HomeMy WebLinkAbout3278 CALIFORNIA ST - Building Permits�
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.Ga.uSCTRICAL PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
CLt
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
3278 CALIFORNIA ST
13905220
Applicant: BETTIS, RAY
Address: 3278 CALIFORNIA ST
, Phone: 774-327-0697
COSTA MESA, CA Zip: 92626-2204
Owner, ' LOMBARD, SHARON AND BETTIS, RAY
Address. . 8278 CALIFORNIA ST � '
- � � � Phone: 714327-0697
- COSTA MESA, CA Zip: 92626-2204
Contrector:
Address:
ISSUE�FEE .
Temp service Jest
Res. a/c package
_ New Res (1-2 units)
New Res (3+units)
Pool / Spa , , .
Lighting FixGs
' Recept Outlets �
Switches
Non Res Appl � �
Res Appl
Service to 200a `
Service to 1000a
Service over 1000a �
Motors to 1hp �
Motors to 10hp
Motors to SOhp
Motors to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
OWNER BUILDER
Phone:
Zip:
License: 000000
SCOPE OF PERMIT
SERVICE UPGRADE TO A25 AMP. �' �- ,
$23.50
$0.00
$0.00
so.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$30.50
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
0
0
0
0
0
0
�0
0
1
0
0
0
0
0
0
0
0
0
0
Status: ISSUED
Applied: 11/13/2003
Issued: 11/13/2003
ISSUED BY: v
�
EX�'�ED
., W�►".�\`•
e
FEE SUMMARY
_ ' � � " _ - Quantity .
. Temp Dist System / Lighting $0.00 0 .��
Busway /100 ft $0.00 0 �
Standing Section $0.00 0 r � �
Misc ElecMcal Equipment $0.00 0',,
Transformers up to 1 kva/kw $0.00 �0 � `
�' .....�:.........up to 10 kva/kw $0.00 0 j ,
":.: �': . .. .
.-,;!,.-� ..........:.:....upto50kva/kw $0.00�.";i0 �
'` ��� - � � .................up to�100 kva/kw $0.00 .� �- 0 ,
. .:...:............over 100 kva/kwy .$0.00.; , 0 '.'
Low Voltage Equipment � - .� � $0.00- 0 �
Low Volt Wiring System / Ckt -$0.00 '� 0
Misa Conduit .$0.00 � 0
Misc. Conductor $0.00 . 0
Circus ( gen or nde) $0.00 0 -.
� Circus (mech ride or lights) � $0.00 0; �",
Christmas Tree Stand . $0.00 � .�.0 -
Fireworks Stand $0.00 �- 0
� Other Electrical Fee ' $0.00
Invesligation Fee $0.00
Plan Check Fee � - 50.00
Reinspectian Fee - $0.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. g2-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned
for a period of 180 days.
� INSPECTIONS: In Order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
i required inspeetlons and final epproval must be obtained. Failure to obtain inspections and final approval will resWt in ihe expiration of ihis permit.
I FOR INSPECTIONS CALL: (714) 7545626
2446d8�W00)
WORKERS'COMPENSAnON DECLARAnON:
I hereby attirm under penalry of perjury ona of Ihe following tleclarations:
❑ I heve end will maintain e cetliticate of consent to selt-Insure tor workers' compensation, as providetl for by section 3700 of the Labor Coda, for Iha paAortnence ot ihe
wark tar w�ich ihis permit is issued. '
❑ I have end will maintain workers' compensetion insurance, as required by section 3700 ot Ihe Labor Cotle, tor Ihe perfortnance i th work tor �yhich Ihis pqertnit is issued.
My workere' wm `ns o S ance cardel,apdyolicy number ere: �/1-'vv \-1`�
Cerner. 'YY��V1.-� Policy Numbec �'A
(Tliis section need not be crompleretl il the pe t is valued af one hundred aollars ($1(�) or /essJ
�I certity ihat in Ihe perfor ance of ihe work for which ihis parmit is issued, I shall not employ eny person in any manner so es to become subject to iha workers'
compensation laws of omla, end egree that i hould become sub�ect to iha workers' compensation provisions oi Section 33700 of ihe Labor Cotle, I shall forthwith
camply with these p � i ions ��/ �� I�
Applicant Signeture: Data: � �_
WARNINp: FAILURE TO SECURE RKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN TIES ANO CIVIL FINES UP TOIXJE HUNORED
THOUSAND DOLLARE (5100.000). IN ADDIiIIXJ TO THE C0.ST OF COMPENSATION, DAMNGES AS PROVIDED FOR IN SECTION 3]O60F THE LABOR CODE, INTEREST, AN� ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATION: �
I hereby aHirm that I am licensed under provisions of C�apter 9(commencing with Section 7000) ot Division 3 of ihe Business and Professions Code, and my license is In full
force antl eHect Lic. # Class N
Conirectors Signature: Date:
CONSTRUCTION LENDING AGENCY: -
❑ I herehy aHirtn thai ihere is a consiruction lending agency for the peAormance oi Ihe work for which Ihis permit is issued. (Sec. 3097, Civil Code).
Lendefs Name: Lentler's Atldress:
Signature: ' Date:
OWNER•BUILDER DECLARATIONS:
I hereby aNirm thet under penelry ot perjury ihat I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Protessions
Cotle: Any ciry or county which requires a permit ro construct, elter, improve, demolish, or repair any stmcture, prior to its issuance, elso requires the epplicant for such permit
to file e signetl statement thet he or she Is licensetl pursuant to the provisians at ihe Contrectors License Ww (Chepter 9(commencing with Section 7000) of �INsion 3 of ihe
Business end Professions Cotle) or thet he or she is exempt therefrom and the besis for the alleqed exemption. Any violetion of Saction 7031.5 by eny epplicant for a permit
subjects the epplicent to e civil penalry of no� more than fiva huntlretl dollars ($500).):
❑ I, es owner of tha propeny, or my amployees with we9es es ihelr sole compensation, WILL DO THE WORK, and the siruc�ure Is not Intended or oHeretl for sale (Sec.
7044, Businesrend Profassions Code: The Contractors License Law dces not appty to en owner of pmperry who builds or improves thereon, and who does such work
himseH or herself or through his or �er own employees, providad ihat suc� improvemenis are not Intended or oNeretl for sale. If, however, the building or improvement is
,�, �sold within one year of completion, Ihe owner-builder will heve the burden of provin9 ihat he or sha did not builtl or improve for purpose ol sale.). �
� i, as owner of the propeny, am EXCLUSIVELV CONTRACTING WI7H LICENSED CONTRAC70RS to consimct the project (Sec. 7044, Business and Professions
'� Cade: The comrectors License Law does not epply to an owner af property who builds or improves ihereon, antl who contrects for such project with e coniractor(s)
license pursuant to the Contractors Licanse Lews.).
❑ I am exe nder sec.
Signature:
Owner ID veritietl tlriver's license.
Venticatlon of Ownership by (lype of
Business and Pmtessions Code for this reason:
Date:
❑ No Drivefs License No. Expires:
i.e. - property taz bill or deed):
DIVISION OF INDUS7RIAL SAFETY PERMIT CERTIFICA710N:
❑ I hereby certlly �hat no exwvetion five (5) or more feet in tlepih into which e pereon is required to descand, will be matle in connectlon with work authorizetl by ihls
permi�, and that no building siructure, scaflolding, falsework, or demolition or dismantling �hereot, will be more than thirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec.
341, Tltle e, Calitomia Atlminlstrative Code).
❑ As owner-builder, I will not employ anyone to tlo work which would require a permit irom ihe Division of Intlusirial Sefery, as noted above, unless such person hes e
pertnit ta do such work from the tlivision.
Signature: Date:
Division of Industrial Safery Permit Number:
CERTIFlCATE OF COMPLIANCE AND AUiHORIZATiON OF EMAV: I certity under penalty oi perjury that I hava reatl this epplicetion antl state thet ihe information given is
correcL I gree to comply with all state laws entl ciry ordinances relefing to building construction, and authonze�presentatives of the Ciry of Costa Mesa to enter upon the
ebove- cnbed property tor inspec' purpases. I egree not to ocapy or ellow occupancy oi any building author �d by t s ep rmit until tinal inspection.
�l l�J
Signature Of Legal Owner(s) �— �— Date
Aut�oriiBd AOPlitan�
CODE �. INSPECTONTYiE
1616 Fixetl Sysiem Final Fire Prevention
1288 Pool Spa Finel
200 Finel Re-Roof
201 Final BIaWRetaining Well
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
Q�IE INTff1ALS
COpEt INSPECTIONTYPE
206 Finel Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Pravention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupency
PAIE II�AL4
March 31. 2006
CITY OF COSTA MESA
P.O. BO% 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200
DEVELOPMENTSERVICES DEPARTMENT
BUILDING DIVISION
COURTESY NOTICE OF PERMIT EXPIRATION
Sharon Lombard
3278 California St
Costa Mesa CA 92626-2204
PERMIT NUMBERS:
FOR:
PROJECT ADDRESS
E03-01069
Service Upgrade
3278 California St., Costa Mesa
Our records indicate the above listed permits were obtained for property improvements or
alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4
Expiration, permits are valid for 180 days from the date of such permit, or the date of your
last inspection for the project and additional fees will be required to finalize expired permits.
According to our records, the permits listed above have not had an inspection for a period
exceeding 180 days. If you have a signed inspection card indicating an inspection was
conducted within 180 days from the date of this letter, piease contact this office so we may
correct our records.
If you need to request an inspection please call our Inspection Request Line at
714-754-5626. If you wish to request an extension, requests must be made in writing
addressed to Ed Petros, Chief of Inspection, at the above address, detailing circumstances
and listing an estimated date of completion. If you do not have an approved final inspection,
your permits will expire on April 14, 2006.
If you have any questions, please contact the Building Division at 714-754-5273, between
8:00 a.m. and 4:30 p.m., and a staff member will be happy to assist you. The accuracy of
recordS affecting your property is our goal and we appreciate your working with us to resolve
this matter.
Sincerely,
��' .Q-��������
Mary Jane Weidenkeller
O�ce Specialist II
BuilOing Division (714) 754-5273 • Code Enforcement (714) 754-5623 • Planning Oivision (774) 754-5245
FAX (714) 754�856 • TDD (714) 754-5244 • vm�w.ci.cosla-mesa.ca.us
RealQuest.com � - Report
Property Detail Report
For Property Located At
Page 1 of 2
HealOuest.�om
3278 CALIFORNIA ST, COSTA MESA CA 92626-2204
_.. -......_ _
� Owner Information:
Owner Name: LOMBARD SHARON
Mailing Address: 3278 CALIFORNIA ST, COSTA MESA CA 92626-2204 CO28
Phone Number: Vesting Cades: UW / I
Location Information:
Legal Description: N TR 3403 LOT 45
' County: ORANGE, CA APN: 139-052-20
ICensus TracUBlock: 638.05 I 2 Alternate APN:
ITownship-Range-Sect: Subdivision: 3403
Legal Book/Page: Map Reference: 27-63 / 858-G4
Legal Lot: 45 Tract #: 3403
Legal Block: School District: NEWPORT MESA UNIF
Market Area: Munic/Township:
Neighbor Code:
Owner Transfer Information:
' Recording/Sale Date: / Deed Type:
���. Sale Price: 15t Mtg Document #:
Document #:
' Last Market Sale Information:
� Recording/Sale Date: 09/12I2003 / 08/07I2003 1s� Mtg AmounUType: 527,500 / CONV
Sale Price: $550,000 1s� Mtg Int. RatefType: / FIXED
Sale Type: FULL 151 Mtg Document #: 1122706
, Document #: 1122705 2"d Mtg AmaunUType: $44Q000 / CONV
�i Deed Type: GRANT DEED 2"d Mtg InL Rate/Type: 5.75 / ADJ
ITransfer pocument #: Price Per SqFt $371.62
New Construction: Multi/Split Sale:
' Title Company: E�UITY TITLE CO.
Lender: CHASE MANHAITAN BK/USA
Seller Name: JOHNSON LENICE
Prior Sale Information:
Prior Rec/Sale Date: OS128/2001 / 07I17I2001 Prior Lender: FIELDSTONE MTG CO/MD
Prior Sale Price: $345,000 Prior 15� Mtg AmVType: 5276,000 / CONV
Priar pocument #: 599274 Prior 151 Mtg 7,gg � ADJ
Rate/Type:
Prior Deed Type: GRANT DEED
Property Characteristics:
Gross Area: 7,480 Parking Type:
Living Area:
Tot Adj Area:
Above Grade:
Total Rooms:
Bedrooms
Bath(F/H):
Year Built / Eff:
Fireplace:
# of Stories:
1,480 Garage Area:
Garage Capacity:
Parking Spaces:
6 Basement Area:
3 Finish Bsmnt Area
1 / Basement Type:
1961 / Roof Type:
Y / 7 Foundation:
1.00 Roof Material:
Other Improvements: LAUNDRY ROOM;PATIO
Site lnformation:
Zoning: R1 Acres:
Flood Zone: X500 Lot Area:
Flood Panel: 0602160258H Lot Width/Depth:
Flood Panel Date: 02/18/2004 Res/Comm Units:
Land Use: SFR
Tax Information:
Total Value: $561,000
Land Value: $493,918
Improvement Value: $67,082
Total Taxable Value: $554,000
GARAGEI Construct Type:
CARPORT
Heat Type:
2 Exterior wall:
Porch Type:
Patio Type:
Pool:
Air Cond:
Style:
SLAB Quality:
COMPOSITION Condition:
SHINGLE
0.14
6,000
60 x 100
I
Assessed Year: 2005
Improve %: 012°/,
Tax Year: 2005
County Use:
State Use:
Site Influence:
Sewer Type:
Water Type:
BASEBOARD
STUCCO
PATIO
TRADITIONAL
AVERAGE
GOOD
SINGLE FAM
RESIDENCE
PUBLIC
SERVICE
PUBLIC
Property Tax: $6,200.32
Tax Area: 15045
Tax Exemption: HOMEOWNER
http://www.realquest.com/j spheport.jsp?serverid�-q02&client=&action=confirm&type=g... 03/20/2006
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CONSTRUCTION AND PLANNING ; � ' POOL & SPA . . . . _ ;
Date Inspector - ' ' � . � � �Date . Inspector; �
APPROVALS Permit #�, � APPROVALS Permit #� �,
1.. Temporary Electrical Service oi Pole 52. Pool & Equipment Location � . � � �
. 2. Soi! Pipe-Undrgmd�. �- . . ' 53. ,Steel Reinforcement� ' aI '
3. Electrical Conduit Utility-Undrgmd. � _ � 54. Forms ' ' �� ,v
, o
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding -�+� ��' � � � ' � o
5. Steel Reinforcement . 56. Rough Plumbing & Pressure;Test � ' � � o
6. Electrical UFER Grnd. 57. APPROVALTO,COVER-GUNITE -
�-' v
7. Footings . . - 58. Electrical Conduit-Undrgrnd� �� • � :�
8. FoundatiOn , . � - 59. Gas Pipe, �� Undrgrnd., T�st ' � �
9. Water Pipe-Undrgrnd. .. � _ 60. Backwash Lines, P-Trap, O.Undrgmd. �
10. Structural Floor System ' 61. APPROVAL TO DECK ��
17. Property Sewer Line & House Connection �- 62. Backwash�& Receptor-Fina! �
12. Sewer Cap ; ' � 63. Heater & Vent-Final
13. Roof Drains�., , �,; � : , � � , 64. Plumbing System - Final .
14. Rough Plumbing , ' 65. Electrical-Final . i_ •
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. POOUSPA SYSTEMS�F.INAL -
19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT �� �,'
20. Rough Factory Fireplace � � ' ! � 'APPROVAIS � Permit# � __ ' � -
�
21. Ducts, in Structure � 70. Underground Hydro . �
22. Ducts, Ventilating - 7;1. Product Piping O Gas OOiI . � � �
23. Gas Pipe-Rough & Test . . ' � ; ; 72. Underground�Flush ' - �
24. Roof Framing ' •73. Undergrnd.SforageTank C�Gas ❑Oil '
�
25. Roof Sheathing; � � 74. Overhead Hydro � .' � -
26. T-Bar'Ceiiing (Structurall.& Monocoat � 75. Dry Chemical � � . -�
-27�. FrameantlFlashing'-' �� � � 76. DryStandpipe "� � � '
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: �.�t,_�7 L�r �n L,,E,J •••L���••�'7 •
34. Final Heating & Air Conditioning _ , � � �.� � � �/j �'+f q�, ��pp
35'. Final Gas Pipe-Tesf ' • ' � . � - �
36. Hood or Canopy .
37. Final.Factory.Firep.lace . ' ' _ • - � � �- �� ' , , '
38. Finel.Plumbing . - _ - � � • �� � ' ' � �,,.
39: Water Service;Final. � ,. ' ��. � � � , ' . -
40. Gas�Service-Final � � . , ' � -
41. Solar pomesticFinal; , � . � . � - t � _: �- �
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 Releaseto Edison - ' . � • � � � - •
50. Gas Release to Southern California Gas Co ' ' "` _
51. CERTIFICATEOFOCCUPANCY .
No.' - Date ' - " + � �
_ _.. _ __ _ . . . . .. _,_._ . � _ ADPlicant to fill in all spares except those wi[hin �eavy_bortle� IineS.anG sign all_appropriate Oeclarationi. , ... . _ . _ , . _ ._ _ 3i{55 , 9/ I 86
_ . . - � si, ... �: e.00 � ri:
CITY OF,COSTA MESA CO ST CTION PERMIT � PERMI O. ^� � TRACT NO. ! 'LOT•NO.� � UNIT NO. � , � , - ' i , � ^ ' � � � , •
Prolect Address � I� � � •:� �� t7 . � � �' ( i ' � . � i , i , • , .
� AppliCant'SMailin ddress ' n � TVPEOFCONSTflUCTION �NEW� ADD ,ALTERATION REPAIR�
Owne1'S Name � • ✓ � Phone � COfVVER510N' ❑ OEMOl.ISH _❑ OTHER_ ' ' � � A P # , _ _ „ _ _ __, , _ , �, _za�g _ __
� i � DESCRIPTION OF WORK/USE OF BLDG. � ' � . � • - �
Address � � • ' � � S Main Building: � Accessory, Buililin9:-
+ E Z
j
Arch/Eng.- � License No. ' � TVPE OF PERMIT .� GRnoiNG OUNDATION ❑ STRUCTURAL ' .T � FfOnt � � � ' � , p
Add�¢55 ' O TENANT ,❑ ELECTRICAL PLUMBING O MECHANICAL � B R¢ar � � I � � ' � N
� �
Contrecror'sNam P e �oa,HER-'-- � ....'_' ' - . -.-' �__ .! ' ._ A. , . . _._ ' "' _ _, ' -, _ , . N
C Right. G
PROJECT,DESCRIPTION' �54. FT. �` occuPnNCv, �
Addresslmailing) '�' ' ' � � S Left � ' � • � � t
� i� i , CON,NTRVCTIONTVPE ! � _,VAWATIONS ; R
CityLiC¢n52NO. ZONE � GRAOINGCV.YDS.' ACRES
LICENSE� CONTR%1CTOR DECIARATION� - ' - � PIOJ. R¢f. # ' �P2lkinJ R¢q./PfOvid¢d � t E
I hereby affirm thab I am licensetl under,provislons of Charter 9(commencing Re'marksi � ' � � •� � � � � � � n
•a ' � . ` Planning Notes: � ry�
with section �000) of oivislon 3 of the Business;antl Professions Cotle, antl ' ' T
my Iicense is in fu f c antl effect. � /�II � �' � , � ��� � '' . ' � � � 5
� icens I�s . - _ �. • Lic;g se o. �'I4.�� Y `: _ � . � � � ' . � - . . . , � ..
3te ' Si9 t ����"1 � I � � ,� � ,y PLUMBING � ! , FEES � ; : . ' i - � - * :'
� WORKE 5'��TIDN DECIARATION � � . � ' � ' ' . . . � � � . ., - . . ,
Bar Sink � - � � $howers � � �
I here0y affirm that 1 have a certi�icate of mnsent to selt-insuie or a certiticate �.- � ELECTRICAI� , . .�� � F,EES
\ of Workers' Compensation Insurance, or a certifietl cooY thereof (Sectlon gackflow Preventer Service Sink ' � � � � � ��''� . .T.ransformer ❑ 75 50 KW � �
� , 3800, Lab: /1 �j �/ �/ - ' � ' � � AutomatiC WaSher „ , � - _
7olicy No. �Li�Q4!/� 1 � Company �0 �.�' �. Backflbwlrrigation . ;SewerCap�- =, �� � ConstructionPoleSub � �� � . ❑'50+jKW � ' ` i
�ertifietl copy is hereby furnishetl. , j
A�J C "f' iled with the city il D' ii n%�/� I 1 �/� ' Bathtubs " � Sewer Connection ' � '� Cooking Unit, ' � .� ' Meter� �up to 106amps � � -
Date ' Appliwnt�A.! lY.l� r 1 � - � ' � ` � ' -
EXEMP IO�RKERS'COMPENSATIONDECARATION: ' ClafifiClS - ' . ` .SOIafColleCtofs� . � . " � DiShwaSher =f � • � ' `r � �Meter ❑Over100amp5� � � �'
(Tnis section neetl no[ be completetl if the permit is for one huntlretl ($300 or - _ _ . ' ' ' '
iess). � , . � DishiMasher � � � " SolaP Piping . �. �- ] i ! �� Dryers �Gasr DElectric, - Sub"Panel. � �
I certliy tnat in the performance oi the work for wnlch this perm�t is issuetl, I . � - � � � �� -" ,
sM1all not employ any person in any manner so as to become subjecLto the Drinkin Fountains: ' �
9 'Solar Tank�, FanJ � L Motor's OO-1,HP O1 %- B� ��
workers' Compensatlon Laws of Califomia. I . ' `
! Date ' ' Si9nature ' � • Floor Drains ' 'Swimmin Pool w/S a - - - � � � '- .
-NOTICE: It, after mdking.this tlecla�atiom,-you shoultl become-subject to the- - - - - _ 9 P F�P'�U� ' .Inc. Solar 09-15 HP 016.15+ _�.
Workers' Compensation provisions of tne labor Cotle; you must forthwith FloorSinks Urinai � � � �� Fixtures Microwave � �
comply with such , provi5iOn5 or , thi5' pe�mit shall �b¢ tleemetl revoketl. - �
CONSTRUCTION LENDING AGENCV ' ' ' � -� � ' � � ' 1 I � � � �
Gas Service Outlets 'Water Closet Device Boxes � � � � � �
1 hereby affirm that there is a construction IenGing agency for [he pertormanee � + � Pole Light � �
of tfie wbrk 'for ':which this permit is issuetl (Section 309] Civ. C.) ' , ' ' I i. r - � .
� Interceptors Water Heater � � � � � i
Lentler's Name � � Outlets' fiange i �
�-Lender's Atltlress-- - - ^- �--- -- - - -t � - - - Kitchen Sink-� -� - - - Water Service' ' '' - 'Switches "'' ' `" ' - - ' - ' '
OWNER BUILpEN �ECLARATION ' ' ' . Siyn ' I
I he�eby aHirm that 1 am exempt from the Contracto�'s License Law (or the LdVdtO�i¢5 . ' , � AutO-Weih � Ga�bag2 Di5po5al � � Standing Sections ' ' I
iollowing reason (Settion ]031.5 Busine55antl Profe55ional Cotle:,Any city or ' � � � , . � . .
"�i�unty which requires a permlt to construct, alter; improve, tlemolish or repalr P-Trep � � ' � � Laundry Trays � ' ' i Generator �0-5 KW �5-15 KW •
�'!�?`ry structure, prior,to its Issuance; also requires the applicant for such permit - � r Trash Compacto�
�?tF`yfiie a signetl statement that ne/sne is4icensetl Oursuant to the provisions of � � � ' '
' 11,'fie Contracjor's License Law (Chapter 9.(commencing with Section 7000) of Roof Drains , • . ' ; ' � i � � � ' -
bivision, 3 of the Business antl'Pro(essions CoOe) or that he/she�is exempt ; . ' ' ` " ' - ' - - '� - - - -
' therefrom antl �,the basis for the allegetl exemption. Any violation of Section ' � ' 1 . � . ' ' ' ' ; '
703115 -by any applicant for a permit subjects the� applicant [o a civil - ' � ! ' ' - � �'
� enaltybf�not more than five huntlretl tlollars�($500). -
� I, as owne� of the property or my employaes witn wages as thei� sole ReinSpeMiOn Fee �' $15 � � �' , �I55�¢ Fee ' $'3 � { , , � . � ' , � � � _
� compensation, will tlo the work, antl ihe structure is not intendetl or offeretl Reinspeetion Fee ' - �$15' Issue Fee ' � . '$ 3 �
� for sale' (Section,7044, Business antl Professional Cotle: The Contractor's ' MECHANICAL FEES '
License.Law tloes not apply to an owner ot a property who builds'or improves'� - � � . �
thereon, antl who tloes. such work'himselt/nerself or through his or her own � - � � DEVELOPMENTSERVICES REQUIREMENTS: ' ' " '
Iemployees, provitletl that such improvements are not intentletl or afferetl for Boiler - • i Hood or Type I ❑ . � � , ' , ''
• sule. If, howeveq-fhe builtlin9.or Improvement is soltl witM1in one year of com- .� �. C2nOpy (Typ2 I I ❑ Zoning Approv6d By� , � Data �'��
� pletion, the owner will M1ave the bu�tlen Of prOving hE/She tlitl notlbuiltl or im- Duct - Under Ground � � i - � . 'Buildin A fav¢d B � �
� prove for the purpose ot sale�. - � � ' � � . � • � � � 9" PP Y } � � Date�t
❑.I, as�owner of the property, am exclusivery contracting with licensetl'con- Duct -Structural ' Refrigeretion System� , `' i Applitation Issued By r '� � " Dat�
tractorsto'construcLthe project (Section�7044, Business antl Professions Cotle: �: , ,
� The•Contractor's �License Law does not apply.to an owner of',property who . Duct - Ventila[ing , � �❑0-100,000 BTU ❑100,000 BTU . , � - ��SUMMARV OF FEES ' ' ' �
'� builtls or Improves thereon, antl who conVacts.for such projects with a con- ' . - � �.
� � tractor(sl ucense pursuant to the Contractor's tilcense Law). I am aware that-. Exhaust SVstem'�i Multiple,❑ System Repair/Alteretion' - BUIL�DING PERMIT'� $� ,`SMIP . �$ 7 �
,� pvoot of their Worker's Compensation insurance shoultl be provitleq to me:, PLAN�CHECK -$: �: PERMIT �� � ' �
� I] 1 am exempt untler 5ectlon , e. & P. C. Por this�reAson _ Firepl]Fact. BIt,ICBO # Fire Dampers ' � 'ISSUANCE �$ "
�� ' ' - ' - - PLUMBING `�$
� � Date - ' ' Owner � � - Heating System & Ducting= � Registeis . � pLAN`CHECK 25% $ � � ' ' �ENERG�' P.C. $ � � �
I hereby certify that 1 have re5tl this application zntl slate that the above � ❑6100,OOOBTU �t00,000BT ' .� " ' - .- GRADING $
; �intormation is correct..l a9ree to comply with all city antl county ordinances � � � � ELECTRICAL �_ $= � . ," "�
and state laws relaling'to builtling construction, antl hereby authorize repre- - � � ��� i - - P�.qN CHECK 50% - � �MICROFILM $ ��
sen[ative5 �of hIs clty to e��[ � upon the above-mentionetl property. /o� - . ' � -. � . , ' . , _ '• �- . $ �i •
� �inspection pu s � ' MECHANICAL $ . � �
• Si9nature ate � � � � � TOTAL FEE . $
Drivers' License or 55 � Reinspec[ion Fee • �'$75 ". �une Fee, • $ 3 � PLAN'CHECK 25% $ �
CMF 0865-46, rev. 30/84 Pink - Accountlng; Goltlenrod - Assessor � .
����f�
CO�TA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 317 COBTA MEBA. CALIFORNIA
For Applicanf fo Fill In Compleiely
� ' TYPE OR PRINT'
Aoo E�s"s 3278 California Street
COSTA MESh CALIFORNIA
�MAIL 1533� Baker St.
AOORFSG
TEL.
Grove
& �oleemve. Inc.
�fE�d�ECEIVED
FINANCE DEPT.
c�rr o� casra �Esa
APPLICATION FOR PERMIT
BUILDING
For Offiee Use Only
asceirr No. I -9eR-U�� oJ�
-LJ r'
rsecetp e�p er ow*� aece�ven OAT6 �seueo
dC� I /-/ 7-G/ IIAN 1 R 1965
BUILDING
ADDRESS
COSTA MESA. CALIFORNIA
FIRE
ZONE
APPROVED
AODRESS 1 Baker Si'i. ZONING
CITY Costa Mesa� Ca1if• ZON — I PLANS � BIIILDIN6
�;� No. 10�293 NO. 111• ���1/� LEGAL
oeacatvr�ox
OF LOT VO iC ZOO I NOW ON LOT�OII�
A. P. NO. _
USE OF YARDS EVE6
EXISTING BLOG. APPROVED ALLOWEC
8ETBACK LINE FROM p [CCHiER 4N8 8TJ
CBNTCR OP BTFIEET SO� REAR YARD ZV � FRONT FT.
SIDE YARD I LEFi S� I RIGHT 7� R. SIDE FT.
DESCRiPT10M OF WORK __ � _
NO. OF
Sin le famil residence �th
attached garage. Plan 11BR
I HEREBY ACKNOWL¢DCE THAT 1 HAV6 RE�D TXIB MPLIGTION
ANO BTATE THAT TH6 ABOVE 16 CORRER AND AGRE6 TO COM-
PLY WITH ALL CITY ORDINANCEB AND BTATE IAWB R6GU(ATINO
6UII.�ING CON9TRURION
SIGNATURE OF
PERMITTE
AUTHORIZED AGENT �ke & COZ I'OVE� II1C�
/ neTc 1 ^ I ' 1 �
'�3b ,
THE RMOUNT BXOWN IINDER VALl1AT1pN 19 FOR iXC
PURP09E OF E6TA6LIBHING A PERMIT PEE ONLY.
g� 15,139• pLAN CHECK $ 1���0
TOTAL FEE J2'�Q