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Home My WebLink About3057 CLUB HOUSE CIR - Building Permits(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIFi �HIVE, GOSTA MESA, GA 92626 Job Address: 3057 CLUB HOUSE CI Suite No Vicinity: Parcel Nunmber: 13951507 Applicant: SZABO, KEVIN Address: 2737 S CF20DDY STE D � SANTA ANA, CA , Owner:' � GETTS, HOWARD L TR Address 305� CLUB�HOUSE CIR COSTA MESA, CA PLUMBING PERMIT Phone: (714)241-1414 ' Zip: 92704 Phone: Zip: 92626 Status: ISSUED Applied: 09/24/2003 Issued: 09/24/2003 ISSUED BY: \. �\ � � . �_ � . � ! �.�_� � �.,'� , i� .�. � , , Contractor: COAST ROOTER PLUMBING HEATING & AIR CONDITIONING Address: ' 2737 S CRODDY - �� - � STE D � Phone: (714)241-1414 SANTAqNA,CA , Zip: 92704 � � - License: 529127 � . Arch / Eng : Address: Phone: Zip: License: � SCOPE OF PERMIT %' � � �. � CHANGE OUT WATER HEATER � � � : � � , �'='FEESUMMARY;•. '"�;' � - � AMT QTY . . . - � - � . AMT QTY �, ,, .,-� , , - " - �� AMT QTY ISSUE FEE, � � $23.5U � Laundry Tub / Wzsher $0.00 0 � � ` " � Sump Pump � , � $0.00 0 BackOow irrigation $O.OQ 0�� Landscape Irrigation $0.00 0 � Swimming Pool �$0.00 0 BackFlow Preventer $O.Op 0 P-Trap $0.00 0 Trap Primer '. '$0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0� UrinaP �: - " $0.00 0 Clarifier System � $0.00 0, Process Piping (per 10 ft) $0.00 - 0 Vacuum Brkr Bkflow(1=4) $0.00 0 Connect pce,Soda,etc). � $O.OQ . 0 . Receptors �' S0.00 0 ' Vacuuin Brkr BkFlow(5+) $0.00 0 Dental Units $O.OQ 0 . - Septic Tank $0.00 0- , : Wash Basin� �� $0.00 0 Dishwasher �$0.00 0' � �Sewer Cap for Demo �$0.00 0 , Wash Basin Set $0.00 0 Drain, Floor $0.00 0 , Sewer Connect 50.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $O.Oq 0 Sewer Pnvate Line $0.00 0 - Water Closet (Toilet) $0.00 0 Drain, Roof $O.Oq 0 , Shower � $0.00 0 - Water Heater / vent $12.30 1 Drinking Fountain $0.00 0 -� Sink; bar $0.00 , 0 .� Water Piping (Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink, commercial $0.00 - 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $O.OQ 0 Sink, Floor $0.00 0 Water Service $0.00 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, 1241-g2) I � EXPIRA710N: 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 780 days. INSPECTIONS: In order tor ihe Work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlred inspectlons and final epproval must be obtainad. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2ans�ae �voo� WORKERS'COMPENSAnON DECLARAnON: �' I hereby aflirm under penelry of parjury one ot the following declarations: - ❑ I heve end will malntain a ceRifiwte of consent to self-Insure for workers' compensetlon, as provide0 tor by section 3700 of ihe Labor Code, for Ihe peAortnance of the work for which this pertnit is issuetl. � I heve en0 will maintain workers' compensation Insurance, es requiretl by section 3700 of �he Labor Code, tor ihe DeAortnance of Ihe work for which Ihis pertnit is issued. My workers' compensetion Insurance carrier and policy number are: 1 /,, -7 y� Cartier: �Z � t�ll fJ � Policy Number. 4�/ ��9 L� �/ � Q� (This section need not be cromp/efed i! fhe permit is valued at one hundred dollers ($100J or less.) � I certity ihat in the pertormanca of the work for which thi pertnit is issued, I shall not amploy any person in any mannar so es to become subject to the workers' compensation laws ol Calitorn'e, d agree etlfT�o become subject to the workers' compensation provislons of Section 3700 of the Lebor Cotle, I shall fonhwith comply with ihese provisions. � ��`D � Applicant Signature: Date: WAfiNING: FAILURE TO SECURE WORKE ' OD 0.ENSSITIO VERAGE IS UNL4WFUL AND SHP1L SUBIEGT AN EMPLOVER TO CFIMINAL PENALilES AND CIVIL FINES UP TOONE HUNDREO THOUSANOOOLL4HE(5100,OW�,INADDITI TOTHECOSTOFCOMPENSATION,DAMAGESASPROVIDEDFORINSECTIIXJ3]O60FTHELABORCODE,INTEREST,ANOATTORNEVSFEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm Ihat I am licensed under provisions ot Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full forca entl ettect Lic. # Class e C��, 9�i1 C. Coniractor's Signeture: Date: q� 2s�_ �� CONSTRUCTION LENDING AGENCV: � ❑ I hereby aNirm ihat there is a consimction lending agency for ihe pedormance of the work for which ihis permit is issued. (Sec. 3097, Civil Cotle). Lenders Name: Lentler's Address: Signature: OWNER-BUIL�ER DECLARATIONS: Date: I hereby ettirtn thet untler penalry of perjury �hat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Business end Proteuions Code: Any city or counry which requires e permit to construct, alter, improve, demolish, or repair any strucWre, pnor to its issuance, also requires ihe applicant tor suc� permit to tile e signetl statement t�et he or she is licensed pursuant to the provisions of Ihe Contrectors license Law (Chapter 9(commencing with Sectlon 7000) of Divislon 3 of ihe Business and Professions Code) or thet he or sha is ezempt thereirom and Ihe basis tor Ihe ellegetl exemption. Any violation ot Section 7031.5 by any epplicant for e pertnit subjecis the applicant to e civil penelty ot not more ihen five hundred tlollars ($500).): ❑ I, as owner of ihe property, or my employees with wages es their sole compensation, WILL DO THE WORK, and the siructure is not intenUetl or ottered for sale (Sec. 7044, Business an0 Protessions Code: The Coniradors License Law does not apply to an owner of property who builds or improves �hereon, end who does such work himseli or herseN or ihrough his or her own employees, provided ihat such improvements are not intended or oHered for sale. tl, however, Ihe building or improvement is sold within one year of completion, the owner-builtler will have the burden of proving ihat he or she did not build or improve tor purpose ot sale.). • ❑ I, as owner of t�e property, em EXCLUSIVELY CONTRACTING WI7H LICENSED CONTRACTORS to cons�ruct the project (Sec. 7044, Business and Professions Cotla: The contrectors License Lew does noi apply to an owner of propeM �'ho builds or improves thereon, antl who contraas tor such project wit� a contractor(s) license pursuant to Ihe Contractors License Laws.). ❑ I am exempt untle(se2 SignaWre: �� Business antl Professions Code for Ihis reason: Date: Owner ID veritied by dmer's license:� ., ❑ Yes ❑ No Onvefs License No. Expires: Verificetion of Ownership by (rype of tlocument:l.e.�- property tex bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICA710N: ❑ I hereby certify ihet no excavetion tive (5) or more teet in tlepih into which a pereon is requiretl to descend, will be made in connection with work euthodzed by ihis permit, entl that no building strucWre, scaMoltling, talsework, or demolition or dismantling Ihereot, will be more ihan thirty-six (36) feet high. (Chap. 32, Grp 2, Ah 2, Sec. 341, Tl�le B, Californle Adminislraiive Code). ❑ As owner-builtler, I will not employ anyone to do work which would require a permit from ihe Division of Indusirial Satery, es noted ebove, unless such person has e pertnit ta do such work irom ihe division. Signeture: Date: Division oi Industrial Safery Permit Number: CERTIFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRY: I Certify under penalty of perjury that I have read this application and s�ate iha� the infortna�ion given is correct. I agree to wmply with all state laws and city ordinances relating to bullding consiruction, entl euthonze representatives of the Ciry ot Costa Mesa lo enter upon Ihe ebove-descnbed property lor inspection purposes. I egree not to occupy or allow acupancy of any builtling authonzed by this permit until finel inspection. CQOE 1. INSPECTIONTYVE ' 1616 Fixed System Final Fire Prevention 1266 Pool Spe Finel 200 Finel Re-Root 201 Final Block/Retaining Wall 202 Final Fectary Fire Place 203 Final Sign 204 Finel Demolition Date -zy.�3 Data ORTE IMRIpLg COOEy INSVECTIONTYPE 206 Final Mechanical 208 Final Plumbing 270 Finel Electncal 212 Finel Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy PAg I�AI� �� ztoncssaeuiaxo:, 3057 ((LUB_.,•�jOUSE CI i avNevsru�eiva+orm: GETTS, HOWA'RD L TR mox�u: 3057 CLUB HOUSE CIR COSTA MESA,CA wr�. wuura woness: 92626 uxr: ,.. ,, CITY OF COSTA MESA — BUILDING PERMIT 1 r� _ �_ PERMIT NO: P 079592 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU �xcxrtttt ox �au��x: uc. rn.: mcx ox �o.�s wow¢ss: urrt: coxrn�craxswue NOCK PLUMBING ( 714 ) 895-1246 caNm�croxs�uimo 11610 SEAHOARD CIR �� STANTON CA ��, 707775 90680 �M, 110EN3ED COMR�CTOPS DECLAPATION: I ha�eby eArm under parely d qr"ryry Nm I em f enaed uMx prwiaione d Gheqm 9 (canmemiM wnh Senbn IOW) d 0'vrimion � d iM Butim» enE Vrdeavone Catle. end mY licenae io in lup lace md eflap. cmuc.No.:05 386 uc.cuss: C-36 uc.No.: 07775 EXP: 02/97 m, �o�,�� Pc.vn� a ��6 ER BUI�OE DECIANATION: I hpmby eMrm under penelry d perFN�Y �� mq hom �M Con�repon Lironae law lar tM Idbxiip �ee+on (�im )031.5 &n'vima vd Rdesaiom Code: My ciy a caunry xfiitli re9uirea e parmn �o omswn. al�s. imprwe. damde�, a ropei eny eVuduro, piv io ns ivaueMe, ebo raquirta tM eppliixnt tw m�ch pxmA b fila e egME eletameM ihel M or eM w IicamaE W�a�� o �M poviaione d tM Contreaae licenae Lew �Cheqm 9(mmmeMi'p vrilh SeGion 1000) of DNebn 3 W tM Bueinms eM Prdmeiom Code� a �hat he a ene ie eumq �herehom enE iha baaia 1« the dleped memption. Nry violetion d Sadion ]031.5 by any eppliranl /or e parmA wbpee iM epplicent to e ovil perelry d �wl mare ihen Me huMred Edlen �SSW�. � I, a� owner d IM propMy a my empbyeee wih wepea u thei ade canpanxtion, will Eo I�a wwk, anE IM aVUCun b nd intaMeE a aRered br We (Section ]OII, Bu¢ineae enE Profeaaione Code: The Comreawe Licensa Lewdoea �wt epply�oen owrrerd qopsny w�o W1Ce a inpmvee thereon, vM who doee cuch xnrk himaelf or herseH w Nraph he a her own emplv�me, pm�detl Ihet wc� imD��enie ue rot iniardad n d1ereA lor sele. II, however, tM buiNirp m'vnpm+emeM ia eok wilhin om yeer d mmpbtion. Ne owrwr-0uiWm xill Mva ihe burden d pwi�q he or eha did rot builtl or impruve lor tM WN�e d aeb). ❑ I. m oxnar d �ha propary. em e:�duvivay mnireclnp xilh licenaed mnvectpe lo wnsVup Ma pmpd (�� ]�. ��e eM Pmfeavme Code: The Conlrenon L'cense lew Eoee �wt eppFy lo en oxner d propMy w1w buiNe w imprwm ihereon eM vAw conlrecte la wch prol�a wil� e can�reear(e) Icaneed W�uent lo IM Canitedora Lioame Lew). � I em ecemq undar Sanion: B. 8 P.C., fa ihia reeeon: Deta: Ovmer: I Ao hereby cMity Ihel I am ewera ol vd ueMareteM ihe raquiremen�a d Celiomie HeeXh eM Selety Code Sedione 25505, 255�3, eM 25530, eM thet I a eiry INure builEi�p oocupent will / wJl nM (arcb ma) need to canply wih eaid elele mEm aM tM req�imneMe br epeminlamnevuciionormodifirationhanlheAi ueaTy�arapement0iatrid.Reeidenlblmnet�utloneppimuroweaamqfmmlhsss prwieiona. oe�e: nvW��u WORKER'S COMPENSATION DECLAF�TION: I Mreby elfi�m undx pareM1y d pajury me d Ihe totlorriiq Aetleral'vn: ❑ � neve e�e m� meimen. oenaiwe a oovem m..n i�.�m m, wwken• wmoemm;on. e, wwieee r« M semm a�oo a m. �.no. Coda, la IM pMamvrw W iM xwk /ar which �hia psmu w isauad. " waktawhieAimein��n�mmueE.M��kan�surC�VLUCN �NlaL3)OD�� ..b,�EXPIRES I mb Pdry�NumM: t 0 9/ 01 / 9 7 (lhia seaian r�eetl rot 6s mmpleleOl uro pemi! is M are hundred dolkrs (Jt0o1 a/w.) � I oenh thet in Ne pMmnvics d tte work 1« which this pumu ie' . I aheA � empb� erry paeem n em� man�r n n lo become wbpd to IM�qe ' mnpmae�ion lawe d CaI prea ahwk became vibpd to iM wahrs' �comparumi�qAiiom d S/uion 3100 d iM LeEa CaEe. I I 1 ' h compy �'Ih e pioNmre. _ M+mlrp: Fauw/ro aseun woMwi mmps�uetlon rovereps l� un/ewNl. aiW alWl �W/ecr an employr ro e�IMnsl pw�Wtlqii 10 elHl Iln�� q b om Ir�ntlrM thouuM oa/Nn (5100.0QDA M tl0ltlon b ffi� roat ol eompwwWR a�p++� PA✓�� In Sectlm 9ro6 0l M� Lebor Cods, InMu( eM ettomsya Issa CONSTqUC110N LENdNO AOENCY: I hmaEy a1fi'm uMer penelry d parjury thm �hxe o e mnn�uaion bd'vp aperw,y lor tlr DertormeMa d IM wak /a xfiich �hi pertni'v 6m»d (Seaion 3091, Civ. C�. LENDEN'S NNI E: LENDEH'SIUDNESS: 1 cerlM �� I heve reed Ihia epdk� � dtle Ihet Ne eEova iMamuion ie mrreq. I eprea to camply xich dl ory ud wuMy pdineiKw erd etale le� relei'rp io WiWip con¢trudan vd Mreby au�honze �apreeenletrvea d thia cilyto enter upon IM abo.e�maMioneE popMy �«ina�aionq�rposes. �� NOCK (5151de.WP) WhBe-Buildinpd5efety;Greao-F�enery-Appliram;Pink-Rnanue;GddenroE-�Avaeaaor PERM NO: P 079592 GOVT; N SUPP: N PURPOSE: OTH JOH DESCRIPTION : C/O WATER HEATER S(j FT; CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT ***x�*x��r�r�x�x *�r�r*��r*�r�r*x �r***x*x x ****x��t*+�x�*��rx��r��rx��r�rx��r��r+r+rx�r��rx�*�*+r**��rx��*�+�*�r�r*�e Z O N I N G R E Q U T A E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 13951507 ZNE: AEF NO: PLANNING NOTES> i 1E 1E 1E 1E if' iF ii ik 1E� iP 1f M if ik 1E a! 1E 1E iE 1E 1F if iF'IE iE if if if if 1E iE 1F iE1E iE if 1f 1f� iE ik 1F iF iF 1F iF 1E 1E 1k If 1E 1E iE 1E If 1E 1E iF iF 1f IE 1EfE if 1E IE IE iE 1E iE �EiE 1E 1i iE iE'IE iE 1E if D E V E L O P M E N T S E R V I C E S R E(� U I R E M E N T S ZONING APPROVED BY DATE: HUILDING APPROVED HY : DATE; oL APPLICATION ISSUED BY: ��_ DATE: ��I` v iEiFiflfklkikik141(�1EiFlkifiklklflfiElEiEifTF7F7F7FiF7F{F3F�{FfF7�'F{F7F3F�iF3FiF��F7F{f�iFiE1f1k1F�lkiklklElkik iblk LEGALIZATION:N F E E S U M M A R Y STAUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 11.00 25t _ SMIP/NON—RES PLAN � ISSUE FEE 22.00 �_ HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 11.00 22.00 �. 0.00 33.00 33.00 ,00 REVENUE DIVISION TOTALS--> COLI:ECTED: 33.00 OVER/SHORT: .00 BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 33,00 f� � ik if 1E 1f 1E iF 1k 1k iF iF iE if M fE fE 1k 1l' iE iE 1i 1E 1E 1E 1E 1f IE 1F 1E k iE iE'If iE ff 1E 1F 1f 1E 1E 1F 1E 1E IE Ik IE 1f il� ikiE 1f M 1E 1E iE 1E 1k 1f iF it iF 1(� 1E 1F iF ik iE 1E 1E 1E 1E iF'IE 1E 1f iE if 1E if 1! I N D I V I D U A�I: F E E H R E A K D O W N � TYPE QTY D E S C R I P T I:O N UNIT COST TOTAL COST � PLU 1 WATER HEATER AND/OR VENT 11.00 11.00 END OF FEES C' EXPIRED �L� 01'002154S0-D0215450 .TC1T 33.00 DATE DATE: Q9/23/9` TIME: "10:41 C,U c— CITY OF COSTA MESA CALIFORNU 9Q62&1200 DEVEIOPMENTSERVICESDEPAR7MENT BUILDING DIVISION P.O. BOX 1200 NOTICE OF PERMIT EXPIRATION To: Nock Plumbine 11610 Seaboazd Circle Stanton. CA 90680 Project Address:3057 Club House Circle Costa Mesa, CA 92626 Date: 5-12-97 Permit: # P79592 Our records show that the listed permits were obtained for property improvement or alteration at the above address and the project was not properly completed. The permits were obtained by: ( X) Contractor ( ) Owner Name: Ron Nock Phone:895-]246 License Number:707775 To construct or install: GO WATER HEATER The permits aze valid for 180 days from issuance or your last inspection, per Section 106.4.4 of the 1994 Uniform Building Code. Should we not hear from you within 10 days, your permits will expire and additional fees will be required to finalize the permit. Your permits will expire on Mav 22. 1997 Please be on notice that without a valid permit and required inspections completed, you will have encumbered your property with an illegal structure. If you need assistance, please contact THE BUILDING DIVISION, at (714) 754-5273, between 8:00 a.m. and 430 p.m. 77 FAIR DfiIVE gyiltling Division Q14) 754-5273 • Cotle Entorcement (714) 7545623 • Plannirg DiWsion'(714) 754-5245 FN( (�14) 754-AH56 - TDD (714) 7545244 �. CITY OF COSTA MESA CALIFORNIA 9262&1200 DEVELOPMENTSEFVICESOEPAR7MENT BUILDING DIVISION P.O. BOX 1200 Fq �;a�> j 91997 NOTICE OF PERMIT EXPIRATION To: Nock Plumbinp 11610 Seaboard Circle Stanton, CA 90680 Project Address:3057 Club House Circle Costa Mesa, CA 92626 Date: 5-12-97 Permit: # P79592 Our records show that the listed perniits were obtained for property improvement or alteration at the above address and the project was not properly completed. The permits were obtained by ( X ) Contractor ( ) Owner Name: Ron Nock Phone:895-1246 License Number:707775 To construct or instalL• C/O WATER HEATER The permits are valid for 180 days from issuance or your last inspection, per Section 106.4.4 of the 1994 Uniform Building Code. Should we not hear from you within 10 days; your permits will expire and additional fees will be required to finalize the permit. Your permits will expire on Mav 22, 1997 Please be on notice that without a valid permit and required inspections completed, you will have encumbered your property with an illegal structure. • If you need assistance, please contact THE BUILDING DIVISION, at (714) 754-5273, between 8:00 a.m. and 4:30 p.m. 77 FAIR DFIVE Building Division (71d)754-5273 • Code Enforcement (714) 7f�d-5623 • Poanning Division (714)754-5245 FAX (714) 754-4856 • TDD (714) 754-5240 �1 AOP��ant to Iill in all soaees enceo� ihase within neavr poraer Iines ana sign all avP�opriate tleclarations. , CITvoFCOSrniweSA CONSTRUCTIOjS�MIT , PER "°S�O� TRACTNO. • iLOT�NO.' ' "UNITNO: ! � � j � ; ' 3458� 9%I9/86' � � ` � y oS _ _ 5:00` . Pmject Address -3oS' ( , ' � ' ' . � , � ! Appliwnt'S Mdilin ddr g5 ' ' TVPE OF CONSTRUCTION , NEW ADD �ALTERATION REPAI R' - ' ' '� � j�kyyy�C ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p,# . ' ' : • Zone � Owner'sName:_L��t��(,�;�., ' Phone ' _ __'.-..,, .. _ .. _ _,-.._ ' ' ",- .,. . _ _' " c � : DESCRIPTION OF WORK/USE OF BLDG. , Address � t��Q `�� ! ' � � � ' ' S Main Building: � 'Accessory Building: Arch/Eng. ' License No. � ' � TVPE OF PE.RMIT GRADING __ �6UNDATION � STRVCTVRAL � T Front � � • � � � ' " • , O Addre55 ' � ' '❑ TENANT ❑ ELECTRICAL Cr: PLUMBING ❑ MECHANICAL B R2d� ' � � � � ' � N � Contractor'sNam _Phone �� QTHER. ' � ' I � • 1 A _ __ __ � �� ' PROJECT DESCRIPTION S(�. F7. � occuaarvCv C Right , . ' ' . " ' � ' ' " ' ' � � � N Address Imailing) � � - ' " ' K Left ; ' G � , - � 'CONSTRVCTIONTVPE VALUATION$ ' S � ' • ' R City License No. ' � � � : i � . , �ZONE GRAOINGCU, VDS. ACRES• � PI❑ Ref.� � "` Pd�kin LICENSED CONTRACTOR DECLARATION� . i i 9� 9 REq./Provided � . � E I hereby affirm that I am licensetl untler provision5 of Charter 9(commencing Remarks: �'. , � � � ', , � �' P�anning Notes:� � •� � p, ja�n^, . " M with section 7000) ot Division 3 of the Business.antl Professlons Cotle, antl my license;is in fu (e antl eHect. . -. ' ' , � _ � � rl ' - `( , , , , ' ' . ' ' ' � _ T �^ LicenseC�s � � ' ir o.. ' � ' � ' � S ,{ ` Oate � Signatire � - ' • PLUMBING ' - ' � ' FEES ' Y� WOR RS' OMGENSATIONDE LARATION BafSink � ' • ShOwE�s 1 I hereby atiirm that 1 have a certifmate ot consent to selt insure or a certiticate �'- � . " � � � ELECTRICAL � � FEE.� ;;�' of Workers' Compensation Insurance, or a certifietl cooY�t ereof (3ection gackflowPreventer• � - 'ServiceSink � - ' „ � ' 3800. Lab. ry` � � ,. ; - � Automatic Washer � ' Transformer ��-.15-50 KW ' ' �\ Poliry No:F�� ComPanv Backflowlrrigation� � SewerCa ' , � . � '� SO+.KW � i ' P � ConstructionPoleSub. ' � -` ❑ Ce/tiLed copy is hereby turnished. - ' - _ , � � ��Cert" 'e ilea with the city B}�1 iJ� i I n /� � Bathtubs Sewer Connection � Cooking Unit Meter' �up to 100 amps Date_�;��r�.� ApPlicant [/�A�j/��/ /�I�d��/�/i� . � . _ ' : _ .. .. . EXEMP ION HOM WORKERS' COMPENSA ON DECLARATION . Cldfifi¢t5' � �, , 5013� Coll¢ct0f5 . ' . _ , Di5hwa5h2�� - � ' i Merer �Ov¢f„100amp5 , ' (Thissection neetl ndt be completetl if the permit is (or one huntlretl (g100) or . _ . , ' -, • less).; � Disliwasher � � �SolarPi in � � - � ' � _ . P 9 � ' Dryers ❑Gas ❑Electric. ' Sub Panel ., i ; . � I certify that in the performarice of the work for whicn this perm�t is issuetl, I ' � ' � � shall mt employ any person in any manner so as to become subjecUto the Drinking Fountains ' �Solar Tank � � Fan � Motors �0.1 HP �1'h- 8' Workers' Compensation Caws of Calitomia. � ' . . • ' . ' � _ � , , � oate � � - Signature ' Floor Drains- , Swimming Pool w/Spa � F,A.U. � ' � ' NOTICE: If, after making;this tleclaration, you.shoultl become subject•to the . Ina Sola� �9-15 HP 016,15+ Workers' COmp¢nsation provisions Ot the Labar Cotle, You mus[ tortnwith FI00�SinkS U�inal ' � Fi%tu�¢S ' ' ' comply with such�provisions o� this!permi[ shall be tleemetl �evoketl. � Mic�Owdv¢ + .� CONSTRUCTION LENDING AGENCV ' ' GasService ' ,Outlets ' �.WaterCloset � DeviCeBoxes � � '1 ' !' 1 hereby affirm that there is a mnstruction lentlin9 agency for the performance � � Pole Light ' ot the work ;far which this permit � is issuetl ($ection 309� Civ. C.) ' ' ' � , � � � tznaer•s Name I � . Inteiceptors � � �Water Heater i � Outlets . Range ' � + � � �entler'sAtltlrezs,� ' � � ' " _ KitchenSink � _ � �WaterService -� -- - - - � Swi[ches -- �- - - � � OWNER BUIL'DER OECLARATION ' ' � _ � i� ' ' �Sign '� ' ' I hereby dffiim [hat I am exempt'from �the ContrdCtor'S LicenSe Law fof the LavatOli¢5 � • AutO-W2Sh Gdfbd C Di5 OSdI � � � following reason (Section ]031.5 Business antl Professional Cotle� Any city or 9 P Standing Sections , county which requires a permit to construct, alter; improve, Gemolish or repair P-Trap ' � Laundry Trays � � ' Generator DO-5 KW �5-15 KW � � any stru�ture, prlo�,to its issuance; also require5 tM1e applicant for such.pe�mit T�dSh�COmpdct0� , [o Tile a signetl statement that he/She is'licensetl pu�suant to the provisions o( Roof Orains � � ' � � � ' the Contractor's License Law (Chapter 9;(commencing with Section 7000) of . , � '� . � � � , � ' '� -^Division-3�of -the�Business'antl Professions Cotle) or thaYM1e/sne is exempt� - - - - �- - � - - �- - - - - - - -- - - - �� —'- -- � - - 'therefcom:and thE basis for the allegetl;exemption. Any violation of Section , � � ' � , � � � j ' � f �031i5 -by any applicant for a permit subjects [he! applicant to �a civil ' • � � � � � � ' enalty,oi.not more than.tive huntlretl tlollars ($500). ' ' � I,�as�awne� of �the'property Or my employees with wages as their sole ReinSpBctiap�FBe � $15 �� Isue Pee� ' � $'3 � , . compensation, will tlo:the work, antl [he structure i5 not intentletl or offeretl ReinspeCtion Fee $15' ISSue Fee � ��$ 3 � tm� sale �Section 7044, Business antl Professional Cotle: The Contractor's ' MECHANICAL , ' �FEES � � License. Law tloe5'nol appry to an owner of a property who builtls or improves thereon; antl who tloes such worklhimseli/herself or mrough his or her own � � � � , DEVELOPMENT SERVICES REQUIREMENTS: - • ' employees, provitletl that such improvements are not intentletl or ofiaretl tor Bo��er ; , Hood or �Type I ❑ � � . I - sale. It, howeveq the buiitlin9 or improvement is soltl within,one year of com- � Canopy Type II ❑ . � � zam^9 Approved By ' Date � �/ •`.pletion, the owner will have the bu�den of proving h¢/She tlitl not builtl o� im- DUCt - Unde� G�OuOd � • � � Building Approvad By DOtB � � i �ove for the'pwpo5e of sale). � I � ' � ��I',ias owner�o( the property, am exclusively contractin9 with licensetl con- Duct-Structural q¢frigeration System� Application Issuad By �— �i� ,/ Dat� � t�acto�sto'ton5trucCthe project (Section ]044, Busin¢55 antl Profe55ions Cotle: � �� The�cantractor's �License Law tloez not apply to�an�owner of property who Duct- Ventilating ❑0.100,000 BTU ❑100,000 BTU : � •. ' . SUMMARV OF FEES '- ' � � builtls or imOroves ihereon; antl�,who mntract5 tor such p�ojec[s with a-con- � • � � - - � � . � � ' " j vactor(s) iicense pursuant to the Contractor's License Law). 1 am aware.that � - ' ' . BUILDING PERMIT_ $; � �SMIP � � roof of their Worket's Compen5ation insurance shoultl be � Exh2u5tSy5t¢rtl O. �MWtiple'❑ SystemRepair/Alteretion� � $ � P , , providetl to me. - • PLAN CHECK $ � � 'PERMIT ❑ l.am exempt untler Section � , _B. & P. C. for this reason � FirepVFacLBlt. IC80 # Fire Dampers , � ' . pLUMBING ' ' $ � " ISSUANCE� � $ - � . � � Date � � ' Owner �� . Heating System & Ducting � 'Registers � ' _ . ' � ' ENERGV P.C. $ � � � � � ' ' " PLAN CHECK 25%' $ - - �I heietiy. certiry that`I'have read this appiication antl state that the above �0.100,OOOBTU �100,000HT � ' GRADING $ ' information Is correct'I a9ree to compry with all city antl county ortllnances ` ' . ELECTRICAL . .$ . .antl state laws relatin9-to builtlin9 �onstruction, antl hereby adthorize reDre- � � ' � . p�qN CHECK �50%. $ , � ' MICROFILM � $ � 'sentatives of t Is t to en r upon the above-mentionetl property for.' -' "1 • 'inspectionp s . ' �l C . . . . ' ' . '� . : MECHANICAL �; . $ ' ' , t .. . � Signature ' Date_��r�Y�T= TOTALF,EE�..$ Drivers' License or 55 � ' Rei�nspection Fee ' � $15 . .. Issue Fee• � � $ 3t� , PLAN CHECK 25% $ • � � - � � . ... GMF 0865-46, rev. 30/84 White - Builtlinq; Canary - qpp��cant; Pink - Accountin9; Goltlenrotl - Assessor ' � �� `� CONSTRUCTION AND PLANNING • Pc '� SPA �. � � a i � � Date - Inspector Date Inspector APPROVALS , Permit# _ APPROVALS Nermit# . 1: Temporary Electrical Service or Pole � � 52. Pool & Equipment Location ' ' 2. Soil Pipe-Undrgrnd. , � � .53. Steel Reinforcement , 3. Electrical Conduit Utility-Undrgrnd. . • 54. Forms � , � • �' m � 4. Elec(rical Conduit-Undrgrnd. � 55. Electrical Bonding � � � � 'D , 5. Steel Reinforcement ' 56. Rough Plumbing & Pressure Test � ` 6. Electrical UFER Grnd. � 57. APPROVAL TO COVER-GUNITE ' � � :u 7. Footings �. ' 58. Electrical Conduit-Undrgrnd�. ` � 8. Foundation ;� � 59. Gas Pipe, O Undrgrnd., Test �� , 9. Water Pipe-Undrgrnd. 60.. Backwash Lines, P-Trap, 0 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 ' � 14. Rough Plumbing • ' . 65. Electrical-Final � 15�.,Rough Electrical-Conduit � 66. Solar System-Final � ' ' 16. Rough Electric Wiring � � � 67. Fencing & Access Approval ' ' '17: Rough Wiring Sign - -� 68. APPROVED FOR PLASTERING - '' � 18.' Rough Electrica6T Bar Ceiling - - i 69. POOUSPA 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 OGas ❑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. Dry Chemical 27. Frame and Flashing � ' 76. Dry Standpipe . . �. ' 28. Lathing & Sicling 77. FIXED SYSTEM FINAL ; 29. Insulation 7S. 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 � . � � 2p.,J7 L �� - � • ' 39. Water Service-Final , � ' ,_ . .h 40. Gas Service-Final � - - � • ' • 0 41. Solar-DomesticFinaL � . , � ' ' . . 42. Backflow Preventer - � " � .. 43. Backflow Irrigation � - . � ' � • � ��.� � r 44� Landscape Irrigation System , _ � . " �45. Sound Attenuation . � � � �46. Handicap Regulations � - , • ' � � , � • � � 47.FINALSTRUCT.URE&BUILDING ' ' '' , �� - .�� ' 48. Special Requirements Completed • � - � ' . 49 �Electric Release to, Edison . �, . . ' . � . � 50. Gas.Release to Southern California Gas Cn _. - _ 51. CERTIFICATE OF OCCUPANCY . ' • No. ' Date ' ' . _ ��n� , . • COSTA MESA BUILDING-SAFETY DEPARTMENT. P.O. BO% 217 COBTA MBBA. CALIFORNIA For ApplicanT to Fill In Completely TYPE OR PRINT BUILDIN6 3057 Club House Circle ADDRESS . COSTA MESA, CALIFORNIA. � OWNER Mesa Verde Dev:Co. MAIL 2850 Mesa Verde Dr. -� ADDRE58 �,T,. Costa Diesa �T,o`'S49039 E. 17th St. S.A. STATE 18132'z ' TEI:. ' LIC. NO. NO. size 26 x 70 � . I xo.ove�con0 OF LOT Now oN tAT USEOF ' _I. ��_ DESCRIPTION OF WORK X II �i rvwarmu I I� �nn s ZIEDIN6 .1232� ROOMS 5 BTORIEB G EXTERIOR WALL � , I ROOF'� . COVERING COVERIN6 USE OF BUILDING AND WORK TO BE PHRFORMED � Res.w/att.Gar: 1 XEREBY ACKNOWLEDOE TX�T 1 XAVE HEAO TX19 APPLICATION AND BTATE THAT THE ABOVB IB CORHECT AND AOREH TO COM- PLV WITH ALL CIT OpDINANCBB ANC 6iRie I.AWB qHOULATINO BUILOINO CONST C ION. ' SIGNATUREOP/1. ��P��L � PERMITTEF ,AUTHORIZ6D AGENT FEE RECEIVED �EB 25 1965 FINANCE DEPT. CITY OF COSTA MF.�A APPLICATION FOR PERMIT , BUILDING For Office Use Only FIRE ZONING ZQN61 I PLANB � I BLIILO H6 •. IS `� g8T8$2 �_�•� Lot 7 Tr. 4660 oeacnimon A. P. NO. ROT1E NOTE: NO EAVE OVERHANG SHALL BE LESS THAN YARD8APPROVEO MAIN BUILOIN6 V � VAR. $C _�. YAROSAPPROVED ;GESSORY BUILDING 1.13Y� 'ROV6 �uM/� DATE ( d'� _ 6 t )LD FOR SPEC REQUIRFMENTS permit on Lotl for conditians 1250 so. �. J 460 0 . THE AMOONT 9HOWN 11NOER VALUATION IB FOR THE _' PUFPOBE OP HBTABLI6HIN0 A pERMIT FE6 ONLY. 0 VALUATION ' '�/._, m H PERMIT FEE $ ��y � S / // ��/� LANCHEGK $ ��//�✓ K � � , LL MESA VERDE DE�7. C0. or — In llATE ' 3-�-65 �.� 'LONE SUBCONTRACTOR