ny. am enclusively wntractin0 �+�� ��cense0 comracmrs �o connmct Ne D�oject (Section 70C4, Business
❑ antl Pmlewions Coae: The Contracmrs' Slate Litenie Law QoeS noi aOPly Io an OwnEr o� D�operly wAo �ullas of impmves lhefean
anA wh0 contracts br such O�ajetl5 vnlh a rAnirac10r�5) licen32 puRudni to ��e ConVactors' $Iai2 LiUnS¢ Law�. I am aware
I�al pwol of I�eir Worker'S Compensation insurance S�aNG Ge O�ovitled ta me.
� 1 am eKempt untler Seclion: B. 8 P. C.
for I�is reason:
Da�e: Ovmec
I do hereby cenity t�al I am aware ol and un0ersiand Ihe requiremenis ol Calilomia HealtA an0 Safe�y Code Seciions 25505, 25537, antl
2553E and �hal I or any fulure buil0ing occupanl wilVwill noi (cir[le on¢) neetl to compty wi�� said sla�e co�es antl ihe reQuiremen�s lor a
perrtul loi cons�mtlion Or mo0ditaii0n Imm ��e Air Oualily ManaOemeni DisVicL R¢SiCenlialtonSlrutiion appliCalions are exem0� ��om
Nese orovisions.
Oa�e: ADDlicant:
I here0y cetlily Ihai I have reatl Ihis appliCaiion ana siate �hal IAe above in�ormation is tarr¢tl. I agr¢e �0 tomply wilh all ciry and tounry
ordinant¢5 anC Slal¢ Iaws relafinp Io �uilEing ton5lmtlion an0 �ereDy auilwnze reDre5enlaiiv¢501 Iks dry Io en�e� Upon lhe aCove-menfiOneG
pmperly tor in5peciion purposes. /'� ` �7
—Uaie: �i ��- `/ �7�— Signature: C�=.l�✓ `SL`-'(/� /!'� 4�-6�6 �
Oriver's License ar Social Security a: *� .�
160Ld6 W�ilo—Bviltlinp; Green—Coae EnbrcemonL Canary—Aoolicant: Pink—Revenu9: Goldonmtl—AFsnsam
JOB DESCRIPTION : CHANGE OUT FURNACE S�,i FT;
CLAIM VALUE: CALC—VALUE; GROUP OCC; R-3 /
COMMENTS: S�;OKE DE:'ECTOR RE�UIRED IN THE HOME
#iFiEiElEiE�i�i(�1E#iEfEiFitiEiF#ifif3fiEiE3FiFle�(�IF iiif��lf�iE#ifjFikiFiEi'riti(•ib3e#iEifaE3F1FIf�liRlEi't�IEaF3'tji��E?f���1E#3eiFiE3FiF�fif-7ciE#ifieiE#f-if1E
7. 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 BUILPING ---------
FRNT; FT TN REAR: rT IN FRNT: rT Itd REAR: FT '11J
LEFT: FT iN RGHT: FT IN LEFT: FT iN RGI-IT: FT IN
FARKING REO• i�ROV; PARCEL: 91916482 ZNE: REF NO:
PLANNiNG N(ST'ES>
1
iF �?f i i41k ih �# if� �le iF ie M� iE k�( 3i� # ic iE 1F iF #` if� it-%� if if if �Y.� if iF iP iF 3(��i( �iF iF if 1f iF iE ff iE 3c #!� k iE-le 1%ii #c iF �IE *�lE ihlE 3f k iE iF !F }} iE �e iF 3i• �%# ii� iE ii-i� 1F ic } fF
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
7,ONING APPROVED BY DATE;
BUILDING APPROVED BY : DATE;
APFiICATION ISSUED BY• I•�• DATE; �,���'L�
aFiEif�ie#iE##�EiE1F1E##af#*k1h1E�1F ie ... iEif?fleiFiEif?i�3iifiF'7F'ir x3FiE
iE �le iE ih 1F # K IF iE iE dk )E IE iE iE iF iE if iE if� # IF # N- k� # iE 3E #�)E 1E # iE ii� iF jf ie �7F ie # iF iE #� ih ir iF# 3F 1E M� IE if i!� iP iF iE le �JF iE il� # i(� �'t iF �lf # IEiF 3£ Y.- iE R 3E iF x IE iF iF M
LEGALI7.ATION:N F E E S U M N, A R Y STRUCTI7RAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHAN_TC FIRE S,'�IP/RES GRADING
PERMIT 9.00
25R SMIP/NON—RES
PLAN
ISSUE FEE 15.00
AUILDING—DIV—> PERMIT ISS(lE PLAN—CHF.CR 1'OTAL PAID DUE
'I'O'CALS----> 9.00 15,00 0,00 24,00 24,00 ,00
REVENOE D7VISION TOTALS--> COLI,ECTEP: 24.00 OVER/S'HORT: ,00
BLDG PMT FLUMBTNG ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
24.00
#-1F ### ih iE IE R� Ik ##�lf ## ie If i(� R if If iF iE 1E H� # i4 if IE # iE iE # iE iE iFle i(� �e ii�iF iE 3f if 3F i�� 3i� i? 1( ii-if iE iE �E iE% 3F iF # 3f iF-lf ii� jF }. iE if i'r 3E iF iF fM1 #� iF iF �f }:� �#
I N D I V T D U A L F E E B R E A K D O W N
TYFE QTY D E 5 C R I P T I O N UNIT COST TOTAL COST
MEC 1 TNST FORC—AIR/GRAV F[IRN <= 100 K BTU 9.00 9.00
END OF FEES
_
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit,$ Date Inspector pppROVALS Permit# Date Inspector
t. Temporary Electrical Service�r Pole ' 52. Pool & Equipment Location .
2. Soil Pipe-Undrgrnd. " 53. Steel Reinforcement •
3. Electrical Conduit UtilitV•Untlrgrnd. 54. Forms
4. Electrical Conduit-Untlrgrnd. 55. Electrical Bonding .
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Etectrical UFER Grnd. 57. APPROVALTO COVEA•GUNITE
7. Footings 58. Electrical Conduit�Undrgrnd.
8. Foundation ' 59. Gas Pipe, � Undrgrnd., Test �
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, I7 Undrqrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final �
12. Sewer Cap 63. Heater & Vent•Final
13. Roof Drains 64. Plumbing SYstem � Final
74. Rough Plumbing � 65. Electrical�Final •
15. Rough Eiectrical-Conduit 66. Solar System-Final
16. Rough Elettric Wiring 67. Fencing & Access ApP�oval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical•T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. flough Factory Fireplace APPROVALS Permit #
21. DuCts, in Structure 70. Underground Hydro
22. Ducts, Ve�tilatinq 77. Product Piping O Gas OOiI
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. Lathin9 & 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 �. S0. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning Z,S/ ���
35. Final Gas Pipe-Test ,
36. Hood or Canopy
37. Final FactorV Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service�Final
47. Sola� Domestic-Final
42. Backflow Preventer
43. Backflow irrigation
44. Landscape Irripation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING ,
48. FINALPLANNING
49. Electric iielease to Edison ,
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
0{9NER gpni VISPA BtJI7,DSN(: COMPANY DATE (_1_�jla.
JOB ADDRESS QQ1{$ �nkPr 1 1 Way BUILDING PEItMIT N0. j2Q18
tE ZONE DESCRIPTION OF WORK T26 W'�tt Q82'
GROUP TR.T TYPE V ZONE R� �
SUBCONT1tACTOR
�a�, �
COSTA MESA BUILDINGSAFETY DEPARTMEPIT
P.O. BO%917 COSTA MHBA, CALIFORHIA
For Applieanf �o Fi11 In Completely
TYPE OR PRINT
COSTA MESA, CALIFORNIA
S
■ e¢TBACK ��NE FROM
� BUILDIN6
,
�� HHHEBY ACK
AND 9TA}Q TF
PLY WITN ALL
BUILOINQ <ON
FEE RECEIVED
,�x Y e a�
rfFINANCE DEPT.
APPLK'A�I� F��TAE�SA
BUIlDING
For Office Usa Only
_ R[C[IITNO. P6PMITNO.
o�reiaaueo
JUN 1 1964
IONINC3
NO.O�/'� U96
�LANO / OU11
A.P.NO. �`�I�� "
�� NOTE: NOEAVEOVERHAN68HALLBB ESBTHAN
90' TO SI�B @ REAR P. L.
HAVES
No.oPBLnoe. � ALLOWED (U.B.C.REOUIREMENT
NOWONIPT ypRDSAPPROVEO YARD9APPROVED
MAIN BUILDIN6 ACCESSORY BUILDING
EFT ( ) I RI6FIT v
DESCRIPTIQN OF WORK
%r � e� t�oe.��N � �� .�.,��,..0
ri �
OS TXAT 1 MAVH RGO Try19 APPLICATION
�BOVH IB COHHECT AND AOqHH TO COM.
lDINANCHB �NO BTAT[ LAWB P[OIILATINO
DISTANGE BET. 9ET. MAIN @ r
MAIN BLD 3. ACGESS. BLD 9. 'z
VAR. # DATH �
G. .P. APPROV/E/O W
APPROV6 ,` /�� � �'
Bl' DATE V �
d
W.
a
�
a
i/ so. Fr. N2o p " w
TXE �MOUNT eHOWN UN�EH VALU�TION 19 POq TXH i�
PIIRP08H OP 88TAB�IBNINO • PBRMIT PE8 ONLY. �
VALUATION �� � m O
PERMIT FEE �
� ll.
/ � m
i Q
$ %38S'.� o 0
/ `
TOTAL FEE $ � � %