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Home My WebLink About3129 CINNAMON AVE - Building Permits� , (714) 754-5273 • Fax (714) 754�4856 • www.ci.costa-mesa.��LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: $129 CINNAMON AV Suite: Viciniry: Primary Occ: R-3 Dwellings/ Cong Res <10 Type of Construction: V-N Parcel Number: 13950301 Zoning: R3 npplicant: VILLA, CHUCK Address: 1923 CHURCH S7 COSTA MESA, CA Owner: BURNS, DAVID Address 140 BELGRAVE AVE SAN FRANCISCO, CA contractoc R C I ROOFING COMPANY Address: 1923 CHURCH ST COSTA MESA, CA Zip: 92627 Arch : Address: Zip: Phone: License: Status: ISSUED Applied: 11/03/2006 Issued: 11/03/2006 Phone: 949- 650-1079 ISSUED BY: I"'�J Zip: 92627 ' Phone: ' � � Zip: 94117 Phone: 949-650-1079 License: 704392 Eng: Address: SCOPE OF PERMIT PARTIAL RE-ROOF. TEAR OFF EXISTING COMP AND INSTALL 30 YEAR CLASS A COMP. REPAIR WORK. FEE SUMMARY Plan Check: $0.00 Permit: $60.10 SMIP Res: $0.50 SMIP Cam: $0.00 Other: $0.00 Inspection: $0.00 Total: $60.60 PLANNING & ZONING SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0- 0 PARKING xistin : 0 Rear 0-0 Rear 0-0 Reouired: 0 Phone: License: Calc Valuation: Si,seo.00 Claim Valuation: Si,sso.00 Left �0-0 Right 0-0 Left 0-0 � � .Right 0-0 Pr000sed: 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 if work is not commenced vnthin 180 days, or if work is suspended or abandoned � for a period ot 180 days. INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with all epplicable codes, and all requlred Inapections and flnel approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiratlon of this permit. FOR INSPECTIONS CALL; (714) 7545828 244G48 (8�00) WORKERS'COMPENSAnON DECLARATION: ' I hereby eHirm undar panelty of perjury one oi ihe following declarations: ❑ .have antl will meintain e certificata of consent Io self-Insure tor workers' compensalion, as provitled for by section 3700 of the Lebor Code, for ihe pertormance ot iha work tor which Ihis permit is issued. I� ve and will main�� tio;�n i isuPrence, as requi �y section 3700 oi tha Labor Code, for the peAortnance ol the work for which this pertnit is Issued. M worker5'co at I sur nc cerre mberar �� M' Carner. � A �.t\ Policy Number: �+.h (This secnon neea no( be re il th pe�ls velue af one hun re dodd�llars ($100) ar less.) `- ❑ I certity thet in the pert nca o w rk for which this permit is iuued, I shall not employ any person in any manner so as to become subject to the workers' compensation law Calitornia, entl e hat il I sh o e wo ers ovisions of Secti n 3700 of t�e Lebor Code, I shall forthwith complywithth provi5i0n5. �y � AppNcaM'Signetu '— � D t � Il.l�/� _ hKKISAND LICENSED CONTRACTORS DECLARATION: I hereby aflirm that I am license r p �" force and eHecL Lic. a O CONST�Gif6N LENDING AGENCV: \ ❑ I hereby affirm that there is e construction lending agency for ihe LentlaYs Name: Signeture: OWNER-BUILDER DECLARATIONS: ECT AN EMPLOVER TO CRIMINAL PENALilES AND CIVIL FINES UP TOONE HUNORED WR IN SEGTON 310fi OF THE LABOR CODE, IIJrEREST, AND FTTORNEYS FEES. with Section 7000) of Division 3 ot Ihe Date: oi ihe work tor which ihis pertnit is issueQ (Sec. 3097, Civil Cotle). Lenders Address: Date: license is in full I hereby aflirtn thet under penally ol perjury Ihet I em E%EMPT FROM THE CONTRAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Cotle: Any ciry or county w�ic� requires e permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, elso requlres the applicant tor such permit to file a signed statemem ihat he or she is IicenseA pursuem to t�e provisions oi the Contractors License Lew (Chapter 9(commencing with Sedlon 7000) of Division 3 of the Business end Professlons Cotle) or ihet he or she is e:empt ihe�efrom end ihe basis for the allegetl exemption. Any violation af Saction 7031.5 by eny epplicant for a Dermit subjects the applicant to e civil penelry of not more ihan five hundred dollars ($500).): ❑ I, as owner of Ihe property, or my employees with wages as their sole compensation, WILL DO 7HE WORK, and ihe stmcWre is noi intentletl or ottered for sale (Sec. 7044, Business and Prolessions Code: The Conirectors License Law does not apply to an ownar of propeny who builds or improves thereon, and who does such work himself or herself or Ihrough his or her own employees, provided ihat such improvemenis are not intentled or oNered for sale. If, however, ihe building or improvemeM is sold within one year ot completioq Ihe owner-builder will heve Ihe burden ot proving that he or she tlid not build or improve for purpose ol sele.). ❑ I, es owner of the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct ihe prqact (Sec. 7044, Business end Prolessions Cotle: The contrectors Licensa Law does not appty ro an owner of property who builtls or Improves thereon, end who comracts tor such projed with e comractor(s) license pursuant to the Conirectors Licensa Laws.). ❑ I am exempt untler sec. Business antl Professions Code tor ihis reason: Signature: Date: Owner ID veritied by dnver'Slicen58. ❑ Y85 ❑ No Orivers License No. Evpir85: Verification oi Ownership by (lype of tlaument, I.a. - property tax blll or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I here6y certify thet no excevetion five (5) or more feet in depih into which a pereon is requirad to descend, will be made in connection wiN work authorized by this permit, and ihat no building siructure, swltolding, talsework, or demolition or dismantling thereof, wiil 6e more Ihan thirry-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, Calitomla Administra�ive Cotle). ❑ A5 owner-Duiltler, I will not employ enyone to do work w�ich would require a pertnit irom the Division of Industnal Sefery, es noted abova, unleu such person has e permit to do such work irom t�e division. SignaNre: Date: Division of Indusinal Safery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORVJITION OF ENTAY: I certify under penalry ot perjury ihat I have reatl this epplication end state t�at �he iniortnation given is correct. I agree to comply wiih all state lews and ciry ordinances relating to building consWction, antl authonze representatives of ihe Ciry ol Costa Mesa to enter upon ihe ebove-described�Inpe�tor inspection puryoses. I agree not to occupy or allow wcupancy ot any builtling authorized by this pertni� until finel inspection. 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Finel 200 Final RB-Rooi 201 Final BIocWReteining W ell 202 203 204 Final Fectory Fire Place Final Sign Finel Demolition i / D%?1 �i%i / CODE 1 INSPECTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approvel 222 Final Sita 250 Final Building/Occupency PdIE Ixmu�s , (714) 754-5273 • Fau (714) 754-0856 CITY OF COSTA MESA BIIILpIN6 DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT BUILDING PERMIT \ �obAddress: 3129 CINNAMONAV Suite: Vicinity: UNITS A THRU D ParcelNunmber: 13950301 Applicant: LE, VINNIE Address: 9612 SUTHERLAND WAY GARDEN GROVE, CA Owner: BURNS, DAVID Address 140 BELGRAVE AVE SAN FR4NCISCO, CA Contractor: WESTMINSTER ROOFING CO Address: 9612 SUTHERLAND WAY GARDEN GROVE, CA Zip: 92844 Arch : Address: Zoning: R3 PERMIT NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 R3 ISSUED BY: Phone: (714)541-5351 Zip: 92844 Phone: Zip: 94117 Phone: (714)547-5351 License: 694940 Eng: Address: Phone: Status: ISSUED Applied: 0 717 3/1 9 9 9 Issued: 07113/7999 Phone: Zip License: Zip: I�icense: SCOPE OF PERMIT TEAR OFF EXISTING COMP ROOF - EXISTING SHEATHING TO REMAIN. INSTALL 2lAYERS OF 15# FELT UNDERLAYMENT 8 RE-ROOF WITH 25 YR. DIMENSIONA� SHINGLES (46 SQ.). FEESUMMARY Plan Check: $0.00 Permit: $124.75 SMIP Res: $0.61 SMIP Com: $O.OQ Other: $0.00 Inspection: $0.00 Total: $125.36 SETBACKS ACCESSORY PARKING NOTES: Front D- 0 Front D- 0 Existinq: p Rear 0- 0 Rear 0- 0 Required: 0 PLANNING & ZONING Left 0- 0 Lett 0- 0 Proposed: 0 Calc Valuation: Ss,�oo.00 Claim Valuation: Ss,too.00 Right 0-0 Right 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 180 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 requlred Inepectione end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545628 , WORKERS'COMPENSAnON DECLARArON: ' I hereDy aflirm untler penelty ot per�ury one tl� Ihe tollowing declarations: ❑ I heve antl will meinteln e caNBcate at consent to self-Insure for workers' compensation, as pmvitled lar by section 3700 0l the Lebor CoOe, br Ihe DeAortnanca of the work for which t�is permit is isSueE. ' ❑ I have end witl maintein workers' compensatlwi insurence, as requiretl by section 3700 ot ihe Lebor Code, for Ne perlortnance ot Ne work lor which this permit is issuetl. My wo Brs' mpe alion Insurance Gerrier e pollcy numbar ere: Carner: r� �, �j�� POIIcyNumber: t�0�� (Triis sectlon need not be comp/eted i/ the 0�^^�� 5 valuetl et one hundred dollars ($100J or /ess.) ❑ I certity thet in the peAormence ol th9 work for which Ihis pertnit is issued, I shall not employ eny person In eny menner so es to become subject to the workers' compensation laws of Celifomia, and ag�ee ihet if I shoultl bacome subject to the workere' compensation pmvision�t Sec' n 700 oi t Lebor Code, I shall forthwith comply with these pr visions. o Applicant Signature: � Date: l S WARNINO: FAILURE TO SEC E WO Cpld ENSATION GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMI PE T 5 ANO C Il FlNES UP TO ONE HUNORED THOUSAND DOLLARE (5100,000�, ADDITION TO OF COMPENSATION, DAhNGES AS PROVIDED FOR IN SECTION 37060F THE UBOR CODE. IMEREST. AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirm Ihet I em licensetl u�der pr isi< force and ettect. Lic. k� ContrecmYs Signature: � �,,,,� with Section 7000) of Divlsion 3 of Ihe Business _ clessa_� _ Date: � CONSTRUCTION LENDING AGENCV: � I hereby ettirtn that there is a construction lentling egency for Ihe partormance of the work for which this pertnit Is issuetl. (Sec. 3097, Civil Code). Lentlers Name: Lenders Address: Signature: _ Date: and my license is in tull OWNER•BUILDER DECLARA710N5: I hereby eHirm ihat untler penalry of perjury tnat I am E7(EMPT FROM THE CONTRACTORS LICENSE LAW lor ihe following reason (Sec. 7031.5, Business entl Professions Cotle: Any ciry or counry which requires e pe�it to construcL alter, improve, demolish, or repair eny structure, prior to its issuence, elso requires the applicant tor such permit to file a signetl statemeN ihat he or she Is Ilcensed pursuent to the provisions of the Conirectors License Lew (Chepter 9(wmmencing with Sectlon 7000) of DiWslon 3 of ihe Business ana Professions Code) or that he o� she is exempt thereirom and ihe besis for the allegetl e:emption. Any violation ot Section 7031.5 by any applicant for e permit sublects the epplicant to e ciWl penalty of not more then five huntlretl tlollars (5500).): ❑ 1, es owner of the property, or my employees with wages as their sofe canpensation, W ILL DO TNE W OFiK, antl t�e structure is not intantletl rn oflared for sale (Sec. 70a4, Business entl Pmfessions Code: The Comrectors License law does not aOPly to an owner of OmDerry who builds or improves thereon, end who does such work himsetl or herself or through his or her own employees, pmvided thet such improvements are not intendetl or aNeretl for sale. II, however, the builtling or Improvemem is soltl wlihin one year ol completion, tha owner-6uilder will have ihe burden ot proving ihat he or she did not build or improve for purpose of sale.). ❑ 1, es owner of the property, am EXCLUSIVELY CONTiiACTING WITli LICENSED CONTRACTOFiS to construct the pro�ect (Sec. 704A, Business antl Professions Code: The contractore License Law dDes not epply to en awner ot property who builds or Improves thereon, end wha contrects for such project with e contrecmqs) license pursuant to tha Contractors LicBnse Laws.). ❑ I am exempt unaer sec. Business end Professions Catla for this reeson: Signature: Date: Owner ID verified by tlriver's license. ❑ Ves ❑ No Driver's License No. Expires: Verification of Ownership by (rype ot daument, i.e. - properry tau bill or tleetl): DIVISION OF INDUS7RIAL SAFETV PERMIT CERTIFICA710N: ❑ I hereby certlty thet no excaveilon ilva (5) or mora feet in depih Into whlch a person is requlretl to tlescentl, wlll ba mede In connectlon with work authorizetl by ihis permit, end that no builtling slmcNra, s�eHolding, falsework, or tlemolition or dismantling thereol, wlll be more ihan thirry-six (36) feet high. (Chep. 32, Grp 2, Atl 2, Sec. 341, TWe 8, Celitomla Administrative Code). ❑ As owner�builder, I wlll permit m tlo/�ey{ch worN� Signature: �� Division of Indus�nal Sa�ey Permit Number: to tlo work which woultl require a permit from the Divislon of Industriel Safety, as notetl ebove, unless such person has a oate: HAZARDOUS MA7ERIALS AND EMISSIONS CER77FICA710N: 7 Will �he epplicant or present or future builtling cecupan� need to lile and cartiy a Business Plan tor emergency response to release or threatenetl release of a hazardous matedal7 ❑ Yes ❑ No � (Section 25505 oi t�e Celi(omia Haelih and Satety Code requires, with some exceptions, that e Business Plan be lilatl wit� the Costa Mesa Fire Depanment by evary busineu which hes at eny one time tluring a reported year a quantiry of harartlous matenals eQual to or greeter t�en e welght of 500 pounds, or a volume of 55 gallons, Does or will the applicant or present or tU�ure building occupant neetl to file a registration tortn lor acuiely hazartlous materials7 ❑ Yes ❑ No (Section 25533 ot the Calitomia Health and Safery Cotle, with some exceptions, requires registretion with the Costa Mesa Fire Department Dy each business which at any one tima hes on hantl a quantiry ot ecutety hazardous materials aqual to or greater than e waigN of 500 pounds, or a volume oi 55 gallons, or 200 cubic teet of compressed 9as at stendard tempereWre entl preuure). Does or will ihe epplicenl or present or fUture builtling acupant need to prepare an RMPP (Risk Management entl Prevention Program for ecutely hazardous materials)? ❑ Ves ❑ No 25534 0l ihe Celifomia Health 3nt oi an RMPP by businesses that the Costa Mesa Fire Department may require Iha preparailon, centlica[ion and filing wiih the Fire ler acutely hazardous matenals with the Fire Depariment. a u an nmrr is presenny requtrea, nas secnon zsosa or me camomia neann ana sarery coae oeen miry compnea wuna LI ves Ll No 5 Does or will Ihe epplicant or present or fuNre building occupent require far the work which is ihe subject ot t�is e plication e permit for such construction or motlification from �he Sou�h Coes� Alr �uality Meneg�ment Distdct or irom any other air pollution control disldct or agency7 � Ves {] No (Section 650502 oi iha Celifomia Government Code requires that the requested Information be tumished on applicetions for non-residential building permits). 6 Will eny pan oi the facility to be construded under this pertnit be within 1000 feei trom the outer bountlaAes of a school9 ❑ Yes ❑ No Qt'ves", ihe facility must meet ihe requirement oi Sectlons 25534 and 42303 of the Californle Health entl Sefety Gode). 7 Ii e permi� from the South Coast Alr OVeliry Manegement District or other eir pollution conirol district or egency is requlred for the work which is the subject ot ihis appllcallon, have all of the disclosures prescnbed by Celifornia Health and Safery Cotle Section 42303 baen mede7 ❑ Yas ❑ No 8 Q�'yes", ettech certificate of wmpliance ��om the eppropriate air pollution conirol oflicer). CERTIFICATE OF COMPLIANCE: I ceAity ihat untler penalry of perjury the informetion given abova is correct. I agree m compry with ell state laws end ciry ortlinances regertling Ha/�i' ous Melenals anA Emissions. y/�� Signature: i �Z_�L�/ Date: ��%�� / CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENiRV: I certity untler penelry of per�ury thet I heve reed this application antl state that ihe information given is correct. I agree ro comply with ell state lews antl ciry ortlinances releting to huiltling construction, entl authorize representatives ot Ihe Ciry of Costa Mesa to enter upon the ebove-descdbed property for InsDectlon purpPses. I egree not to occupy or ellow occupancy of any bullding euthanzetl by this permit until final Inspection. COOE t. INSVECTIONTYVE 1616 Fizetl System Finel Fire Prevention 1266 Pool Spa Finel 200 Final Re-Rooi 201 Finel Black/Retelning Wall 202 Finel Fectory Fira Plece 203 Flnal Sign 204 Final Demolition 2606G8 QAIF. It�ELS GODE� INSPECTIONTYPE 206 Final Mechanical 208 210 212 220 Final Plumbing Final Electncal Final Fire Preventlon Final Planning Approval 222 Final Site 250 Finel Building/Occupancy P�T INTIf11L5 6 e City of Costa Mesa Building Safety Departmenf P. O. Box 317 Costa Me�a, Califomio 6 CERTIFICATE OF OCCUPANCY lY� 22p5 C The Building lomted at 3�` � G:�[�R1 AV�klj A�ii11Pl � has been inspected and found to comply with the provisions of oll City of Costa Mesa Ordinances applicable thereto for a Group �� J Occupancy. Use of Building� �j,�1�d�S'�i�lllti }�+41M1reg�t�{{�br:�! ��g�gE ps$ ]F�1R�,�p Legal Description � Z� �t T�I7 (Soe roverso �ida for Mate� and Bound�) 8uilding Permit No. �� Elecirical Permit No. �g';r'%�%i Plumbing Permit No.�}� Floor Lood Signs have been installed as Room Capacify Signs have 6een iristaled as required under Sea 2308 U. 8. G . reqoired under Sec. 3301 (1) U. B. C. — 17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occ�pied until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency. (b) A new certificate of occupancy shall be obtained whenever there is a change in: 1) Occupancy classification of a building or portion thereof 2) The number of apartments or guest rooms ' 3) Ownersfiip � If Group H Occupancy, number of aparfinents and/or g�est rooms as required under Sec. 17050.1 (d), California Administrative Code, Title 8, Chapter 9, Article 8. Number of apartments � and/or guest rooms ISSUED TO: Building Official _BALw� �P�' CO�TI� by ��%% _ / Date AOTSl g� 1�� This Certificafe of Occupanry SHALL BE posted in a conspicuous place on fhe premises and SHALL NOT 8E removed except by fhe Building Official of fhe City of Costa Mesa under Sec. 306 (e) U.B.G. porm sua��M.—ii-ea_s.a r ,« � C I T Y 0 F C 0 S T A M E S A Cti1LIFORN7A P. 0. BOX 1200 From the Ofiice of tiie Planning Department February lb, 1965 Alliad Constructors 1�2 $outh Euclid Pullertoa, Calilorniet The City of Costa Mesa wishes to advise you that in revising street addresses, the numbers listed below were changed: �lJ1� 1) �e 5475 Old Address ].�i� (`.lnnamtm i�V2II11C New Address 3729 Ctnnemau Avenve For your convenience �ae are listing the agencies below that �ae will notify of this change. In addition to those listed, you may desire to notify your correspondents o£ the change. rlb cc: Your cooperation in this matter is appreciated. Southern Calif. Edison Co. Southern Co. Gas Co. Costa Mesa Co. 4Tater Dist. Pacific Telephone U. S. Post Office County Clerk (4) Public Works Dept. Engineering Dept. / Bldg. Safety � Street File Pacific Facility Test Center Very truly yours, W. L. Dunn Director of Planning By: g�<�� - Planning Technician CITY OF COSTA MESA� � ' � ' CONSTRUCTION PERMIT ' `' . �' ' Applleant to till in all ipaees except t�ose within �aary bortler Ilnes.anA sl9n all apProoNata Geclantions._ . ; � - - PER IT NO. � � TRACT NO. �. � LOT NO. BLD ., • . � TVPEOFCONSTRUCTION NEW ADD' ALTERATION" �REPAIR , f.f �/L ProjectAddrett� - /° �' � ."� ��', ,/r Owner's Name '-,'n �!/� � vhone �GL9�2� Addreu' �Z��'' C��%cUlf � -C%�'i � - Arch/Eng.� Licente No. Addieu dontracmr's Nam � Phone ��`�'1 S�S�� Atldreu�Imailingl��Z 6io �aa� �`/ ,L//S License No. �� I.ICENSED CONTRACTOR DECLARATION 1�hereby aftirm that I am Iicensetl untler provi5ion5 of C�arter 9(commencing with sectlon 7000) of Dlvisian 3 of the Business an0 Profe55ions Cotle, an0 my Iicense is in full f ce antl eftect. - - License Class license No , �te �� Signature - ORKERS' COMPENSATION DEC�ARATION • i �ereby affirm that I have a certlficate of consent to self-Insure or a��certlTiwte of Workers• Compensation Insurance, or a certlileC coOY t�e�eoi (Sectlon 3800, 12G. CJ . . , ; Policy No. � Company BCertitietl topy is hereby furni5he0. ' Certifietl <opy is filea with the city Bulltlin9 Dlvlsion. Date ADC��Ent EXEMPTION-�FROM WORKERS' COMPENSATION DECLARATION ' (Thissection naetl not ba comD�etetl iT the permit is for one hunUretl (5300) or less). . . . . . ' . I certify that in the pertormance of the work for which this perm�t is IssueC I� shall not employ any parson In any manne� so �a o become subjatt. to t�e Workers' Compe SaTon Laws of Calitomia/. .7_ % Dace' � ignature Yj� NOTICE:I ,after making this_tlaclaration o�'snould become suDject to tha Workerz' Compensatlon provisions of the LaCor Cotle,�you must forthwith comply .with such provisions° or this �bermit shall ba tleemetl revoketl. CONSTRVCTION LENDING AGENCV ' ' ' ' I hereby aTTirm that tnere is a constructton lentlin9 agency tor the performance of th¢ work for whiGh;thiz permit Is�issuetl'(Section 308� Civ. C; LenEer's� Name ' LenGer'S. `AaOress OWNER'BUILDER OECLARATION� ' � ' . I her8by�dfTirm Sh2t I am Exempt Tram tha�ContrdttOr'S� Llcen58 Law fOr [hB followino reason.(Section'-7W7.5 BuSinessand Professional•Cotle: Any city or_ LJ I; as owner ot� tne � compensation wtll tlo' for sale (Secfion 704� License l.aw tloes not a � thereon,�antl .who �tloe! empioyees, provitletl tn . sale. If, �oweveq the b � . pletion, Ihe owner:will rovG fo� the pu�pose o W�� I, as owner of the F tractorz to constru<t thi The Contractor's Cicer builtls or improves the �' tractor(s) license purw. i � I'am ezempc untler : O' Date ' !VI V� � �xempt iecNon a_ clvil , anE [o an owner or a proper[y wno ouiias or improves ' i work himself/herselt ar through hls or her own :h improvements are not IntentleA or offeretl for g or improvement is soltl wlthin one year of com- ' the burtlen of proving he/she tlltl not builtl or im- � � , � , ty, am ezUusivery contracting!with�llcensed con- act (Sectlon.7044, Business�antl Pro(esslons Cotle: ' iw does not apply to an owner of Property who , antl who contracts Tor such Dro�ects with a con- . the Contractor's License Law). � n , B. & P. C. for tnis reason ❑ GONVERSION ❑ DEMOLISH �T�OE�� DESCRIPTION.OF WORK k , � TVPEOFPERMIT GRADING FOUNDATION STRUGTURAL � ❑ TENANT 0 ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑,�OTHER - � ' PROJECT DESCRIPTION� SQ,FT.� �occ�aaNcv— , CONSTRVCTIONTVPE - VAWATION$� ' ZON� ' GRADING CU. VDS. ACR� Remarks: - ' ' � � � Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains � Floor Sinks Gas Service Sink - Drains " Sewer Cap � Sewer Connection Solar Collectors Solar Piping So1ar Tank , Swimming Pool wlSpa � � Urinal , � Water Closet� � Outlets' � I Service Sink " . Boiler � Duct�-UnderGround ' � Duct - Strucjural . � � �. Duct_.Ventilating. . '.. _ � Exheust System ❑ Multiple �; Fiiepl/Fact.Blt.ICBO�k . � � Heating System & Ducting ; � � n:......'.......:.,r�.� n..�........or�! senta[�ives �ot�th)'a�(city � oy�nter� upon thB above-m,entlonetl� Droperty for ' Hootl of Type I ' inspectlon pur 65E5. � � � ' Date p� tpO 1 CBno T. e I � �W�O,J Sig�ature ' • I i 9 CMF OB65-46 rev. 12/82 White - Builtling; Canary - Applicant; Pink - Actounting; Goltlenrotl - Assessor Water Heater - �- . ' - WaterService a� � ' ' ' - � Reinspection Fea $15 laue Fee , S 3 iANICAL � Refrigeration System � ' ❑aioo,uoaeTu ❑ioo,o�sru System Repair/Alteiation '" " _ �_ �.. . � � . I , � � ".' _ t Reinspectioq Fee< $15 , , Iwue Fee i . S 3 A. P..� PLNG. REF. �p' �TO BUILDING PROPERTV LINE �CEFTSIDE VARD .PKG.SPACE REQ. STREET WIDTH SPECIAL CONDITIONS: . Automatic Washer Construction Pole Cooking Unit Dryers ❑Gas Fan F,A.U. Fixtures Device Boxes � . 3.:U '�/I'i%i;3 20NE BUILDING - � ecZgpCY rii c�r REAR VARD (TO P/L) RIGHTSIDE VARD ' " � � PROVIDED PARK FEE $ Meter LJover 100 amps � Sub Panel Sub Pole i Motors LJ04 HP LJ1%$ Jectric � InaSolar 09115 HP �16-15+ Microwave ' ' . ' Pole�Light . , ,. $eCtiOns Switches Trash Compactor Garbage Dispoul Generator OO-5 KW 05-15 KW � Transformer ❑75-50KW 05U+ KW' . . Reinspection Fee ; !,:��i: TL �, Meter ❑up to 100amps � laue Fee- �$ 3 Zoning Approved By � � Date I 1 . ApPliption APGroved BY �`v/ /� � r ^ate - Appliotion Issued BY ' "" Date � �� —�3 ' // S�U7 M�M�A,RV OF FEES � ' ' � BUILDING PERMIT $ �� SMIP ; � ' $ . •'S � PLAN CHECK - $ PERMIT : PLUMBING $ � � ISSUANCEj $. .PLAN CHECK � $ t GRADING ' ; $ , , ELECTRICAL $ � - � $ ' , PLAN CHECK� ' $ ' , MICROFILM � $ i ' . TOTAL FEE' . $ � � ' �MECHANICAL $ ; � � PLAN CHECK , $ �� LESS ' , � � � . ADVANCEDPC � $ , �/ �-�y �� ! � � � ' � . i FINAL FEE' $ '� t \` � rCONSTRUCTION ANDtPLqNNING, ,� . w - � - . -' -�' �` SPA' 4 - " - L - . � t r > � � , , r � � = �Date � �I ris` ector � - "' � � �' - ' ' � '" � Date +Ins ector. :APPROVALS � Permrt�# � P � � :APPROVALS � Permi4 # - ' � � P .. GJ i N . 1 < - . J . � t ' . . _ .. I "`' 1� Tem orar Ele'ctrical SerJice'or!Pple � � � � "'- � ` ` - ' - � � - - - ' .� P Y . , "'� Gn � � - '52:,Pool & Equipment�Location' . � � , � . , ni 2, Soil Pipe Undrgrnd:� � . � _ . � � : �53~ Steel Re`inforcement ° - . - - _,r y • E' � 1, r 3? Elecfncal Conduit Utilitv Undrgrnd. �� , ` :,� , °�54.. Forms . �` _ . , -_- �i � 4.i Electncal Conduit-Undrgrnd ° ' � : '. i r <, . `' � � ` 55r' Electrical.Bondmg ` - . �� . , � -7 � 5:� Steel'Reinforcement� , i � ri �• `� - - - � -� y � 56. Rough'Plumbing"& Pr,essure Test.' - � 6: Elecfrical UFER Gmd. ' ` = � - � ^� � � , � 57.� APPROVAL TO�COVER-GUNITE - � ' � • � i � � �c � 7. Footings; ', � � � I =' �. � ' = � =�s � `.�58. Electricai=Contluit-Undramd.�_ . _ � � �� - � ' i �, � , . . - � . _ � .. 1� - � : - - ' i - � 8. Foundation _I � � .. �I _ ` _ s �� 59. Gas Pipe,<O-Undrg'rnd.; Test'_ � : , . .� r - 4 ; . - . : . , - , ' - ' ' _ 9. N/ater'Pipe-Undrgrnd,. �� o�- ' _ _ '��60. Backwash'�Cines,�P,-Trap�,O Undrgrnd. j_ 10. Stcuc4ural Floor System i "" , ��' -- ` 61. APPROVAL�TO DECK , � -: i� 11. Property Sewer Line.& HouseConnection � - ' � _ ,' , 62. Backwasti &4Receptor-Final;� _ ". ' 12. Sewer Cap , ' � - � � � � b=' n ' ''63. Heater�&,YentrFinal�,. � ' i ( 1 I 1 . ,� , - 13. RoofDrainS � � , ; " � j �'' , - .!64. Plumbing-Systein_;Final`� -� � .. �:-, . n 14. Rough-Plumbing ' ; � �-�� - � � � 65. Electrical-Final - �'_�' ' • -' ` r �;, �'75=Rough' Electrical=C�nduit-� "-T '�� -'- � ` � -'�'-' - �- -' � " ' -66.i Sola� System-Finaf - � - �"- -�' - " � '� "' - - � i � � ��iQ6.�',R'ough Electric�Wiring-; ,. � � ; ' `�� -�;'j _,-Y� ' _- �-r:_'- �67.y Fencing & A'ccesi Approval �, � .� " � " ' -' '- c rn, ; m _ ,: i �. � _ ,'17. Rou h�Wirin �Si n `-, ' ' � " ! �' i: _ � � . . . . �� . �� 9 T 9 9 . �. �' `68. QP.P.RO,VEDFOR.PLASTERING �_ _ - - : �18: Rough�Elecirical-TBar'Ceiling' ' � � V � � � i" �� :y' � 69.�POOUSPASYSTEMSFINAL � � � ' � � � ' 0 19. Rough�Heating�&'Air Gonditioning � � _ , _ ' � � � i � , FIRE DEPT. REQUIREMENT � � , - � _ � - : = t� 20.�Rough>Factory; Fi�eplace i ' � +� ! , I j � � APPROVALS � � Permit # � , � � > r � y . � i : ._ n , . . � , , _ •: 21-. DLct,s,:ih Stiucture� `, i : ' : j � � � � . ' 70. � Underground Hydro � � = s ' _ ' :_n 4 i e.--. . ' : , , . ' . ' � �`,22. Ducts, Ventilaiing ,. ' 't � , f j � ! � � ! 7L i product Piping O Gas ❑ Oil ' � . 1 ' � ��;23i Gas Pipe-Rough & Tesf � ' 1 � ` ' ' � 72.! Underground Flush � , � � � � � � az i i ��24. Roof'�;Framing; � � � ( � i �j',;I,�,; � �'<< ;��, � ;;. 73.�Undergrnd.StorageTank�'OGas ❑�Oil� ' � ' ' ' 25. Roof Sheathing ; ' y, � � �:� �. ; � �_ ; � � 74. Overtiead�� Hydro � � ' , � 3 '� 26. �-6a� Ceiling (Structucal)� & Monocoet - ` + _ � � ��'� � ` . 75.� Dr,y Chemical _ . � � _ ' ' � < , � . ` �`-27. Frame and Flashing �� i i � � � �' � � ; � � 96.� Dry Standpipe � � i �� . c � 28. �Lathing & Suding ; ;� ' . � � ` � �, ' ;; � ' j 77.� FIXED SYSTE�M'FINAL ' ' ' , ; d 29._ Insulation s� �-" � i � �, ' ; i i � i I'' 78.j FfRE PREV. FINAL , ' . i. ='30. Drywall Nailing ! "'��T� I � � � � , i ' ' � � ,Notes:� � � . ' ! ` �'31. �Plaster Brown Coat , . �� - � -� � �- .- - � - j- -�-..� . . -. " .� . .I _, . . _._ . - i , '- y. .'.. � . � � , � . � i � . . , . � ;; 32. �Electrical Power Meter�Final i � t ! , i � ' , . . � . � � :; , - � " _ � , .: , . , , , � � 33. Final�� Electric !� i �; � , � � � ' � ' i ..-. . -. ,-..e.. _._... .._ -,._�-_ _: - .. . __.� .�...• _ -' _ ' .... . . . .. , � , . � . , ," " " y 34. FinalHeating&�Air.Conditioning �i � � , � i . ' � � ' � a r ��.- : r . I � 35. Final Gas�Pipe'Tesf, � � � •' - , ; � _ � ' ' I " � '� __ - - - - . • - � 36. Hood Or Eanopy.:i_i t i ' ' �' � . { �, . ' � � ti � _ � � ' , - . , + ': il Ir' � I - ._. � 'l� ^i � I � ' ' - - 37. Final Factory Fireplace ; � " � � � ' . , � . ' � ' - ` � " - ' • . � .- : . � i . � , � � . .. . , 38. Final�lumbing'. � `��' , �.j . ' � � ! , ' `i . , .. . . . 39. Water Service-Finalj I � � ' ' ' � �� ' ! � � � � � i � i i - - 40. Gas Se�vice-Final � � � � J i � � � ! j . . � ��-� . � : , . � . � 41. Solar pomestio-Final i . � �' � ' ' i 1 ; ' ; � , :' � ; rs =r. - -- - - - - - -. . , . � � 42. Backflov✓�Preventer� Q � � ' ` , � � : ' ' ' � ' � � � .� . . . - --'-�. _'� -" � r._ - _ _ _ . �' . i - _ 43. Backflow'Irrigation� : � � _ , _, �'; � � ; � ' ' i � ' � � 44. Landscape Ir�ci,qation�System � ',i - � � , � , ' ' � � . , � , ` � - 45. SoundKAtterivation, a �;, j � � �� I i. ' i � ! .=� �� . • . • • r' . 46. HandicapiRegulation"s� I ' � , �' _ . , I ,; - ' - ,• t' .. . . � � . , � j � i 47. FINALSTRUCTURE & BUILDING � � ' � � �. � : j � � � � . i 48. Special Requirements Corripleted ; � , � � � , � ' , � � : � � ' , , , _ 49. Electric Release;to Edi;on' ; i �.. � _� .' a_.; . � _ 1 .. . , " ' � ' . ' • 50. Gas Release to Southem Californla Gas Co � � : � � � � j � . i -, � � i ' , , � 51. CERTIFICATE OF;OCCUPANCY � _ � � ! ' ' � � . No. �, i i � Date � � -�--i -- i - � - i ; • �-- - � -� - .. ' - . .x RO(,_ COVERING CERTIFI�.�TION Permit No. � /�� Property address 3/ 7�! C%i �iti �o c. �//I�J Owner ��Q TGi �.C�i Contractor State Contractor License Number Classification C`/ 3 d- C 3 9 1 hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the above address in conformance with Chapter 32, and Section 1704 of the 1979 Uniform Building Code, as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the manufacturer. ❑ I further certify that I am the owner of the property. (Owner-Builder permittee only�. �' I further certify that I am: ❑ Owner of sole proprietorship company C� Full partner of the company C� Limited partner of the company ❑ Officer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, whiCh shall be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. Received by Building Division by: `�I'i ,b ,s� �/� � ioi:iai odee Spaee fo� Notarial Statement !o� aul�o�lieE affiee� a� aqenl / or Coroorate Name �%ZCi2 .Gid7ZLiav�✓ '�9 � Atltlross fy�G s.. �i.�<t �r�, �iA!' Li ('� �o��, � � ��,.�,�- Printetl or Typetl Name CMF 0990-46 White • Bulltling Dlv.: Canary - Contrattor, Plnk - Owner •� � 2�2�� COST. MESA BUILDINGSAFETY DEPARTMENT � P. �,: BO%91] COgTp M69A. CALIFORNIA � For Applicanf to Fill In Comple�ely PE qR PRINT aui�oiN6 �/ aooaess ` r a y mG ✓G COSTA MESq, CALIFORNIA S � ARCHITEGT LIC. NO. TEL _ $ 3S OFLOT 73 X ZLO I NOWONtAT� O USE OF EXISfING BLD6. - SETBACK LINE FROM �� (��I CENTER OF BTRE6T Y R6AR YARD LO I SIDfiYARDI LEPI' 1H t R16NT 9� DESCRIPTION OF WORK � EXTERIOR 1 HEREBY ACKNOWL8C0H THAT � H/�V8 RPAD TXIB �PPLICATION AND STATE THAT TH8 ABOV6 IB CORRBCT AND AORHB TO COM- PLY WITH ALL QTY Oq�NANC�B �t �BTAT[ L�W6 H[OUt,ATING BUILDIN6 <ON9THIIC/IG� SIGNATURE OF PERMITfE � ✓ AUTHORIZfiD AGENT ,..\ Pv � T. � rtt Kt�t�vtv FINANCE� DEPT. CITY OF COSTA MESA APPLICATION FOR PERMR BUILDING For Ofilce Use Only 11HCt1If NO. � PENMIT NO. .� ZONING NO.Ol� YG60PN[W �LAN6 pUiLDINO „ LBOAL 7 '. NO. �� ` � / 'E: NO EAVE OVERHANG SHALL BE LE38 THAN TO BIDE Q REAR P. L E8 .OWED (U.B.C.REQUIREMfiNT] YARDSAPPROVED YARDSAPPROVEO MAIN BUILDIN6 ACCESSORY BUILDING IOMC/LBTRHET) I �Nr ' C;uuAac7�r, j� ID8 C '= iT. /� ..n i VAR. S� DATH � , s4. �. o �1l , 9� , TN8 �MOUNT 6HOWN UND6P VALUATION IB POP TH8 PUHPOBH OP 88T/�BLI8HIN0 A PEpMIT FEE ONLY. VALUATION �� //�/� (� PERMITFEE y � $ � / c /� �— T TAL FEE / / � � LL. � LL3 c: 3 y W � � Q U {l� a � � O � 0 � e _ �;� � ��767 CO$TA MESA BUILDINGSAFETY DEPARTMENT ' P.O.BOX91] COBTAM68A,CALIPORNIA For Applicaqt to Fill In Complefely TYPE OR PRINT ILDIN6 .�y/� a-� H / JRESS � I ¢,r.,�J �fJ COSTA MESA. CALIFORNIA � MAIL � FIRE TEL.�—� ZONE NO. APPR �_� TEL BY NO. ��.,__��—.. STATE ,n �O �ic LIC. NO. . .�. SRE�--�—� ■ 6ETBACR LINE FHOM EFT �__ I RIGHT DESCRIpT10N OF WORK BUILOIN6 -�__ 61ZE EXTERIOR WALL 0 �� BLDOB. � � �sr� �r ��s�A �fsa MAR 24 1965 Fo� Office Use Only I R6C[I'T NO. ��plp� �1 er .. � I PLAN9 � I BY LD NO� �Jyv f JV ��.,o� � �� r fi�- sZ-i� �o. 13�.iyl�-iy NO EAV E OVERNANO BHALL BE LESH iHAN YARDSAPPROVED MAIN BUIL�ING VAR. �j C. U. P. SF MPROV ED YARDSAPPROVED ACCESSORYBUILDIN6 DATE I HEREBY �CI(NOWLEOOE y{�AT 1 XAVH qBAD TNIB �PPLICATION TXe /�MOUNT BXOWN UNOBR VALU�TION IB FOR TMe ANO STATE THAT THE �90V6 �9 COqRlCT ANO AOqE! TO COM- PUHPOSE OP EBTABLISXINO A PERMIT FHH ONLY.� PLT WITH ALL CITY OPDINA C88 ANG BTATB L�W9 q80ULATINO Bf11LO�N6 CON9TRUCTI VALIlAT10N A SIGNATUREOF � �` PERMITFHE $ �� PERMITTE $ I/ L � PLAN CHpCK 8 AUTHORIZEO AGENT ` "� 7