The URL can be used to link to this page

Home My WebLink About2775 CIBOLA AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856 > ,. CITY OF COSTA MESA BUILDING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT lob Address: 2775 CIBOLA AV Suite No Vicinity: Parcel Nunmber: 14164405 Applicant: NOCK, RON Address: 11612 KNOTT ST GARDEN GROVE, CA PLUMBING PERMIT Phone: (714)895-1246 Zip: 92841 Owner: MOULTRUP, TUCKER JAMES TR Address 2775CIBOLAAVE COSTA MESA, CA Contractor: NOCK PLUMBING Address: 11612 KNOTT ST Arch / Eng : Address: GARDEN GROVE,CA Phone: Zip: 92626 Phone: (714)895-1246 Zip: 92841 License: 707775 Phone: Zip: License: SCOPE OF PERMIT 1 WATER HEATER CHANGE-OUT. ISSUE FEE BackFlow irrigation Backflow Preventer Bathtub Clarifier System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $O,DO $0.00 $O.DO $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 SewerCapforDemo $0.00 Sewer Connect $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar $0.00 Sink,commercial $0.00� Sink, Floor $0.00 Sink, kitchen $0.00 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COMMENTS I SPECIAL CONDITIONS 77 FAIR DRIVE, �IT NUMBER �3�5 Status: ISSUED Applied: 07/17/2000 I ssued: 07/17/2000 ISSUED BY: ��_ SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $12.30 $0.00 $0.00 $0.00 50.00 so.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: 535.80 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspeetlona and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS'COMPENSATION DECLARATON: I hereby afrirm untlar penalry ot perjury one of ihe tollowing tleclarations: ❑ I h ana wlll maintain a cenitica�e of consent to self-Insure for workers' compensation, es provided for by sectlon 3700 of ihe Labor Code, for the peAortnance of the rk for which this permit is issuBd. I hava antl will mainWin woBere' compensatlon insurence, as requiretl by section 3700 of t�e Lebor Code, for ihe pedortnance of ihe wo�k tor which this pertnit is issued. My workere' wmpensation In urance carrier and poli mber are: �� l � Carrier. �,'�'�%L�� Policy Number. 3 T�� (This sectlan need nof be complefad i! the permif is velued e� one hundred dollars (5100) or /ess.) ❑ I certify that in Ihe peAormance of the work tor which this permi� is issued, I shall not employ any person in eny manner so as to 6ecome subject to the workers' compensation laws oi�a 'a, entl agree that il I should become su ect to the workers' compensation provisions of Section 370 of the Labor de, I shall forihwith comply with these pro io�. ApplicantSignaWre: Date: i WARNING:FAILURETOSECUREWORNER5'�dPENSATIONCOVEfiAGE UNLAWFULANo-5HALLSUBJECTANEMPLOYERTOCRIMIN LiIESAND �ILFlNESUPTOIXJEHUNDFEO THOUSPND OOLLARE (5100,WU), IN ADDITIIX� TO iHE WST OF COMPENSATipN, ppNqGES PS PFqV10E0 FOR IN SECiiON 3T060F THE IAWR CODE, IMEflEST, AND AiTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm that I am licensed undeyp[qvis on�Gh�p�eg (commancing with Section 7000) of Division 3 of Ihe Business and P�Qfe ns de, and my license is in tull force and eHect. Lic. M � 6� // Class x ( i�� /� Coniracbfs SignaWre: Date: CONSTRUCTION LENDING AGENCY; ❑ I hereby affirm Ihat there is e cons��uction lending agency for the peAormnnce of the work tor which this permit Is issued. (Sec. 3097, Civil Cotle). Lender's Name: Signature: _ OWNER-BUILDER OECLARATIONS: Lentler's Address: Date: I hereby attirm that untler penalry of parjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business antl Professions Code: Any city or counry which requires a permit to consirucL alter, improve, domoiish, or repair any strucNre, prior to its issuance, elso requires Ihe applicant for such permit to flle a signetl stalemenl ihat he or she Is Ilcensetl pursuent to Ihe pmvisions of Ihe Conirecrors Llcense Lew (Chepter 9(commencing with Sedion 7000) oi Division 3 of the Business antl Professions Code) or thei he or she is exempt therefrom entl tho besis for the allegetl exemption. Any vlolaUon of Section 7037.5 by eny epplicant for e permit subjects the applicent to e civil penelty 0� not more then five hundred dollars ($500).): ❑ I, as owner of ihe property, or my employeas with wages as their sole compensation, WILL DO THE WORK, antl the struclure is not intended or oHered for sale (Sec. 7044, Business antl Professions Cade: The Contrectors License Law doos not apply to en owner ol property who builds or improves thereon, antl who does such work himselt or herselt or through his or her own employaes, provided Ihet such improvements are not intendetl or ottered for sale. If, however, iha builtling or improvement is sold within one year of completion, Ihe owner-builder will hava the Ourden of proving that �e or she did not builtl or improve for purpose of sale.). ❑ I, as owner oi ihe property, em ffXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business antl Protessions Cotle: The contractors License Law aoes not epply to an owner of property who builds or improves Ihereon, end who coniracts for such projed with a contractor(s) license pursuant to ihe Con�rectors License Laws.). ❑ I am exempl untler sec. Business end Pmfessions Cotle tor Nis reason: Signature: Date: Owner ID veritied by driver's license. ❑ Ves ❑ No Drivefs License No. Verification of Ownership by (type of doCument, i.e. - property taz hill or tleetl): DIVISION OF INDUSTRIAL SAFE7Y PERMI7 CERTIFICATION: E:pires: ❑ I here6y cehity �hat no excavation five (5) or more teet in tlepih Into whlch a person is requlred to descend, wlll be made in connec�ion with work authorizetl by ihis permit, and thal no building slmctU�a, scafloltling, telsework, or damolition or tllsmantling Ihereof, will be more then ihlny-six j36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Celifornie Administretl�e Code). ❑ As owner-Duiltler, I will not employ enyone to tlo work which would requiro e permit from Ihe Division of Intlusirial Sefe�y, es noted above, unless such person has a permi� to do such wark from the tli�ision. SignaWre: Date: Division of Indusirial Safery Pertnit Number. CERTFICATE OF COMPLIANCE AND AU7HORIZATON OF ENTRY: I ceM1ily under penalry of perjury ihat I have read Ihis application and sta�e that ihe information given is wrred. I agree m comply with all stete laws an0 city ortlinances relating to building construciion, entl euthonze representatives of the Ciry of Costa Mesa to enter upon the above-described pmperty for inspection purposes. I agree not to occupy or allow occupancy of eny building authonzad by this pertnit until final inspection. CO�E I, INSVECTIONTYPE 1616 Fixed System Final Fire Preven�ion 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWReteining Well 202 Final Fectory Fire Place 203 Final Slgn 204 Final Demolition 2a1s as PAIE 1N��lS �. , � I�r � . COUE 1 INSPECTION TYPE 206 Final Mec�anical 208 Final Plum6ing 210 Final Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupancy LUg, INTRIRLS i ApD��ant to /ill in all spaces exceDt t�osa wit�in heavy Eo�Eer Iines anE sign all appropriate Oeclarations. .F COSTA MESA CONSTRUCTION PERMIT Address 2775 Cibola �Ave. jo64k5273 .anYsMailingAddress Z..�� . Dupont DT1VE 'sName�AL PAC ROOFTNG Phone97R-76h$ �Addrew� Mr. hfoultrnn 2775 C'ihnla A�.e A�n/Eng. Licenu No. � %�.S n � Address Convacror'sNamP �AT. pA� Rn(1FTN(' Phone�2.(y.b$ Addreulmailingl 222n S- nunnnt ilr City License No. �% 7 F i i LICENSED CONTRACTOR �ECLARATION I he�eby affirm that I am licensetl untle� provisions of Charter 9(commencin9 with seclion ]000) of Division 3 ot tM1u Business antl Profess� s Cotle, antl my license is in full force a eifect. Llcense CI s cense No� Oate � Si9nat�yre WORKESi ' COMPENSATION D RATION I hereby affirm tnat I have a certificate of consent to seli-insure or a certlficate of Workers' Compensption Insurante, Or a certifletl copy thereof (Sectlon 3800, Lab. �1CS13%HSG ROYAL olicy No. / �Pa �ertifietl copy is hereby furnishe _ er�J fietl So y 15 filetl with the ty Builtlinq � i Date� / � � / �� Applic t . EXEMPTION FHOM WORKERS' NSATION DECLFRATION (This seclion neetl not be cOmpletetl it the permit is for One huntlretl ($300) or less). I certify thal in fhe Performance ot the work for which tltis pe�m�t is ISsuetl, I shall nol employ any pe�son in any manne� so as to become Subjett [o [he workers' Compensation Laws ot california. Date Signature 'NOTICE: If, a(ter makin9 this tleclaration, you shoultl become subject to the Workers' Compensation provisions oi the Labor Cotle, you must forthwith comply wilh such provision5 or tnis pe�mit shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV I hereby aftl�m that there i5 a construction lentling a9ency tor IhG perto�mance of the work for whicn this permit is issuetl (Section 3097 Civ. C.) LentleYz Name �entler's Atltlress OWNER BUIIDER �ECLARATION 1 hereby af/irm that I am exemo� trom the ContractorY License Law for tne followin9 reason (Section 7031.5 Business antl Protessional Cotle: Any clty or county whiU requires a Oermit to const�uCt, al[e�, improve, tlemolish or repab any structure, prlor to its issuance, alzo requirez the applicant for such permit [o tile a ziqne0 statement tnat he/She is licensetl pu�suant to th¢ Provl5ion5 of the Gontracror•s License Law (Chapter 9(commencing with Sectlon 7000) of Division 3 of tM1e Business antl Professions Coae) or lhal ne/she is axempt roerebom antl the basis (or the alle9etl exemption. Any violation ot Sectlon 7031.5 by any applicant for a pe�mit subjects the applicant to a civil penalty of not more [han tive huntlre0 tlollar5 (5500). ❑ I, as owner ot tne property or my employees with wa9es as Iheir sole comoensation, will tlo the work, antl the structure is not Intentletl or ofteretl for sale (Section ]044, Buziness antl Professional Cotle: Tne Contrac[or's License Ldw tloes not apply to an owner ot a property who builtls or Improves Ihereon, antl who tloes such work himselt/herself or throu9h his or her own emo�oyees, provitleE that such improvemenis are mt Intentletl or otloretl for sdl¢. H, however, Ihe DullOing a� impwvement I5 soltl within one year of Com- pletlon, ihe owner will have the burtlen of proving he/she tliC not buila or Im- �rove for the puroose of sale). 1, as owner ot the property, am exclu5ivery cont�acUng with IlcenSetl Con- I�actor5 t0 construct [he 0/ojecf (Section 7044, Bu5ine55 antl Protesslonz CoOe: The-ConVacior's License Ldw tloes not app1Y to an owner ot prooerty who buildz or Imoroves thereon, antl who contracts tor u<h projects wRh a co tractor(s1 license pursuant to the Con(ractor's Lic se Law). I am awar ha proof o( Iheir Worke�'S Gompensa su�anc shoultl be provltle e. ❑ 1 am exemp4untler Section B. & P�G. o I5 reason CD Date 1 hereby c r ity that I intormation is mrrecL I antl state laws r ing 1 sentatives ot is ci inspection p rpose� Signature ��-�< Dtivers' Licbusa-af�5 � ite t1 coun �ep�e- v for . _....,. ........ .._. __. .._. ...... ...,. � 90 TVPE OFCONSTRUCTION NEW ADD ALTERATION EPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p.# DESCRIPTIONOFWORK/USEOFBLOG. rPrnof with decra ti 1 S Main Buildi E TVPEOFPERMIT GRADING FOUNDATION STRUCTURAL T FrOnt ❑ TENANT ❑ ELECTRICAI ❑ PLUMBING ❑ MECHANICAL A Rear ❑ OTHER PROJECTDESCRIPTION S�.FT. oCCuaANGv Sing e C Right CONSTRUCTIONTVPE reTOOf VA�UATION$6000.00 g Left ZONE GRADING CV. VOS. ACRES P�ng. Ref. # Remarks: Planning Notes: 8ar Sink Backflow Preventer Backflow Irrigation rinking Fountains loor Drains loor Sinks as Service Outlets Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fea eoiier Ducl - Under Ground Duct - Slrucaral $15 Exhaust System ❑ Multiple Firepl/FacL Blt. ICBO # Heating System & Ducting ❑P700,000 BTU 0100.000 Reinspaction Fee � $15 IF 0865-46, �ev. 10/B4 White - BUlltling; Cana�y - Appllcdnt; Pink - Accountin9; Goltle�rOtl - Ass¢SSo� Service Sink Sewer Cap Sewer Connection Solar Collecmrs Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash laue Fee Hood or Type I ❑ Canopy Type I I ❑ Refrigeration System ❑0.100,OOOBTU ❑700,000 System Repair/Alteration Fire Damperz � Issue Fee FEES Automatic Washer Construction PoleSu6. Cooking Unit D ishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal 0584 0584 172-I,S9' Z�^a Accessory Building: Parking Req./Provided ELECTRICAL Transformer ❑ 75-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100 amps Sub Panel Motors �0�1 HP �7'h � 8 Inc. Solar 09-75 HP �16-15+ Microwave Pole Li9ht Range Generator 00.5 KW 05-15 KW ; Standing Sections Trash Compacror $ 3 Reinspection Fae $15 Issue Fee FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By APPlimtion laued By � $ 3 30,55 TL FEES 53 SUMMARV OF FEES BUILDING PERMIT s'i�L, nn SMIP $�SA PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PIAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ 3� - 5B PLAN CHECK 25% $ Q']� i oQJ ��1'Q � � �`�-�.5 Z O N I N G R E Q M T S UCTION AND PLANNING POOL & ✓ALS Permit# Date Inspector pppROVALS Permit# Date Inspector '1. Temperary Electrical Service or Pole.� 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - ,, 53. Steel Reinforcement 3. Electrical Conduit Utility-Undr9rnd., 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 '' ' o ,: . 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, � Undrgrnd., Test � ' � 9. Water Pipe-Undrgrnd. •,� •� 60. Backwash Lines, P-Trap, O Undrgrnd. / � �10. Structural Floor System J j� 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final �12. Sewer Cap `�� ' ��' 63. Heater & Vent-Final � 13. Roof Drains �I� � 64. Plumbing SYstem - Final • 14. Rough Plumbing • � .65. Electrical-Final 15. Rough Electriral-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fenci,ng & Access Approval i7. 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 O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemiral 27. Frame and Flashing 76. Dry Standpipe � 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION � 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric , Notes: 34. Final Heating & Air Conditioning � � 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace • 38. Final Plumbing � 39. Water Service-Flnal ;h 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 r'�D BS B'� 48. Special Requirements Completed 49. Elearie Release to Edison ' 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No. Date AOP��ant to fill in all soaces encev� thase within neavy boracr Iines ana sign all approoriate aeelaratlons. CITY OF COSTA MESA ' CONSTRUCTION PERMIT Project Address 7 � Q Applicant's Mailin Addreu Owner's Name U/ � Phone'� 4—S?QG Address Arch/Eng. � License No. _ Address �j Contractor'sNamPrac��:C�v.Sinl��PlSphone �Y�3y�� Address (mailingl W � �^� a City License No. � LICENSED CONTRACTOR DECLARATION I hereby atiirm that I am licensetl untler provisions of Charter 9(commencing with Sectlon 7000) ot Div(sion 3 of tha Busfness antl Professions Cotle, antl my Iicense is In II f rc antl effecL ,� ;,�-y� �/ License,Clas ` itanse N �.us� Date � Sig t f' ��Q �� WORKER •C MPENSATION DECLARATION 1 hereby aflirm that I �ave a certlticato of consenC ro selLinsure or a certifiwte rf Workers' Compensatlon Inwrance, or a cerU tl copy thereof (Se tlon saoo. �b. �. o�q6(/ a�;F��s�l�� Pollcy No. Company ❑ [ertltietl copy i5 hereby fumishetl. •B-eertiii cop is Bletl with the city iltl' ivis'@ n. � 'Date�� Applicant �' ��Z Y/C��7'� EXEMPTION FROM WORKERS' COMVENSATION DECLARATION (This section neetl not be completetl if the permit I5 (or one huntlred (SI00) or 1e55). I certify Ihat in the pertormance ot the work tor which thiz permk is issuetl 1 sltall no[ employ 5ny person in any manner so'as to become subject to t{�e workers' Compensatlon Laws o! California. Date Signature NOTICE: It, afle� making fhi5 tletlaralion, y0u shoultl becOme Subject t0 the Workets' Comp¢n5ation provi5ions of the Ldbor Cotle, y0u must Tort�with comply wlth suc� provislons or this. permil snall �e tleemetl revoketl. CONSTRUCTION LENpING AGENCV I hereby afflrm that there is a con5truction lentling agency for t�e performance of tho work ior whlth this permit is i55uatl (SecHon 309] Civ. C.) Lentler's Nama Lentler's Aatlress '- OWNER BUILDER DECLARATION - � I hereby atfirm t�at I am exem0� from [he Contractor's License Law for the following reason (Sectlon 7031.5 Business antl Pwfessional Cotle: Any dry or county which r¢qWres d p¢rmit to ConStruCt, dlter, improve, tlemolish or repair any structure, prior [o its Issuance, also reqWres tbe applicant tor such permit t0 file a slgnetl statemenl thal he/she IS licensetl pu�suant to the p�ovisions ot the Con[ractor'S License Law (Chapter 9(commencfng with Sectlon �000) of Olvision 3 0/ the Business antl Professions Cotle) or that he/she is exempt therefrom antl tne basis for tne allegetl exemptlon. Any violation of Section 7031.5 by any applicanl for a permit sub7ects the applicant to a civil �nalty of not more than tive huntlretl tlollars ($500). . LJ I� as owner of the property or m�y employees with wages as their sole �mm �nealinn will iln 11�a r4 anrl � r r1 rn rc nnf in n u nr n(in�nrl License Law tloes nol apply to an owner ot a property who bulltls or improves thereon, antl who tloes such work himself/herself ar throu9h his or her own em0�oyees, provitletl that such improvements are not intentletl O/ offe�ed fo� sale. If, however, the builtling or improvemen[ Is soltl within one year of com- ple[loq tM1e owner wlll have tho burtlon of proving he/she tlitl noi builtl or im- �rove for the purposa of sale). I, as own2r Of [ho prope�ty, am exclusively contracting wlttt licensetl con- tractorsto construct the oroject (Section 1oa4, Business antl Professions Cotle: The ConbaCtOr'S License law does not apply to an owner ot property who bWltls or improves theraon, antl who contracts for such projects with a con- tractor(s)license pu�suant lo the ContractorY License Law). _ ❑ I am ozempt untler $ection B. & P. C. tor this reason Date Owner 1 hereby certify tnal I have reatl Nis applicatlon antl state that the above information is correct. I agrae.(o com0� , th all city anC county ortlinances antl state laws r 1 tlng lo b��Itlin co ction antl hereby duthoriie ¢pre- sentatives of t� city n[er/� above-mentionetl proper y f r inspecUon pur�i 5. " $i9ndture � Date TVPE OF CONSTRUCTION LI NEW LI AOD LI ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK - TVPE OF PERMIT LJ GRADING FOUNDATION LI STRUCTURAL ❑ TENANT ❑ ELECTRICAL LUMBING' O MECHANICAL ❑ OTNEft PROJECT DESCRIPTION 5Q. FT. oCCVPANCv_ CONSTRUCTION TVPE VAI.UATION $ ZONE GRADINGCU.YDS. ACRES— Remarks: �J � 3ackflow Irrigation 3a[htu6s Clarifiers �ishwasher Jrinking Fountains � Floor D�ains Floor Sinks uas Service DULI2[5 Interceptors ' Kitchen Sink Lavatories P—Trap Roof Drains Reinspectian Fee $25 Boiler Duct-UnderGround Duct - Sttuctural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt, ICBO # Heating System & Ducting ❑6700,000 BTU 0100,000 Drivers"Uc¢ e r 55 � I I Reinspection Fee I $$5 CMF 0865-46 rev. 7/83 White - Builtling; Candry - APpliwnt; Pink - Accounting; GOItl¢nrotl - As5e55or Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service . luue Fea Hood or Typel� ❑ Canopy Type I I ❑ Fiefrigerotion System Oo-ioo,oaoeru ❑ioo,000aTu System Repair/Alteration Issue Fee $ 3 FEES $ 3 A.P. # S Main Building: E T Front A Rear C Right g Left Ping. Ref. # Parking Req./Provided Use of Building: Planning Notes: E Automatic Washer Construction Pole Sub. Cooking Unit - Dishwasher Dryere ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets 1 Switches Garbage Dispoul Generator �45 KW �5-15 KW. '�9::� I :/ ; '/ ' � Zone Accessory Buildin9: Park.Fees $ �AL FEES Transtormer ❑ 15-50 KW � ❑ 50+KW Me[er ❑up ro 100 amps Meter �overi00amps Sub Panel Motors 00.1 HP � i'h - 8 Inc.Solar �9-75 HP 016-15+ Microwave Pole Light Sign Standing Sections Trash Compactor I Reinspection Fee I$25I �uue Fee I •$ 3 PUBLIC SERVICES RE�UIREMENTS: Zoning Approved By Date Application Approved By Dete Aoolication luued Bv r L Dnrw /� BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PIAN CHECK SUMMARV OF FEES $ SMIP $ PERMIT $ �, ISSUANCE $ ENERGV P.C. $ GRADING $ MICROFILM $ TOTA� FEE $ $ Z O N I N G E U U I R E E 1 CONSTRUCTION AND PLA INCy{� �� ' . POOL a SPA . APPROVALS. Permit# b" � Date Inspector AppROVALS Permit# Date .Inspector ,i.. Temporary Electrical Service or Pole 52. Pool & Equipmeni Location � 2. Soil Pipe-Undrgrnd. � . r . 53. Steel Reinforcement . � 3. Electrical Conduit Utility-Undrgmd. � 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. Foundation .59. Gas Pipe, � Undrgrnd., Test 9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, O Undrgrnd. 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 �� ai gs 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 1S. Rough Electrical-T Bar Ceiling ' � 69. POOL/SPA SYSTEMS FINAL 79. Rough Heating & Air Conditioning� FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � , APPROVALS ' Permit # � 21. Ducts, in Strucwre ' � 70. Underground Hydro 22.Ducts,Ventilating 71.ProductPipingOGas ❑Oil 23r�Gas Pipe-Rough & Test , � 72 -Underground Flush 24:�Roof Framing ' ' 73. Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathing • ' ' � , 74. Overhead Hydro 26. T-Bar Ceiling (Structural�, & Monocoat 75. Dry Chemical 27. Frame and Flashing , � 76. Dry Standpipe � 28: L.athing & 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 � Nptes: � 34. Final Heating & Air Conditiqning - � ' . 35. Final Gas Pipe-Test � . 36. Hood or Canopy � 37. Final Factory Fireplace _ � � 38. Final�Plumbing - 39. Water Service-Final . . . 40. Gas Service-Final 41. Solar pomestic-Final _ . 42. Backflow Preventer � 43. Backflow Irrigation � � � � 44. .Landscape Irrigation SYstem � . 45. Sound Attenuation . 46. Handicap Regulations - - , � 47. FINALSTRUCTURE&BUILDING 48. Special Requirements,Completed • - 49. Electric Release to Edison � ' - - ' � - 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY' . No. Date � � INTERNATIONAL TESTING CORPORATION IA170 Chory Ave., Lonq Baech, Calil. — long Bmch GA 2b550 - GA 27500 � NE 6�7B31 �670 B�bw<k Avenue, Cofta Me�a, CaliL — Cos�a Mese MI 6�d826 � KI S�BBBB � 7552 Buan� Vi�t� Ave., lemon Grov�, Cefif. — lemon Grave HO 3-7751 REPORT ON 6RQI�9YxSPECIMI:N TESTS Identification No.: F-363-634 P-464-3-4 Client: Co Eo Moseley Architect or Engineer: Anthony Poole Contractor: Anthony Poole Structure: Sw3�iag Pool - 2775 Cibole Avetsue, Coata Mesa � (Aarold Dague) Sample From: Wall Snction at West Wall Clo Mix: 1- 4� PoBoI. 2,000 Total h�ater: Field Nos.: Age: Specimen No5•: Date Made: Date Tested: Average Size: Area, So. In. cortP,��ssioN --- Total Load, Lbs. Lbs. Per Sa. Inch: Specimens 14ade By: Specimens Delivered By Specimens Received: ca: Co E. Moaeley (4) �tl.: r '� F=3 7 Days AP-15 12-k-63 12-11-63 3 x 3 9 28 Davs AP-16 12-4-63 1-1�64 3 x 3 9 25,000 35,250 2,780 3�920 Cs $o LWBeley International Teating Co� 12-5-63 28 Days AP-17 12-4-63 1-1-64 3x3 9 32,250 3,580 EC NEO � J.4P! 6 i96 a City of Costa Mesa Building Dept. INTlRNATIONAL Tr:STING CORPDRATIOiv OWNER DA'�� DATE AUG 3 0 1963 JOB ADDRESS 2775 Cibola Avenue BUILDING PERMIT NO. 20 INSPECTIONS a ZONE DBSCRIPTION OF WORK llATE I GROUP J TYPE SUBCONTRACTOR �� ' zo�so COSTA MESA BUILDING-SAFEfY DEPARTMENT � P.O. BO%9f] C09TA MESA� CALIFORNIA For Applicant to Fill in Completely TYPE OR PRINT aui�oiNa aooRess A COSTA MESA, CALIFORNIA � MAIL ANTHONY POOLS $R71 FTRF.CTl1' SOUTH GATE s'ZE � 71X93 OF LOT USE OF EXISTING BLDG. 6ETBACK LINE FFOM DESCRIPTION OF WORK BUILDINQ NO.OF SIZE ROOMS SfOR1ES EXTERIOR WALL I ROOF GOVERING COVERIN6 USE OF BUILDING AND WORK TO BE PERFORMED PRI VATE SWI I+4 POOL I NENEBY �CKNOWL6O6i THAT � HAVH HBAO TMIB APPLICATION •N� BT�TC THhT OVt I6 COHRHQ AN Ei TO COM- PLY WITH wLL Y OFOI �NCB➢ �NO BTA LAWB Ol1LATINO BUILOINOC BTfl�UCTION SIGNAT EOyi_��j_. / i _ 1 � PERMIT /(CC � S, �•��—VQ i . ■ AUTHORIZEO FEE RECEIVED APPLICATION FOR PERMR flHCHIry' NO. sr �rtqFerve 1, �� 2775 CIR APPROVBD AVE � � ZONINCi 6 NO.OR UY80PNeW � 7 ' �LANB � GUILCINa �a�R�o� .CoY- 67 TP 5'B o8 '. NO. "E: NO EAVE OVERHANO SHALL BE LE85 THAN TO SIDE @ REAR P. L. ES .OWED N. B. C. REQUIREMENT'. YARD9APPROVED YAROSAPPROVED MAIN BUILDIN6 ACCES60RY BUILDIN6 !OM GL fiTREET) ,.,.. � p�/� VAR. }� HOLD 3 DATE APPROVE narE � � � � r so. rr. � TMH AMOUNT BHOWN UNDEfl VALUATION IH FOF THE F' PUFPOSH OI 88TABLI8HIN0 A P6PMIT F!E ONLY. p VALUATION m 2600 � OO PERMIT FEE S /� j / m $ PLAN CHECK $ CO � p d/ 4 TOTAL REE � � ' 1892Q Cf�STA MESA BUILDING•SAFETY DEPARTMENT P. O. BOX 9f7 COBTA MEBA. CALIFORNIA For Applieanf fo Fill In Complefely TYPE OR PRINT BUILDING __—_ . _ _ COSTA MESA CALIFORNIA Mesa Del Mar Development Co. del Same as ab '�dB-fi-C'4�lco��??� *st*iS2.5� APPLICATION FOR PERMIT BUILDING For Offiee Use Only BY DATE PECEIV[D DATH 193UED, .�,�, — �0 3 �i 6 15oJ BUILDING ADDRE55 COSTA MESA. CALIFORNIA �.e� �� cirv same as adove �� icTrEio.207343-A-SB-1 No:OR 34220 LeGAL DBBCRI s�ze 6231 S.F. I"�, o" B1G�ione OF LOT rvOW ON LOT p p � USE OF none Y��' EXISTING BLDG. qppp� eBTBACK LINE FROM �U-'NT� ceMBrs ov sTxeei SO � REAR YARD 3O � FRON' I 5� I 5� SIDE YARD LEFT RIGHT R.SIC DESCRIPTION OF WORK _ ZONING NO.OF U6E OP I ruHe ew�.owa Lot 67, Tract LIN6 BT.1 REPAIR I IIMOVING I IIDEMOLI6H I BP,PROVED � ��Vv1DATE fV "' S ZE DiN�54' x41' 6" ROOMS % STORIES 2 � EXTERIOR WALL `StuCCO I ROOF t�ood Shake COVERING �t WOOd COVERING USE OF BUILDING AND WORK TO BE PERFORMED Plan �500-B Living Area: 2266 S.F. Garage Area: 460 S.F. i H8R88Y RCKNOWL80UC THAT 1 HAVE R¢AD TH18 APPLIGTION TXE ANOUNT 9HOWN UND¢R VALUATION 18 FOR THH AND 9TATE THAT TH6 ABOVE 18 COPFECT RND AGREE TO COM- pUpp08! OF ¢BTR0L19HIN0 A PEftMIT FEE ONLY. PLY WITH ALL CIT' ORDINANCE9 AND BTATE LAWB pEOUTAT�NO BUIIDINO GONBTIiUGTON. VALIIATION L PERMIT FEE $ �l � SIGNATURE oFMeSB D21 M2I Development Co. PERMITTE �7 � Q�� /7 ��/ s 2:;,925.00 PLAN CHEGK $ J/,S F II / Sz' LL F � W 0. Q � � 2 F C q] F a G � Q � r a m w a O a a. z W 3 �lA'7?l�1.g COSTA MESA BUILDING-SAFETY DEPARTMENT �P.O. gOR 7200 COSTA MESA, CALIFORNI'A 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING 'Y77j L+t g� L� e� ADOFESS OWNER rf�N� G� I M O UL�/�/ f TEL.�^ CITV NO.� ry CONSTRUCTION ._.� IENDER BRANCH _� � AODRESS ARCHITECT ...i,� �i...n . TEL. AD�RESS ADDFES5 TEL. GITY NO. STATE � CITY LIC. NO. LIC. NO. SIZE / 3,x 9 3 I NO.OF BlD("'aa. � OF LOT �O NOW ON l0T U 5 E O P . � . _ . � . . _ Separa[e permits are required for elec[ric, plumbing and hea[ing work. UILOING AND WOFK YO BE PERFORMED � I hareby acknowletlpe thet 1 have reatl this epplication antl stata thet the eCove Information is corfect antl apree to comply with ell laws re9�lating builtling conrtruction, entl I shall not amploy any persor �� olatlon ot the workman's compansation lews of Ma Stata tlf Celifornie. I hereby c0rtify that I am p�o0efly Iitensed as a contrector untler t�e Stata tlf Callfornie Busfness anC Professlons Code, Divlsion 3, Chepter 9, entl thet z�eh Iicenses ara in full force end ef ct, or I am exampt from Ua provlsions of tha State of Cellforn usinass and Ptofes4�a�s , Division 3, Chap r. Signature ot �, PermlttBe Authorized .�� M.f400 4/25779 = 6•50 TL ��-� - •- . , _.. APPLICATION FOR STRUCTURAL PERMIT E EDBv DATLRECIIVED ne-rv�ccimr s�..r. rv�. / / ♦ � f0 � BUILDING ADORESS pZ,T 7� TRACT `/8OD RMIT bo l a� vvvrvcn — 5 ��c�,_ /�ALUS SDO. °.� aiC. FIRE ZONE � TVPE GROUP BVPROVED OATE � Zd � ZONE / NO.OF USE OF NEW �{{�� PLANS Z BUILDING YARDSAPPROVED VARDSAPPpOVED MAIN BVILDING ACCESSORV BUILOING (FROM C/L STREET) FROM �0 FT. O FT. 34 T. 0 FT. L SIDE �� FT. O FT. REAF FT. DISTANCE BET. BEf. MAIN & MAIN BLOGS. ACCESS BLDGS. VAR.qW OATE C.U.P.qW APPROVED APPROVEDC �Q L�I ..�rc �'i/Z �/i0 N � m i m SQ. FT. a THE AMOUNTSHOWN UNDER VALUATION IS FOR m THE PURPO6E OF ESTABLISHING A PERMIT FEE ON�Y: � VALUATION PERMIT FEE $ .�� Q N n dp PLAN CHECK y � $ �� Q TAX 5 �p LL f U TOTALPAID $ � �� /