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Home My WebLink About2925 CHESTNUT AVE - Building Permits(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR ORIVE, COSTA MESA, CA 92626 BUILDING PERMIT Jobnddress: 2925 CHESTNUTAV Suite: Vicinity: RESIDENCE AND ATTACHED GARAGE Parcel Number: 13928421 Zoning: Applicant: ALLEN, MIKE Address: 537 NEWPORT CENTER DR "" „ - - ' -_ . ,.- �,ii. Phonei (949)673-922 NEWPORT BEA,CN; CA �� ' Zip: 92660 owner. ZORN,�DALE� , � Address �2925,CHESTNUTAVE . � - - � � � . � . Phone: � � - COSTA MESA, CA� �. - Zip: 92626 Contractor: ABOVEIT ALL ROOFING Address: 537 NEWPORT CENTER DR � - Phone: (949) 673-922 . NEWPORTBEACH,CA � Zip: � 92660 ' License: 765842 Arch : Address: � Zip: ,-� Phone: License: Status: ISSUED Applied: 10/15/2001 Issued: 10/15/2001 ISSUED BY: � Eng: - Address:, - � Phone: . - . �� License: � . _ SCOPE OF P_ERMIT _„ . _ , , � REROOF: T/O EXISTING COMP SHINGLES_ NEW 1/2"'OSB, 7 CAYER 30#'FELT, INSTALL 25-YEAR "ELK" COMP ' �� SHINGLES. 1900 SQ FT � � � � � - , ` - � , � , Plan Check: $0.00 Permit: � $83.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: - $0.00 � � . FEE SUMMARY :-�� . - - - � Calc Valuation: �- gz,soo.00 � ,� � , � Claim Valuation: � � $z,soo:oo� Total: $83.75 �_._ . �, ,' SETBACKS. � � MAINSTRUCTURE Front� 0-0 , Rear 0-0. ACCESSORY Front - 0-0 �� -- Rear 0-0 PARKING Existinq: 0 Required: 0 NOTES: � PLANNING & ZONING Left 0- 0 Left 0- 0 � Proposed: 0 � Right 0- 0 Right 0- 0 ;� ,� � NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) � EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned for a period of 780 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 Inspections end finel approval must be obtained. Failure to obtain inspections and final approval will result in Ihe expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 zaae�ae �s�oo� a WORKERS' COMPENSATION DECLARA710N: � � ' I hereby ettirm under penalry at perJury one of ihe following declarations: ❑ I heve antl will maintain e certificate of consent to self-Insure tor workers' compensation, es provitletl for by section 3700 oi the Lebor Code, for ihe performance of Ihe rk lor which this permit is issued. I have antl will ma(ntaln workers' compensetlon Insurance, es required by section 3700 oi Ihe Lebo� Code, for ihe pertormance oi Ihe work for which [his permit is issue0. My workers' compep� io�n�,I,nsu1r carrier entl policy number are: c--�� I Certier. �/ I'—l_J I V � Policy Number: ��^ Q (This secti�not b— com�the permit is velued et one huntlred tlollars ($100) or /essJ ❑ I certiy Ihat in the perfortnance oi Iha rk for which ihi pertnit is issued, I shall not employ any person in eny manner so es to become su6ject to the workers' compensation laws of Calitornie, nd g ihat if I shou become sub�ect to the workers' compensation provisions ot Section 3700 of t�e Lebor Code, I shall forthwith comply with Ihes i' s. /) � Applicant SigneWre: �• � Date: f o/ � —� �— WARNING: FAILURE TO SEWRE WORKERS' �dPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMIN�NALTIES ANO CIVIL FlNES UP TOONE MUNDRED TFKKISAND DOLURE (5100,000�, IN ADDITIIXJ TO THE COST OF COMPENSATION, DAMAGES AS PROVIDE� FOR IN SECTION 3106 OF THE LABOR CODE, IMEREST, AND ATfORNE`f5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm ihat I am force and eflect. Lia k_ Coniractofs Signature: of Chapter 9(commencing with Section 7000) of DiNsion 3 of Ihe Busine�s�d Professions Code, and my license Is in full Class A L� E � � Date: / /� �/'�//9 _ CONS7RUC710N LENDING AGENCV: ❑ I �ereby aHirtn ihat there is e constmction lending agency for the peAormance of ihe work for which this pertnit is issued. (Sec. 3097, Civil Code). Lentlers Name: Lender'S Atldress: Signature: Date: OWNER-BUILDER DECLARATONS: I hereby attirtn thet under penelry oi perJury that I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business antl Professions Code: Any ciry or county which requires a permit to consiruct, alter, improve, demolish, or repair eny siructure, pnor to its iuuance, also requires the epplicant tor such permit to file a signed statement ihet he or she is licensee pursuent to the provisions of ihe Contractors License Lew (Chapter 9(commencing with Seclion 7000) of Division 3 of ihe Business and Professions Cotle) or ihat he or she is exempt theretrom end tha basls for Ihe alle9ed eaemption. Any violation oi Section 7031.5 by any applicant for a pam+' sublacts ihe epplicant to e civil penalty of not more than five hundrad dollars ($500).): ❑ I, es owner of �he property, or my employees with weges es ihelr sole compensation, WILL DO 7HE WORK, and ihe structure Is no� intentletl or otteretl for sale (Sec. 7044, Busineu antl Protessions Cotle: The Contractors License Law does not apply �o an owner oi properry who builds or improves thereon, and who does such work himself or harseH or ihrough his or her own employees, providetl that such impmvemeNs are not intended or ottered for sale. If, howaver, the building or impmvement is soltl within one year of completion, ihe owner-builder will �ave the burtlen of provinq ihat he or she did not build or improve for purpose of sala.). ❑ I, as owner ot ihe property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business antl Protessions Code: The coniradors Llcense Lew tloes not epply to en owner ol p�operry who builas or impmves ihereon, end who coNracts for such project with a contrector(s) license Dursuant to ihe Contractors License Laws.). � I am ezempt under sec. Business and Protessions Code for this reason: Signature: Date: Owner ID veritied by drivers license. ❑ Yes ❑ No Driver's License Na. Venfication of Ownership by (type of document, i.e. - property tax bill or deed): UIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: Expires: ❑ I hereby certify that no axcevetion five (5) or more feet in depth into which a person Is required to descend, will be mada in connedion with work authonzetl by this permit, and that no building structure, scaffoltling, falsework, or demolition or tlismantling thereof, will 6e more than thirry-six (36) teet high. (Chep. 32, Gry 2, Art 2, Sec. 341, Ttle B, Calitornia Adminlsiretive Cotle). ❑ As owner-huilder, I will not employ enyone to do work which would require e permit from ihe Division oi Intlustrial Satery, es noted ebove, unless such person hes e pertnit to do such work irom the tlivision. Signature: Date: Division of Industrial Safery Permit Number: CERTIFlCATE OF COMPLIANCE ANU AUTHORIZATION OF ENTFiV: I certify under penalry of perjury ihat I have read ihis application antl state ihat ihe information given is corred. I egree to comply with ell s�ate laws and ciry ordinances relating to builtling consimclion, end authonze representatives oi the Clry of Costa Mesa to enter upon ihe ebove-descnbed propetly for inspection puryoses. I egree not to occupy or allow occupency of any 6uilding authonzed by this permit until final inspection. CODE �. INSPECTIONTYPE 1676 Fixed System Final Fira Pravention 1266 Pool Spe Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition PtSF INi1TIpL5 �l ... ,. � ( / S /°G'B/ Dat cooe� ixsaecnoxmae 20fi Final Mechanical 208 Finel Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 FinalSite 250 Finai BuildincyOccupancy PAIE I[�ELfl ADp�icant to fill In all spaces except those wit�in heavy Dortler lines antl sign all appropriate tleclarations. CITYOF.cOS'rAMESa CONS UCTIONPERMIT `Projeit'4ddress _ Applican�'s Mailino A,/d'd'rrcc �-��/ -� Owner's Name �✓ /y �/y/ q l Phone c.t,�z_f-/Z.`.� Address �((d.�[-�C-/ ' Arch/Eng. ' ' � License No. Address p ConVactor'sName hone ds � Addresslma'I' gl-Q � � City Licen N LICENSED CONTRACTOR DECLARAY�ON � I hereby affi�m that I am licenzetl untler P�ovisions of Charter 9(commencing with section ]000) ot Divislon 3 ot thC Bu5ine55 antl Protessions Cotle, antl my licenze is in tull fo%�%� effect. /�/�'/ (± � Licens CI s ��/I!/ ic . No�.'�+T1V— ��1 7— ( ite �� 5"g t � �� J0.KER5'COMPENSATION DECLARATION .iereby affirm that I have a certificate of consent to selLinsure or a certiticate � of Workers' Compensation Insurance, pr a certi�ied co y thereof (Section \ 3800, Lab. C.) {/��/,� /�J � P,�oli9 y No. �L�� Cort�Pany /� 1 /-"�" v' IyCerti�ietl copy is hereby fumishetl. - ''// XJ Cer i' is tilea with ehe city By��y�� 9PJ�S�� Date Applicant f � �� EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl no[ be completetl if th¢ P¢rmit i5 (o� one hUntl�etl ($300) or iess). I ceriify that in the pertormance oi the Work tor which this perm�t is issuetl, I shall not employ any person in any manner so as to become subject to the Workers' Compensation lawz of California. Da[e Signatu�e NOTICE: If, after making this tleclaratioP, You shoultl become subject to the Workers' Compensation provisions of tne Labor Cotle, you must torthwith comply with such p�ovisions o� tnis pe�mit Shall be tleemetl revoketl. CONSTRUGTION LENDING AGENCV I hereby affirm that there is a constructio� lentling agenty tor the performance ' of the work for which this permit is issuetl ($ection 309'] Civ. CJ Lentler's Name Lentler's Atltlress - ' .�OWNER BUILDER DECLARATION I hereCy af�irm lhat I am exempt from tM1e Contractor'S License Law tor the following reason (Section 7031.5 Business antl Professional Cotle: Any city or county which requires a permit to constluct, alter, improve, tlemolish or repair any sVucfure, prior to its issuance, also requires the applicant for such permit • file a signetl statement that h¢/she is ��ensetl pu�suant to the provisions of - e Contrac[or's License l.aw (Cbap[er 9(commencing with Section 7000) of rvision 3 of the Business�antl Professions Cotle) or-that he/she is exemp[ " [heretrom ana tne basis for the alle9etl ezemption. Any violation ot Section ]031.5 by any apPlicant (or a permlt subjects the applicanl to a civil �enalry ot not more Ihan (ive M1untlretl tl011ars (E500). I, as owner of the property or my employees witit wagEs as thei� Sole compensation, will Oo the work, antl th2 Structure is not intenAetl or ofter¢tl for sale (Section ]044, Business antl Protessional Cotle: The ConVactor's License Law tloes not apply t0 an owner of a prop¢rty who builtls o� imprOVCs thereon, antl who tloes Such work himself/herselt or through hls o� h¢r own employees, provitletl [hat such improver�ents are not intentletl or offeretl (or sale. Ii, nowever, the Duiltling ar imoroVement Is soltl withln one year ot com- pletion, the owner will have the burtlen of proving he/she tlitl not builtl or im- � prove for the purpo5e of sale). / ❑ I, as owner of the property, am exclusively�contractin9 with licensetl con- tractorsto construct the project (Section 7044, Business antl Professions Code: Tne ConVactor's License Law does not apply to an owner of Oroperty who builtls or improves thereon. antl who c0�t�act5 fo� such oroiects wi[h a con- tractor(s Lcense pursuan[ to [ne ConVActor's License Law�. I am 2ware that praof o� tneir WorkeYs Compensation insurance 5houltl be provltletl to me, ❑ I am exempt untler Section B. & P. C. for this reason Date Owner I nereby certify that I have reatl tnis aoPlication antl state that the above information is correct. I agree to complV '�+'�th all city antl county ortlinances antl State laws relating to builtling cons�ruction, antl hereby authorize repre- 5¢ntatives of this cit to enter upon the above-mentionetl property for InSDectionpur � s )_�� M, $igpdture � Date__ OY /T Orivers' License or 55 � � � _�f � 7 3 � ....._. .._. � _�. ..�. � ��„ ,��. 39 TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR ' O CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLOG. ' TVPE OF PERMIT LJ GRADING �L�/J FOUfJDATION LJ STRVCTURAL '� TENANT ❑ ELECTRICAL LQ PLUMBING ❑ MECHAfVICAL ❑ OTHER PROJECT DESCRIPTION SQ.FT. OCCUPANCV GONSTRUCTIONTVPE �VALUATION$_ ZONE GRAOINGCU.VDS. ACRES— Remarks: Backflow Preventer - Backflow Irrigation . Bathtubs Clarifiers . Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets K'itchen S'ink Lavatories Roof Drains Reinspection Fae� � $15 Boiler Duct-UnderGround Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. BIL ICBO �k Heating System & Ducting ❑0.700,000 BTU 0100,OOOBT� Reinspection Fee � $15 0865-46, rev. 5/BBr White - Builtling; Canary - Applitant Pink - Accountin9: Goltlenrotl - Assessor � Showen Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Laundry Tra'ys Issue Fee I $ 3 I FEES Hood or Typel ❑ Canopy Type I I ❑ Refrigeration System ❑4100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers Issue Fee � $ 3 A.P. ;IE S' Main Building: E T Front B Rear A C Right S . Left Ping. Ref. # Planning Notes: Parking ELECTRICAL Automatic Washer Transformer ❑ 15-50 KW Construction Pole Sub. � ❑ 50 + KW Cooking Unit � Meter ❑up to 700 amps Dishwasher , _� Meter ❑over100amps Dryers ❑Gas -�Electric Sub Panel Fan " Motors �0-1 HP � 7%- 8 F.A.U. Inc.Solar�09-15 HP �16-15+ Fixtures -* Microwave De�ice8oxes�,�, PoleLight Out�ets Range Swi[ches Sign � Garbage Dispoul Standing Sections Ge�eretor �65 KW �5-t5 KW Trash Compactor . Zo�e Reinspection Fee �$15 � � Issue Fee DEVELOPMENT SERVICES REQUIHEMENTS: 2oning APProved By Building Approved By "�� Aaolication luued Bv � / �� `FEES $ 3 1 N G R E Q M T 5. SUMMARV OF FEES BUILDINGPERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ �O��SSUANCE $ � PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ �� /�)/ MECHANICAL $ TOTAL FEE $ �" ' PLAN CHECK 25% $ Ol OL�025209-QDR253t7�i T9 aT 5,�]0 �HTE: �2/pE/&9 TSfiE: 3,"58 i . . . . , : `� `\ 1: . . ,. . . ..:.....:C-x:. � . _ � '" , . . ' " • , , , . � 'CONSTRUCTION AND PLANNINI. ' - , � & SPA APPROVALS Permit# ' Daie Inspector p�ppROVALS Permit# Date ��Inspector r `1. Temporary Electrical Service or Gole ;_ 52. Pool & Equipment Location � 2. Soil Pipe-Undr9md. �' �� ' 53. Steel Reinforcement � i � 3, �Electricai Conduit Utility-Undrgrnd. ' 54. Forms . 4.`Electrical Conduit-Undrgmd. ,' � 55. Electrical Bonding i 5: iSteel Reinforcement� � 56. Rough Plumbing & Pressure Test . � .6. EleciricalUFER�Gmd`.� � 57. APPROVALTOCOVER-GUNITE � 7�.Footings �� ! ' . , -� � 58. Electrical Conduit-Undrgrnd. 8"'Foundafion �- � , 59. Gas Pipe, O. Undrgmd., Test � '� 9;.Water Pipe-Undrgmcl. -.; 60. Backwash Cines, P-Trap, � Undrgrnd: 10. �Structural Floor�System � .i 61. APPROVAL TO DECK , 11. Property Sewer Linel& House Connection ' 62. Backwash & Receptor-Final 12.� Sewec Cap .- -. - 63. Heater & Vent-Final � , 13. Roof-0rains . ' , : � ` ' 64. Plumbing System - Final� . _ ' 14. Rough Plumbing� � J � 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 578. Rough Electrical-T Bar Ceiling ,69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning � � FIRE DEPT. REQUIREMENT L�� - �20. Rough Factory Fireplace APPROVALS Permit # � �21f Ducts, in Structure ' 70. Underground HYdro � - 22. Ducts; Ventilating 71. Product Piping � Gas ❑ Oil ' 23. Gas Pipe-Rough & Test 72. Underground Flush � r 24. Roof Framirig 73. Undergrnd.StorageTank �Gas ❑Oil �� 25. Roof Sheathing - 74. Overhead Hydro � 26. T-Bar Ceiting �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. 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 � � L�, � 39. Water Service-Final li- 0. � 0 40. GasService-Final i) [ti� .•n C 1 41. Solar pomestic-Final�: '•,T.' � 42. Backflow Preventer �_� ^��ti y� 43. Backflow Irrigation � �:- , �� -� � v 44. Landscape Irrigatio{i�System � �,� %� r _I 45. Sound Attenuation.4a � ' . r , 46. Handicap Regulation"s; � 47. FINALSTRUCTURE&BUILDING � - ag. Soer.ial Requirements Completed � 49. Electric Release to Edison ' ::- Ii 50. Gas Release to Southern California Gas Co , � '� �� • V . n 51. CERTIFICATEOFOCCUPANCY - � , � �;, No. Date - /Y� ii � QIECT AODflESS: z 9 z�HESTNUT AV OWNEN'SNRME:,JOHN E, WILLIAMS eooness: z0725HOI�ACE ST , CHATSWORTH. CA.91311 unn: 714/751-1790 pPCH1ENCINEEq: ' flEG.NO.: - . ROPRESS: ' . UNR: , �� PEflMITTEE: HARBARA ZORN - .( 714 ) 751-1790 ,eooxess: zgZS CHESTNUT AV COSTA MESA CA 92626 " LICENSEO CONTMCTOB OECUMTION: I here�y attirm that I am licensetl unAer pmvisions ot ChaD�e� 9(commencing with Section 7000) oi Division 3 of t�e Business antl Professions CoOe, an0 my license is in full torce anA effect. CITY IIC.: STRTE 11C.: C1A33: Uate: � SiOnature: � WOBKEBS' LOMPEN&1TIOX OECIAMTION: I hereby aHirm ihat I have a certificata ol consent ro seli-insu2 or a certificate of Workers' Compensation Insurance, ar a cenified coOY thereof (Section 3800, Lab. C�. '�1LICY NO.: � , E7IP. OATE: . , OMPANY: J Certified copY �s herehy fumisheA. ❑ CertifieA copy is IileO wit� the ciry Buildinq OiNsion. M . . , Date: ADDlicant: IXEMPfION FPOM 1VOHKE115' COMPEN511TION DECWWTION: (tM1b secuon neeA not h comDleteO A Me pemtit is for one AuntlreA (5100) or less�. I cenity ihat in ihe pedormance of ihe work for which this permit is issueA, I ail nat employ any person in any manner so as to Oecome su6lect ta the WOBers' Compensatio�nq.Law�s of Califomia. � . Oaie: �_I' � �ipnaNre: N0710E: Ii, er maltinA � rs aeclaration, you shoWC become sublect to the Workers' Compensati n mvisians af tAe Labar Coae, you � tort�with wmply wit� suc� provisions or ttus permi� shall he OeemeO avoketl. CONSTBUCTION LENOING IGENCY` I herehy`aflirm IAat there is a constmction Ientlin0 agency for tha pedarmanca of the work for whicA this permit is issue0 (Section 3097, Civ. C�. IENDER: ' FUDflESS: ' - OWNEfl BUILOEB OECIAMTION: I Aere6y aflirm ihat I am exempt from the Contractors' State Licensa Law tor the following reason (Section 7031.5 Business an0 Professional Code: My ciry oi counry w�ich requires a permit to cansimct, atler, impmve, demolisn. or repair any strucNre, D�or ta ils issuance, also requires t�e appliwnt for suc� Dermit to file a sipneU staroment t�at he/she is IicenseU pursuant to tAe D�ovisians oi the Cont2ctars' State License Law (Chapter 9(commencing with Section 7000) ot Division 3 oi the Business anE Pmiessions Code) or thai �e/she is exempt thereimm and the hasis lar Ne alleged exemption. My Nolation al Section 7031.5 �y any aDDlicanifar a�permit sublecls t�e apD�icant ro a ciWl penalry oi nat more Ihan tive Aundred Eotlars (5500�. � I, as owner ol the property or my employees vnth wages as Iheir sole campensation, will do tAe work. anU I�e � sirucNre is not intentle0 or oHereO for sale (Secbon 704d, Business antl Pmtessional Cotle: T�e Contracrors' S[ate �icense Law Aoes not apDly to an awner uf a property who 6uilOs or impmves ihereon, an0 who Ooes suc� vmrk himself/hersel� or [hrouph his or her own employees, pmviAeO that such imDrovem¢nts are nat intenOeA or aifea0 for sale. I(, hawever t�e huiltlinq ar improvement is mIA within one year ot completion, the owner will have t�e EurEen of proWnA he/she AiU not �ui10 or improve lor the Durpose of sale). ' . I, as owner'o/ the pmpeny, am exclusively contracfng wit� IicenseA cwiroctars ro canstmct t�e praject (Section 7040, Business � an0 Pmlessions CoAe: The Coniractors' State License Law Aaes not apply ta an owner ot Draperry w�o bmltls or impraves therean antl who contracis for such Orolects wi[h a contracror(s�license pursuant to the Contracrors' State Licensa Law�. I am aware that�D��i oi iheir Worker's Compensation insurance should he pmvided ro me. � I am eaempt untler Section: B. 8 P. C. CITY OF COSTA.MESA - HUILDING PERMIT PERM NO: E_ 04866'9 �, PERMIT NO: E 048664 PLAN CHECK NO: N GOVT: N SUPP;,N � CONSTRUCTION TYPE; PERMIT TYPE: ELE •, PURPOSE: OTH JOH DESCRIPTION : ELEC FOR PORTABLE SPA SQ FT: CLAIM VALUE: CALC-VALUE: ' GROUP OCC; /, � COMMENTS: HIRING ELECTRIC CONTRACTOR TO DO WORK . � ��r*�r�r�r�r�r�r�r�r*x��r�rx�x�r�***x+r�*****��r��r�r*�*�r��rx��*�*+r�r��r�r*��r+rx�+i**x***�**�*�r***�*** Z 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 bUILDZNG FRNT; FT IN AEAR; LEFT; FT IN RGHT; � � -------- --------- ACCESSORY BUILDING --------- FT IN FRNT: FT IN REAR: FT IN FT IN LEFT: FT IN RGHT;, FT IN PARKING REQ• PROV: PARCEL: 13928421 ZNE; REF NO: - PLANNING N6TE5> � > , ' " ik it iE ik ik j! �E iF jf 3F ik iF i! if iF iF i! i! iF if it iE iE ik iF iF iE iF �k aF jE it iE iF iE iE iE iE if it it iE if �E �F iE iE jE it iE iE iE it iE iP ik 1E �F iF �E iF iE ±E iF jE iE 1E i! 1E dE �E 9E 9E �F it 1E it iE 3E 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, 20NING APPROVED HY �' DATE: BUILDING APPROVED BY : '' DATE: APPLICATION ISSUED BY: • � DATE: �� ikiEiEiEiE�kiEiEifiEifiE3fiEifj:iElfif�iFitit ifiE�k�E±EiEiElEiEiE'�F'iFiF'ioiF� iF 3E 9E jE 3f iF it jk iE iE it it iF iF iE iF jk 3f iF ik iE �E it it �! �F �F iE iE if �E iE 1E iE iE iE 1F iE iE if it dE iE it dE ik dE ik iE K 1F iE ik iE if iE iF if iE �If ik ik iF iE iE iE iE IE dE 1P iE iF iE iF jF dE iE iE iE dE iE LEGALIZATION:N F E E. S U M M A R Y STRUCTURAL SEGMENT;N i HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 12.50 50� ' SMIP/NON-RES PLAN � ZSSUE FEE � 15.00 ' � ' BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE TOTALS----> 12.50 15.00 0.00 27,50 '27.50 ,00 REVENUE DIVISION TOTALS--> COLLECTED;, 27.50 OVER/SHORT: .00 BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECFC 2%,r]� , iE 9E iE �E 1E iE iE 3E i4 �E jE if fE ik iF iE �t ik jE 3F if it ik iE it ik iE it * 4 i! iE �E iE �E 3F jf iE k 1E 1E iF iE if !E iF iE iE iE iF it �)E iF iE IE iF i! if iE �E iE if if 3E iF iE iE iE iE �E if iE 3E �F iE 3E iF it iE I N D I V I D U A L F E E H R E A K D O W N� �or tnis reasan: ' l�/ - �.` � TYPE ' oate: —�( t,g�/ �� 9� D trwner. �- ""'�-�'�- �°�"'— EL E I Oo hereby cenity t161 I am aware f and un0erstanE the aquirements oi Califomia Health and Salery Cotle ' s 25505, 25533, antl EL E 25534 anA that I or any future builtling occupant wilUwiil nat (circle one) neetl ro comply with said state codes antl tAe requirem¢nts Por a E L E permil for constmction or moAitication irom the Air Oualiry Manapement Uisirict. Residential constmc[ion applications are exempt irom these Drovisions. , Oate: Applicant: I here0y certity Ihat I have reaA ihis application and state ihat t�e a�ove iniormation is conect. I aA�ee �o comply wit� all ciry antl counry or0inances and state laws relatinp to building conslmction and here6y authonze represenWtives af ihis ciry ro enter upon the a6ove-mentioneU propeM �orinspectian Dufpous. p Oate' �� / !�� Sipnatura: � ��,�� ' ��— Driver's License Social Securiry � � 1601-a6 W�ite—Buil0lig; Graen—COEe Enlorcemant: Cenary—Applican�: Pink—Ravenue: GolEenroC—Assessor n QTY D E S C R I P T I O N UNIT COST; TOTAL COST 1 FIXTURES, LIGHTING 1 ST 20 EA. .75 .75 1 RECEPT/OUTLET 1 ST 20 EA. .75 ,75 1 MISC APPARATUS NOT LISTED REQ PERMIT 11.00 11.00 END OF FEES � 71 04Qd7953-60G579ti'a Y'r� � ?7,:s0 ' , ' DA7E: O�sl.?i/90 TI11E: lCl:i4 y ! CONSTRUCTION AND PLANNING +� � .� P' � SPA - ' APPROVALS Permit # '- � Date Inspector qppROVAIS Permit # Date Inspector i. Temporary Electrical Service or Pole �� ,. ' 52. Pool & Equipment Location { „ 2.,SoilPipe•Undrgmd. ' . 53.-Steel-Reinforcement � ��"� 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � 4. Electrical Conduit�Undrgmd. 8 �� 55. Electrical Bonding . " �' 5. Steel Reinforcement - - 56. Fough Plumbing & Pressure Test � 6. Electrical UFER Grnd. � 57. APPROVALTO COVER�GUNITEy� 7. Footings - 58., Electrical Conduit-Undrgrnd. � ' 8. Foundati0n . 59. 'Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgmd. ,' ! 60. Backwash �ines, P-Trap, O. Undrgrnd. 10. Structural Floor System � 61.'APPROVAL TO DECK � 7 7. Property Sewer Line & House Connection ," ?, � -� 62. Backwash &�Receptor�Final �.'�� " 12. Sewer Cap ; , - ' 63r Heater & Vent-Final � � . � � 13. Roof Drains - 64. Plumbing System - Final �. : ' 14. Rough Plumbing � � ' 65. Electrical�Final � ' " ,. 15. Rough Electrical-Conduii 66. Solar SYstem-Final . •`•<� ' ' � �� 16. Rough Electric Wiring _ � 67. Fencing & Access Approval � ' 77. Rough Wiring Sign �. � 68.'APPROVED FOR PLASTERING - I 18. Rough ElOctrical-T Bar Ceiling �� 69. POOL/SPA SYSTEMS FINAL 19. Rough Hsating & Air Conditioning � , , ,FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. DuCts, in Structure � 70. Underground Hydro . 22. Dutts, Ventilating � 71. Product Piping O Gas ❑ Oil 23. Gas Pipe�Rough & Test . �� .. 72. Underground Flush � 24. Roof Framing , � ' 73. Undergrnd.Storage Tank O Gas ❑ Oil 25. Roof Sheathing � . 74. Overhead Hydro . 26. T�Bar Ceiling (Structural) � Monocoat � � 75..Ary Chemical 27. Frame and Flashing -, � . ' . � 76. Dry Standpipe . , � 28. Lathing & Siding , � 77. FIXED SYSTEM FINAL � 29. Insulation ' 78.:FIRE PREV. FINAI 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION � 32. Electrical Gower Meter�Final ' 80. FOOD CERTIFICATE ISSUED ' 33. Final Electric _ �� g Notes: . 34. Final Heatinq & Air Conditioning � -� , � 35. Final Gas Pipe-Test � � � � 36. Hood or Canopy . 37.-Final Factory Fireplace _ x 38. Final Plumbing � , 39. Water Service�Final . � 40. Gas Service-Final � , . �_.:1 41. Solar pomestic-Final � ` � 42. Backflow Preventer' . � � 43. Backflow Irrigation . " • � 44. Landscape Irrigation SYstem , . - � - 45. Sound Attenuation � � . • � 46. Handicap Regulations ., _ � 47. FINALSTRUCTURE&BUILDING � 48. FINAL PLANNING � Jj' 49. .Elearic Release to Edison ^� 50. Gas Release to Southern California Gas Co '� � '' �� 51. CERTIFICATE OF OCCUPANCY .� No. Date I GENERAL ACKNO�VLEDGtiIENT State of Cali County o( �2�%C.r� � SS. .,�, OFFICIAL SEAL „ • DARLIENE DOWLIN� �,y� NOldry Vup6t Cd1��0inld . Ofl�NGE COUN7Y My Commission Exp. 09/10191 :.: :.'.:�. ', �. :.:.:....... ... Ihe % �y of � Cu-z3 19 ��u before me, the undersigned Kotary Public, personally appeared �o�1,J �. G(�/L�i�,�ls O personally know�n to me , proved to me o/n the basis of satisfactory evidence to bz the person�.6) whose name� �-�_subscribed to the. w�ithin instrumznt, and acknowledged that ff� •xecuted it. �VIT\'ESS,rt'i�� hand and official seal,� Notary's Signature ................................ LIMITED STATEMENT 6� RESPONSIBILITY TO WHOM IT MAY CONCERN: Bldg. Permit # This Permit # .� 9as C�� r�v� r v� Street Address � AP Number I, J o�int � l,l)� L L/A�S , as Owner in Title of the above referenced property, do hereby authorize: �F/�E zo,eN � 13,9fLf��t2� Za2�J Name .2 S Z 5 (a'�6si NuT f�-J�. �(1 S T/� i'1'/G-5.� � � . 7/S�- 7�/-/7�v C%Z/oZ.G to obtain permits in my behalf, as ownedbuilder, for ��-C�'-T��+��- w'o�2-r� at the above referenced property.`� Should eny oerson become an wmo�__�__�giov g engaged in the improvement of the property, I shali immediately provide Worker's Compensation Insurance coverage and cause a certiticate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other per- son, company or corporation. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal iniury to myself or any other parties. �J o Ifn1 C. l.t� I L C//9 ruS , Printed Neme _ p . i � � �L/ti2� ` Signature 0]]9dQ rev. 6/B7 NOTARIZAT�O� ��:��I�� ; , �2�� "..y2 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 317 COSTA MESA. GALIFORNIA fOR APPUCANT TO F/LC /N COMPCETECY TYPE OR PRINT BUILDING .__-.. _. . . . COSTA MESA, CALIFORNIA ER Adams Acres� Inc. ,F�� 419 �. 17th St. L CONT D oe & Colegrove� II1CL C?NTO. 16�29: ADDRESS 4-�/ E. 17th St�) COSt.2. t4esa nrscaiwrioH I NOT 15� I BL�CK I TRACT 1 SIZE 65 X 1� I NO. OF BLDGb. OF LOT Now oH �oi 1 A • � "sIL OY��L�� f � :I AUG � 1959 Flft�;�10E [�EPT. `yf', (`ni�'ri a.,tC� . APPLICATION FOR PERMIT BUILDING fOR OFf/CE USf 8Y COSTA MESA, CALIFORNIA FIRE ZONE APPROVED BY ZONING ZONE /� NO. OF u5E OF NEW l(l/ PLANS � BUILDING �� /� APPROVED J. �J/�/ � BV C�l/T/7 /' DATE (CENTER LINE STJ SEfBACK LINE FNOM �J , 35, CENTER OF STREET S 1. REAR YARD R. SIC SIDE YARD ILEFT S IftIGHT l�t~ L. SIC DESCRIPTION OF WORK � _ — REAR SI=�EDING l�f�o ROOMS � STORIES � EXTERIOR WAL�.tllCCO ROOF COVERING COVERING Rock 115E OF BUILDING AND WORK TO BE PERFORMED Sin le £amil residence with attached garage. I HEflEBY ALKNOWLEOGE TNAT I HAVE REND THIS APPLICqT10N ANO eTATE THqT THE A90VE IS CORRECT AND qGflEE TO COM- PLY WITH ALL CITY OPUINRNCES AND STATE LNWS REGIILAJ� Ny BOILDING CONSTRO��C� , �// i SIGNATURE OF A 'AUTHORIZEDAGENT Dike & ColegrOVe� InC. V'1 ISSUEO TME AMOUNT SHOWN UNDER VALUATION IS FOR TME PUPPOSE OF E9TABLISHING A PEiiMIT FEE ONIY. VALUATION M PERMIT FEE $ 3�,��y a ]1+, 552 PLAN CHEGK $ ]_7�00 TOTAL FEE $ 51.�00