HomeMy WebLinkAbout2796 CIBOLA AVE - Building Permits•oowEssaea�mx+: �73b CIbi�LA AV
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110EN5ED CONTfl4CTON4 OECI�XATION: 1 hereby ellim udx pere�y d prjury Nm I em licrosed ivder poiu'vu d Gheqa i
(oommmarq wn� Senion ]000) d piv'sun � d Ne &ni�wee eM PmlaeLme Code. eed mY ��+� w in IuA lam ud oHap.
CRYl1C.N0.: 11C.CUSS: IIC.NO.: �X�'
Dme: Cmumor.
OWNER BUILDEH DECUPATION: I heroby �rm uMer peroly d pmjury �hai l em ezemq Imm �he Gom�rfon lJcpus lew Ip tM
IOAoxeq nnwn (Setlion )OJ15 Bufneat end Rdeaaana Code: Any UY a mvuY wfiid� �epwm e OM�! lo muN'cl. eltar. inVvn.
demoleh, a repeir eny evucturo, pna io ae oauvaa, e6o rxryrryiras iM epplimnl la eucA pertnil lo fik e eqiwE statament tlW M a aM
u IinmeE W�� �o ihe pwiaions d Ne Convrfon Limnaa lew �Cheqm 9(�m�^Y �h Satlion 1000) d Divwian � d ihs
Bu.�ea ud Vrdmaiom CoCal «thm M a ehe b e�em0� �herelmn ud �M Esm la Ne eAeped memqion. /iM'vidu'vn d 6wion
)W 1.5 by enY WWiram lar e parmil wbpes the eppli�ant to e avil parely W mi mps Ihen Me huedmd dd4n �550p�1.
� I.mo�xwW�hepoV�Y«mYemGM�r.ih�vepn+mthei�obmmD��.wi0dotlnxdk.udNsebucwee'snd'vardd
«dtmed la xle (��bn nW.Buzr�e aM Pmbeapna Code: TM Contretlae Liomse Lewtlom M appyto en owmrd qoperly
wM Wltle n inporos tlweean. vd xtn doee auM Mak limeetl n MnN a Wuqh he u M own amVM'�. P�� thm arJi
imP�+emam ma nd inlakM a oHared la eab. X. howaver. iM dntluq a inP��em u eold wnh'ur me Ymr d mmG�'v�. tlr
ow�ror-0uiltlm vnp hava tM burden d proviep M w ehe d'M ml Wik or imqove la iM WT�e W eeb).
❑ 1. n mmer d tM D�OeM. am urhmre!/ oomroe�B wA 4cermad comrenvs b ow�w Ms pMb (9ecion 1014. Buei�s� eM
Proleaiwa Code: TM Conlmtlon L'cenee Lew doss iat epply w en awmr G qopeny wla Wlld� a impovr �la�on eM who
conirata br wd� pqwa Wh e mMretlor(e) ��E� w�+�d to ihe CaMmem Licenes LeW.
�7 �,,,,u,,,�,���e„s«u�:bP��94 e.aPc..rorimerea�:OWNHR &UILDER
o�a: o.,b,:
I do heroEy ce�iN Itw I em ewere d enE isMe�alerid Ms mVuieeme�N d Colfomie HeeM entl Sa1M/ Cotls Setlbm 25W5.255�J. eM
255Ja, uM Mei I ar eny Mun WiMiiq oou�pent wiA / wll rwl (d�cb an) roM ro canply wYh seA aela ooEm aM iM naWmnanb br
ePermiltwmmvuctionormaAifiretbnhwn�MA'r�8 tue�e�uYememDimrid.Rridsmidcwmiuebnewk'mimsuaazemqhanNne
a��..
Dma: Apqicem:
WONKEfi'S COMPENSRTIOH DECLANATION: I Mreby elfirtn urder pe�W�y d perjury wr d Ne bllow'uq datlere�iom:
� I heve eM wJ meiniei� e cMX'rale M mvent �o vatli�n br worken' compm�Nion, m pwidod la by Satl'vi �100 d tM laEw
COEe, i« ina peAamw.a o11M v.ork lor which �hie pe�mn u iaued.
❑ �newenewm.�m:n..alw.•oomv�o��wre�oe..,�.nWedMseai�n�rooame�ma.coe..wrmew�«meMaain.
wpk lar whi A Ihie pertnil ie ivuad. My warMert oompeneelion ineuruice mmer erM pdiry wmEer era:
Ce�rix:
Pdiry Numbec �
�mrs �ecria, ne.e na ee cm1Warod � w o�*� Ab, o,. n�,w,.e dwm,. rs,ao� o, hoa
❑ i mny inet m ma �no,�e a m, .�x ro, whkh ihie pe�mn o imueE. I�hell mi empby eny peinn in eny menner n m io
becane wEjetl Io �he xdkwe' campeneetim le�+* d Celtlarve. erd yres �IW E I 4ak become abjq to iM wabn'
�oem.�w� a��e a s.e�, oroo m me ima, caa.. i.nen rann.mn cancN wnn inon a�o+uion..
Dme: Appliraru:
Wem/np: FeNun b uc�n rorten'rompwwtlon covsnp� l� unl�wNl, �ntl Nsll ��ONef en anplonr ro cNMnl pw/tlu �M
clHl flnu �p ro om h'narH Mous�M dal4n (S/0qP00A M MNtlon ro tln cwt ol rompru�tbM1 Wnv�}� n povMW br In
Sxtlon J106 0l Me Lebo� Cods, Inferwl, end ettomsy'a ha.
CONSTNUCTION LENDINO G�ENCY: I haeby elfi�m uMar pereXy d perjury Ihet IMn n e oonNvtlion landiiq epency lur IM
peAormance d ��a work I« wfiiM I�e pemii n ueueE (5eclon 3081. Civ. CI.
LENOEN'S NAME:
LENOEN'S ADDRE55:
I caniy Iliel I �eve reeC Ihia epplke�im eM nele Ilu� the ebwe iMormetbn n mrtea. I eprae io canply wnh dl ay and couMy ordiwce�
eM elele levn relelmp lo W iWvq caruVud'wn e�d MreEy eulhw¢e ropaeenlNivp d Ihb tily lo onter upon tM ebovs�memin�eE piaperly
IIXIM�MLIIOIIDIIfpMl9.
JAiV bESSER
Signewm W OwmdApenVRpptiranVCanveea
(5151-16 WP) W�Fe-Buildip 8 Sdety; Oreen-Fle: Cenery-AppSunl: Fnk-Revanue; pddenrod-I�eeewr
CITY UF CGSTA MESA - bU1LLING PERMIT
PERMIr NU: b "v85119 PL:9N CHECIt NG: N
CGNSI'RUCTIGN I'YPE: V-N PERMII TYFE: STR
JGB UE RIPZZGN : 7/UFF �6 REkSHAETH ti REROGf WiCVMF.
GuVI: N sUFP: iv
Yl7FtP(ist; ufH
SQ FT: 3,0"vv
CLAIM V UE: 3,"v00.00 CALC-VALUE: 3,OOu."v"v �RuUF GCC: R-3 i
CUMM NI'S: .5�10�CE ,El: ORS E RE�UIREU IN EVERY HEUAOGM ti HALLWAY
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O I N Gy �RTEBQAU`LKr25E M E N T S
---- ---- -- AI HUILUING ---------- --------- ACCESSURY bi.iILLING ---------
FRNT; rT N REAA: F'I IN 'r'kNi; Fi IN REAR; r"i Iiv
LEFT: Fi' IN RGHT: F'I IN LE'r"I; FI IN RGri7: r't IN
PARKING RE{j: PROV: YARi:EL: 141b9323 ZNE: REF NU:.�.
F+LANNING NUTESS
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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,tT 5
ZONING AFPROVEL BY uATH: �
i . .r
BUILDING APF�ROVEL bY : LAI'E:
APPLICATION IS
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LEGALIZATIGN:N
bL
PERMIT
PLAN
ISSUE FEE
BUILLING-LIV >
TOTALS---->
LATE;
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F E E 5 U M M A R Y STRUCTURAL SEGMENT:Y
PLUMBING ELECTRIC M�.CHANIC FIRE SMIF/RES GRALiNi;
.50
SMIP/NGN-t2E5
UE
QQ
REVENUE DIVISId10—PGTAirS--� -
BLLG �MT PLUMBING E EC2RI
74.75
iF ii'vf w iF ii i'r ie i! if iF iF's't i't iE iF w iF ii fi iF iF iF if iF if iE ie �F ii �
I N D 2 V I D
TYPE QTY L E S C R I P T
SFR 3000 REROUF BY VALUE
CHECK TGTEIL PAIU LOE
�0 75.25 75.25 .00
EL: 7�.25 UVER/SHGRT: "vG
NIC FTRE SMIF/'f0'I GRADING PLAN—CHECX
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it ii iF i't iF iFK iF i'r �f iF if i'e 1F i@ if iF if iF ii iF if ii if iF iF iF �)f iF iF ii iF if iF w iF ii� iE ii iF if
F E E B R E A K u U W N
UNIT COST 1'O'PAL COST
NTIAL NUZUNE 1,t�0 3,"v0"v,OV
OF F�ES
CONSTHUCTION AND PLANNING -: POOI � �rA
APPROVALS Permit # Oate Inspectar APpROVALS Permit # Date Inspector
1. 7emporary Electrical Service or Pole 52. Pool & Equipment Location
2, $oil Pipe-Undrgrnd. 53. Steel Reinforcement
. 3:..�lectrical Conduit Utility-Undr9rnd. 54. Forms
�' 4'-Ejecirical ConduiDUndrgrnd. ` 55. Electrical Bonding
-',5._�,eel Reinforcement . 56. Rough Ptumbing & Pressure Test
= 6' Electrical UFER Grnd. '' 57. APPROVAL TO COVER�GUNITE
- -� -• .
�'7.'Footings 58. Electrical Conduit-Undrgmd.
�$.' �Foundation 59. Gas Pipe, Cl Undrgmd., Test
,
:9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undr9rnd.
10. Siructural Floor Sysiem 61. APPROVAL TO DECK
71. property Sewer Line & House Connection � 62. Backwash & Recepror-Final
S
12. Sewer Cap . 63. Heater & Vent�Final
13. Roof Drains � 64. Plumbing System � Final
14. Rough Plumbing .. � 65. Electrical-Final
15. Rough Electrical•Conduii -' . �� 66. Solar System-Final
S
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 FVRE DEPT. REQUIREMENT
' - - � ,, r _ n _ .
20. FjQugt� Faetory;Fireptace � ^ i � ' �? y ; ''k1PPRdV/jLS � _Peiinit # ` ��
A �
� ' _
21. D+rets, in $truciure= �� • •• - _ ' � } �70. tlnderg%an�l H�dro
22. Qucts; Ventilating; �: � _ - r; '7�, producyW'pjng �Gas C�OiI
23. Gas Pipe�f3ougFj & Test , q � x .n _ ^ { • �
'J : - 72. Undergro0nd FIesS - _
24, iioof�raming' `_� � ' ' � ' k ' . " '73tyUndergrntl.Stor3g�.Tsink�LlGas ❑Oii
25. Roof Sheathing ,�;, y: ��3� q�} ��t 74:,Qverhead Hydra, l F
26. gBar•Ceiling (Struc�^ral) & Men�Q�ac r , _ � `_. � 75�D?y Chemical , ' ` x
i i - �. 1 . } ..
27. ECameand,Flashing.; =, r F �• •» � 76. Dry StandpiAe l k -�
�28. Lath�g&Sidri�g -� • 7 C;� j' �, ` ". "'' 77.:� FIXEDSY$TEfi4FINA4 � . �
29. Insulation �� ; . � � � � 78: FIRE PREV. FINfCL • = " �
'30. Drywall Nailing` r:� , y ,. �� ?iFjALTf-[,DEPTK REi]UIRflMENT
-�.31. Plaster BGpwn 6oat�" t g .. . ' j� :�79.�FINAL IPjSEECTION e J ' �
-�32. Etectrical,-Bowet M2ter-Binal �"" �i. 80^FOOD CERTIfICATE I�$I�ED � .
� ' t 1; , . . -• - -3 2..
:33, h�tnal�lecYric � �,;. „ ; s Noies: - y., , .
1 r.
•s34. F�nal�Heaung & AiniGondiaionin¢ .: '. - � - " ' -' '
r �
n t. _ , �. ,� . � y K a.
,�35. Final Gas�'ipe;Test ' x ; � ` T;" � . _ ;
� I� � r.� J �
y i , •
r36. Hoodwr C-anopy * � -� � • � = ' %� # � T
a � -� -+ r� r. �
,37. Final FactOry F1reWa�= �_" � �' I ' �� r i
l i _ r -
�38. Final'Flumbin9 •� � � ' i T ' �
� a
=39. WaterService�Finalr t c ' - k•: i i .' ' '
�:
..40. Gas Service-Fin"_al i�; „y � r� ; _ s,.. � � li n�, n � i �
� i
-�41. SoVar pomestiNFinatY " �� • - '' . . -
f '! _
Y y � 1 ��
!42, BSckflowPreventerr: s � ' r - • . -
:u
�43. Backflow Irrigatiorr:' I�'� - ' � " " � - ,
- r � ti
44, l,andscape IrrigationSystem : - -� � , _ 7 �7 �� r v - �
�, �.
45. Sound Attenuation , - ^ "' k : - � '' � .
r i 0 *. ; 2 •
4&, F{andicap�RegLLlation5. : - � t r - n�� S �
- � -
47. FINA.L STRU6TURE & BUIL�ING l�.u...Gt��� ' •- '
_ r
48. FWALPLANNING .. � � i � �
_ �
43. Electr•ic R'lease to Edison ' - � ,. i �' _
��
50. Gas Release to Southem California Gas Co �. - �-�� - :
51. CERT-IPICATE OF CICCUPANCY - • - -
No. Date
AOPlicant to fill in all spaces except those witnin heavy bortler lines ane sign al1 appropriate tleclarations.
PERMIT PER T NQ.�,,,,�„ TRACT NO. LOT NO. UNIT NO.
CITY OF COSTA MqESA CONS RUCTION
Project Address �A. a-
Applicant's Mailing Ad ress ? 3 ��!
Dwner's Name 'S Phone7 �
Address - �( �
Arch/Eng. License No.
Address �r.�e—
Convactor's Nam Phoynye) � Uw
Address Im '�' � `3 �y� � �/ � �
City License No. \,��� �`��
LICENSED CONTRACTOR DECLARATION
I M1ereby a/(irm tha[ I am Ilcensetl untler provi5iOn5 of Charter 9(commenCin9
with section ]000) of Division 3 of the Business antl Pro�essions Cotle, and
my Iicense is In tull ( antl eifect. �
Licens I icen No.
Date $ignature
WORKE 5' OMPENSATION DECL ATION
I hereby a(tirm that I have a cerlificate ot consent to self-insure or a cerlificate
of Wo�ke�s' Compensation Insu�ance, o� a certifi¢tl /c-Opy thereot (S_e/ctlon
,aoo, �ab.�y�y�y—�,� CompanyiS�,Yf_ ���/s{
Poli<y No.
❑ Certifietl copy is he�eby furnishetl.
O�Eert' 'a qpp Iletl with the city B' i i si
Date pplicant � �� �
EXEMP ION ROM WORKERS' COM NS�ECLARATION
(Thissectian neetl not be rompletetl if the permit is for one hunaretl ($100) or
less).
I certify that in the pertormance of tne wo�k for which this perm�t is issuetl, I
snall not employ any pe�son in any manner so as to become subject to Ihe
Workers' Compensation Laws of Califomia.
�aie Si9nature
NOTICE: Ii, atter making this tleclaration, you shoultl become subject to the
Wo�ke�s' Compensa[ion provisions ot the Labor Cotle, you must fo�t�wilh
comply with such ptovision5 or this permit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV (,
I hereby atfi�m-that tbere is a Cons[ruction lentling agency tor the pertarmance
ot the work for which this permit is issuetl (Sectlon 309� Civ. Q)
Lentler's Name
Lentler's Atltlress
OWNER BUIL�ER OECLARATION
I hereby affirm that I am exemp[ trom the Contractor'S License_,Law for the
following reason (Section 7031.5 Business antl Professional Cotle:FAny city or
county whi<h requires a permit to construct, alter, improve, tlemolish or re0air
any st�ucture, prior to i[s is5uance, also �equire5 the ap0��cant tqr,SucM1 permit
to fi�e a signetl statement that Ite/she is Iicen5e0 pu�5uant to the p�ovi5ions of
the Contractor's License Law (Cnapter 9(commen<inq witn Section ]000) oi
Division 3 of the Business antl Professions Cotle) or tnat he/she is exempt
[he�et�om antl the basis for the allegetl exemption. Any violation of Sectlon
'031.5 by any applicant fo� a permit subjects Ihe applicant to a civil
enalty of not more than five huntlretl tlollars ($500).
� I, as owner ot the properry or my empioyees with wages as their sole
compensation, will tlo the work, antl the structure is not Intentletl or offered
for Sale ($ection ]044, Business antl Prote55ional Cotle: TM1e Contractor'S
License Law tloes not apply to an owner of a property who builtls or improves
thereon, antl wbo does SucM1 work M1imself/hersell or tM1rougM1 his or M1er own
employees, provitletl lhat such improvements are mt intentletl or offeretl tor
� sale. If, however, the builtlin9 or imDwvement is soltl within one year of com-
� Oletioq Ihe ownet will have the burtlen ot proving hE/she tlitl not builtl o� Im-
p�ove fo� the OurpoSe of sale).
❑ I, as owne� of [he pro0erty, am exclu5ivety cont�acting with IicenSetl Con-
iractors [o construct the pro�ect (Section 7044, Busine55 antl Prote55ion5 Coee:
The ConVactor's License Law aoes not apply to an owner oi property who
builds or improves thereon, antl who mntracts tor such prqects with a con-
tractor�s i¢ense pursuan[ to the Cantractor's License Law). I am aware that
pr0of o� their Wo�ke�'s Compensation insurance should be provitletl fo me.
� I am 2xempt untler Section B. & P. C. for this reason
Date Owner
I hereby certify that I have rea�
info�mation is correcL I agree to
antl state laws relafing to builtli�
5entative5 of tFlis cit to en r
inspection p s
Signature
Drivers' License or 55 � �
this application antl state Mat the above
�molv with all citv antl muntv o�tlinanc¢5
upon
�
TVPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION VXREPAIR
❑ CONVERSION ❑ OEMOLISH ❑ OTHER q p, #
DESCRIPTION OF WORK/USE OF BLDG.
� . S Main Buildi
E
T.YPEOFPERMIT GRADirvG OUNDnTiON STRUCTVRAI. T Front
❑ TENANT ❑ ELECTRIGAL PLUMBING ❑ MECHANICAL B Reaf
❑ OTHER p`
PROJECT DESCHIPTION 5c1. Fr. oCCUaarvcv C Right
K Left
CONSTRUCTIONTVPE VALUATION$ $
ZONE � GRA�ING GU.YDS. ACRES Ping. Ref. #
Remarks: Planninq Notes:
Sink
Preventer
Irrigation
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks
GasService Outlets
Interceptors
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspection Fee � $15
Boiler
Duct- Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Muitiple ❑
Pirepl/Fact. Blt. ICBO #
Heating System & Ducting
❑0.100,000 BTU �100,000BT
peinspection Fee � $15
CMF OB65-46, rev. 10/84 WM1ite - Builtlin9; Canary - Applicant; Pink � Accounting; Goldenrotl - Assessor
$hOW¢f5
Service Sink
Sewer Cap
Sewer Cannection
Solar Collecmrs
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Issue Fae
Hood or Typel ❑
Canopy Typell ❑
Refrigeration System
❑0-100,OOOBTU ❑100,000
System Repair/Alteiation
Fire Dampers
Registers
laue Fee
FEES
$ 3
FEES
$ 3
Automatic Washer
Construction Pole Sub.
Cookin9 Unit
D ishwasher
Dryers �Gas �Electric
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Dispoul
Generamr �0-5 KW �
Zone
Accessory Bu
Parking Req./Provided
ELECTRICAL
Trensformer O 15-50 KW
❑ 50+KW
Metef ❑uptOl00amps
Meter ❑over100amps
Sub Panel
Motors 00.1 HP 01'h - 8
Inc.Solar 09-15 HP �16-15+
Microwave
Pole Li9ht
Range
I I Standing Sections
15 KW � Trash Compactor
� Reinspaction Fee �$15 � � Issue Fee
DEVELOPMENTSERVICESREQUIREMENTS:
2oning Approved By
Building Approved By �
Appliption Issued By
FEES
$ 3
Z
O
N
I
N
G
R
E
Q
M
T
5
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ � ISSUANCE $
PLAN CHECK 25% $ ENERGY P.C. $
EIECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $ �� —
PLAN CHECK 25% $
: i���v�8r� T
CONSTRUCTION AND PLANNING POOL & SPA
�% Date Inspector Date Inspector
APPROVAL&: Permit # APPROVALS Permit #
i. 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
. 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd.', 57. APPROVAL TO COVER-GUNITE
�
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundati �� 59. Gas Pipe, O Undrgrnd., Test:�
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O'Undrgrnd.
10. Structural Floor System 67. 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 .
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. REQUIREIVIENT r�1
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 �j L�(�
39. Water Service-Final �
40. Gas Service-Final
41. Solar pomestic-Final
. �
42. Backflow Preventer ' ^l,.f
43. Backflow Irrigation ;�
44. Landscape Irripation System ���;
45. Sound Attenuation ,
46. liandicap Regulations -`%
47. FINALSTRUCTURE&BUILDING ' ' � , J,
.�
48. Special Requirements Completed �
49. Electric Release to Edison ' •
50. Gas Release to Southern California Gas Co � ,
51. CERTIFICATEOFOCCUPANCY . �
No. Date _ _ , ' `
. .
�on����wa z�9b LIbOLA AV ��* LITY UF CVSiA ME�A - llUT�U1NG PEkM17
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.
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LICENSED CONTP�CTOfl4 OECLIPATION: I hereby eflim uMx pmely d pajwy ihat I am IicenseE under povi�im� ol Cheqar D
(oommenofq wit� SMion ]000) d Onuun ] d Ne &�rn vd P�deadon� Coda. end mY 6wn�e'w in Iu01au eM efletl.
cm uc. No.: uc. cuss: uc. No.: gj{y �
pda: Caaroea:
OWNEN BUILOEN OECIANATION: I hneEy elfirm uMs penW W perjm� thm I em ewmq fmm tM Comimas lloema Lew /or tM
Idbx�q rse+on (�� �15 Bueim eM Ralmau Cada: My dy a mimy w/iirA �aqu've� e pamt to awbucl. edr.'vnprow.
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ia liceneed pursuem io �M pwiaiona d Ma Comrmoro L.ioensa lew [Cheqm 9(�mene�p wil� Sedion 1000) a�ebn � d Ihe
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a ollerad lor mla (Satlion 106a. emnm enE Prdesabna COEe: The Cavrmve L'vue lnw dom mt eccN �oen awnerd popeny
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impovaneNa ue m� irvaNed a a11aeG Iv ub. tl. howwer. ths buiNinO a inqwsneY u wltl w4hm ans Yev d canObiion. Na
owrorbuiMr wYl Mve �M1e buNan d povi�p M or Me EA nd driM a impewa lor tM qupoee d eeb).
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PMenione Code: TM Caqreem L'cmae lrx does rcn eWM m en oww d V�WMY xfio buffi a MV�'� �Mrson W who
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WONKEP'S COMPEN4ATON DECL�fl�T10M: I lwab� elfmn udar pmeEy d px�W ans d Ns fo0owmp Mdnmiom:
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CoM.ln tM pMamv�c� d tlr rak ta xtich Uv penm u muW.
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Pdiy Number.
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n«om..�qea m in. �.• o�,w�m� m.. d Cafbnve. ud nGns tlw � I JnWJ bacmr a�4a io iM wvrken'
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s.caon aros o� m. t�w caa. �m.mt .nd �mnrol'• n,.
CON9iflUCl10N LplMNO AGENCY: i Mahry elfvm unCs paWy M perjay �het Owa's e rdw�uqion 4�d'vp q��ncy lor Ihs
yertam.�n a �ne ww k..nid, inu o«mi e'nue (swia, ao�. c«. cl.
LENDER'S NAME
LENOEP'S ADOFE54:
I<eNh �� I �eve �eeE qe nppficmion eM ame thel Ihe eEvn eddmmion u wnaG. I q�na to compty wh eC cdy enE mumy oidinenrr
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Ci�NSIftUCIIGN 'iYPE: V��N PERMI'i TYP'e.: �'iR PURFiiaE: U'iH
JGb LESCRIFTiGN :'IlOFF x6 kEkSIiAETH e itEkGc�F W/COMF. :;� "r'i: 3,�'vu
i:LAIM VALUE: 3,"v00.vG CALi:-VALUE: 3,"v"vG.'vG G�iGUP ui:C: R-s i
Ci�MMENTS: SMi:iKE uE7tCTGRS ARE n�:QiilhEu IN E'v�iiii bELR�UM e ii:9LiWAY
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PLANNING NOZEs'>
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ZGNING APPRGVBIi'i3Y uA'it: "
6i7ILLING AFPRu"_J,EL BY : _ 1iAit:
APFiICA'Ilulv ZSStltu bY
ii ve w iF vi ir w w ii ii'vf ii» ii ii iR ii ii vi ie'vi
LEGALI'LAT'tiiN: N
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F E E S U M M A k Y
PLUMbINi� ELECIkIC M6CHAN1i:
uATr.:
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PLAN
TSSUE FEE
BUILLTNG-LiV-� PERM17 ISSUt PLAN-CHECK itil'AL rALli uiiE
TGTALS-�---> 7�.2� G.G"v 0."v0 "15."lS "75.25 .�"v
tiEV£NUE LIVISLGN 7ilTAi,S--> CULLEi:I'tL: 75.25 i;vrttis�ioKr: .'v'v
6LLG FM'I YLUMbTNG ELEC7RIC MECHANIC fYRE SMTYiTUi �RAii[Nu ri,AN--CfiEi:K
/4.�5 ,5�/
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I N L I V I L U A L F E E N lt E A K L' v W N
1'YPE QTY U£:i C R I P T I U N UNTT CU:iT '1'ufA.� i:O:i1'
SFR 3GGG REROiiF bY VALUE RESILENTIAL NtiivN�; 1.0"v 3,vuG.G"v
ENL uF r�t5
IB�A-1997/83:49 DM/f75.25
�cvT�:ei�e�as�
PERMIT:085119
AONSTtiUCTION AND PLANNING
PPROVALS Permit �`r Date
t. Temporary Electrical Service or Pole
2. Soil Pipe�Undrgrnd.
�3. Electrical Conduit Utility-Undrgrnd.
'd. �lecirical Conduit�Undrgmd.
�5. Steel Reinforcement
�,- �lectrical UFER Gmd.
7. Footings
T8. Foundation
�n
9. Water Pipe-Undrgrnd.
10. Structurat Floor Svstem
11. Praperty Sewer Line & House Conaection
12. Sewer Cap
13. Roof Drains
14. Rough Plumbing r�
15. Rough Electrical-Condoit '
16. Rough Elettric Wiring
77. Rough Wiring Sign
18. Rough Electrical-T Bar Ceiling
19. Rou�h Heatiny & Air Conditioning
20.'RougB Facrory Ficeliiace �� ;
21. Ducts, in.StrUCture � �• • - �
- �
22 �ucn Ventilating�' ' � _ '
, � JO L & SPA
Inspector, qpPROVALS Permit#
52. Pool & Equipment Location
53, Steel Reinforcement
54. Forms
_ 55. Electrical Bonding
� 56. Rough Plumbing & Pressure Test
• 57. APPROVAL TO COVER-GUNITE
58. Electrical Conduit�Undrgrnd.
59. Gas Pipe, � Undrgrnd., Test
60. Backwash Lines, P-Trap, O Undrqrnd.
67. APPROVAL TO DECK
62. Backwash &.Receptor-Final
- 63. Heater & Vent-Final
64. Plumbing System � Final
65. Electrical-Finai
' 66. Solar SyStem-Final
67. Fencine� & Access Anp�oval
68. APPROVED FOR PLASTERING
� 69. POOL/SPASYSTEb7SFINAL
_ t t FIfiE qEPT. BEQUIREMENT ,
. ' APPROVALS.� _� Pecmit #�. .�
_.. _ .
- ` 70. Undergrourttl F{pdro �
. + � ' -'
. � 71. Product Piping O�as .�'�.Oil
---�i-- _
�
72. UndergroUnd FtusP-� F ' �
�" 73� Undergrnd. SmKy jr Ta�q� � Gas -� ��'
.-�r�--��l-y
� � 74. Overhead Hydriy
_--� `
=' � 76: Dry Chcmical _ � ' � -' >
__r - �� �
76. Dry Stan�9dme � %' � -
� �.
� 77. FIXED SYSTEh��FINA�. .
' 7g FIRE PREV. FIMAL t- �
� �
i �', _ �HEALTHDEPT.AEQLIR,EN�ENi
t-�- �--r _ .
jR � 79, FI�AL INSPECTfaN �
� � 80. FOOD CERTIFl�ATE I�SWED .
. �/
r Natesl� -��� - �'7 j�6 / /5 ��/�
� �, .- _• � - f/
,. _
i • �._'�-
, -- i. - .
� .�r . . _ ; i ~
��
• r -
23. Gas °+Pe-fiough & Test -� C .
24. Roof�Framing • . .. r
. �
25. RoofSheithing � � � (�-��
_ i
26. T-Bat'Ce�ling (StrutYuraq & �,No�q2oat � '�
27. F'rartie and Ftashin{� � - : �
28. Lathing k Sic�rn9,� � • J � � � � • ..
' i,'�-^ . .
29. Insulation . � t •• �
5 >�
30. Drywall f�Iailmg � J � r
r �
37. Plaster Bro�vn Conc �-. ��r r.
32. Etectrica�power hl�ier-F�nal ' • ��
33. Finat Electric � . ;
34. FinaP"Heating & Ait Condicionirig : � ^
, l +
35. Final Gas Pipe;Test ' � .'. ,. -
36. Hood or Panopy " � ' � �
- �
� 37. Final Factory Fireplace� , � � _ � F "
38. Final�Plumbin9 ��
39. Water Selyice_Finat '
40. Gas Service-Final - � . - -� . •
41. Solar por�Sestic•Final � �' -
42. BaGkflow Preventer .
43. BaGkflow Irrigatio� . � ,.
44. Landscape Irriqation System � � ' -
�45. Sound Attenuation ; � - - :
46. Handicap Regulations � �
47. fINALSTRUC7URE&BUILOING �� 6
48. P.INAL P�ANNING _
49. Electric Release co Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
�,
�.
T
Date � Inspector
�
� � �89?�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COBTA MEBA. CALIFORNIA
For Applicanf fo Fill In Completely
TYPE OR PRINT
�R-K•� PnCIIS�,,^zs ,►�**9uso
,-� .
APPLICATION FOR PERMIT
BUILDING
COSTA MESA. CALIFORNIA For Off�te Use Only
Mesa Del Mar Development Co• pE�'� "�' �P�I
3800 East Coast H1ghW8jl Recerv er I DATE�=erve� I o�re
� p
Coiona del Mar NoOR 34220 BUILDING
ADDRESS
� M8CC0 Realty Co. NE�7R 34220 COSTA MESA. CALIFORNIA
Same as above ioNe rrae GROUP �
Macco Realtv Co. aPPaoveo _ __
c�rr Same as above `""E
�icTrEio.207343-A-SB-1 No: OR 34220 �eo..�
DEBCR
SIZE � NO. OF 91D68
�� � �r 6789 ...,w ..., �.,. none . _ .
B6T9�CK LIN6 PROM
cexTea Oa eTx68i SO � REAR YARD ZL �
SIDE YAR� I LEFf lO� I RIGHT 5'
DESCRIPTION OF WORK
NEW I X II ALTERATION I II AOOITION I
REPAIR I IIMOVING I IIDEMOLISH I
BZEDING 6O�XSO�LO��ROOMS 6 STORIES 1
E%TERIOR WA1�� S tucco � ROOF Wood S�iake
COVERING tk WOOCI COVER�NG F• RnC
U6E OF BUILDING ANO WORK TO �E PERFORMED
Sin le Famil Res. w att. Gara e
ZONING
`NO. OF '}/� uee or
I PLANe /� BOILDI�
Lot 62, Tract
LINB BTJ �_
plan ¢450-B Living Area: 1780 S.F.
Garage Area: 460 S.F.
I HERBBY ACKNOWLPDGE TNAT I HAVQ READ TXIS MPLlGT10N THE AMOUM 9XOWN UNDER VALUATION IB FOR TH8
ANO 9TATE THAT THE ABOVE �8 LORR¢GT AND AGR¢E TO GON-
PURP088 OF EBTABLIBHWG ♦ PERMIT PEE ONLY.
PLY WITH ALI. CITY ORDINANC¢9 ANtl BiATE LAWB REOULATINa
BUILDINO CON9lA�1CT10N. VALUATION �{
91GNATURE OF esa Del MaY Develo ID2RC _PERMIT FEE $�/
PERMITTE
s 19,065.00 PLAN CHECK $�/ � D
By: _ ,
AUTHORI2ED AGENT i (,<.a.},Q-�` ' L
TOTAL FEE J �