HomeMy WebLinkAbout3017 CLUB HOUSE CIR - Building Permits7
'�
PflOJECIi}UOBESS: 3 O 1% CLUB HOUS E C I
� OWNEfl'SNAME: JACKSON, ROBERT Z TR
aooeess: 3017 CLUB AOUSE CIR
COSTA MESA,CA 92626
NPCN/ENGINEEfl:
PDUHESS:
flEG.NO.:
UNIT:
UNIT:
PEHMITTEE: rjETERSON ROOFING { 714 ) 979-7111
aooRess: 3006 ENTERPRISE
LICENSEO CONTflpCTOB OaAFA�TIONMESA al�irm Ihal I am IitenSetl untler povisios ol��pi8er 9(Commenting wi(h Sedion
7000� ai Drvision 3 al Ihe Business antl Pmlessions Code, antl my license is in full force antl e��ect.
arr uc.: 0 5�,9 5 STRTE LIC.: 6 O-� 8-� z cuss:
Date:���� � Si9na�ure: _ _ —
WOflREBS' COMPENSATION DECLANATION: I here�y aftirm �hat I e a cetlifica�e oi consen� to sell-insure or a certifica�e o� Worker5'
Compensation Insurance, or 2 certdie� coOY �hereot�Section 3800, la�. C�.
roucrxo.: NC3501565 E%P.DFTE: Q3/zO/Cj�
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 067115 FLAN CHECK NO: N
FERM NO: B 067115
GOVT: N SUPP: N
CONSTRUCTION TYPE: V-5 PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION .: REMOVE BUR & AEPLACE W/HUR SQ FT; 2,091
CLAIM VALUE: 2,091.00 CALC—VALUE: 2,091,00 GROIIP OCC: R-3 /
COMMENTS• SMOKE DETECTORS REC�UIRED PER 91 OBC
+�+�;r*it�txxae+���ric*ati.*it��+r*x��ie*if� it�xitirirft***�r*�r*+t+t*it*tt**�.r*+t**ir�rf[ftx*+t�r*�#x�+�fEieir*it+r*+[
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 REAEi; FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGFiT: FT IN
camraNr:.REPUHLIC PARKING REQ� PROV; PARCEL; 13951537 ZNE; REF NO:
❑ Cenified copy is here•6y' Wrnisned. � Cenitietl copy is filea wi�h Ihe city Building Division. P LANN I NG NOTES >' �v
S� 1 1 �/ � l
�aie' Applicant:� �.--�.�' �fiElFiEffiFiElE�kil-iEiFiEiFiFiF3EiEif�EififififlEiEiEitiFiElElEiEjFiEififiEiEifiFifiEiFiEiEitlfiEMiElEiEiEiEiEiEiEiElEiFifiEifjEiE9E!(-iE:�flEiEiF�tkiEiEifiE
E%EMPiION fROM WOHKEHS' LOMPENSATION OECLABATION: (T ection neetl na� be complere0 il ihe Dermii is lar one nunOretl �5f0u1 or lessl. D E V Er 1. O P M E N T S E R V I C E S $ E Q U I R E M E N�'T S
I ceriity Ihai in I�e pedormanre ol Ihe work br which ihis permi� is issuetl, I shall no� employ any person in any manner so as �o become �
subjeq Io Ihe Work¢rs' Compensation Laws of Califomia. �
ZONING APPAOVED BY DATE; t"
�ate. Signa�ure:
NO710E: iL a�ier making Inis aeclaraiion, you snaultl become sublec� m �he Workers' Compensalion pmvisions o� the Labor B Il I LD I NG AP PROVED B Y DATE : !�
CoOe. you musi Iortnwii� comply wilh suc� pwvisions or ��is permii ihall �e tleeme0 revokea. t '
CONSTflUCTION LENOING RGENCY: I hereby alfi�m Ihal IM1ere is a cons�mclion lentling agency for the pedormance ot lhe work fot AP P L I CAT I ON I S'SUED B Y; �;F����
wm�nin�sve�mn�s�ss�ealsecro�aosi.c�� ci ********************** ' DATE:
*****��r*�* Fi��r�
LENOEP: 1f if iE iE iE iE if i�� iE jF 9F iF iF iF iF 9E IF iE if 1F if iF if iF j: N�lE aE �lE 3E �If iE �N-iR i4 iE iE if iE �)E iE if iE iF iE iE iE iF iE if 3E iF �lE 9f iE if if� iE if-ih �IM1 iE 1E iE iE i6 iF 1E if if iE iF iE if i(-iE iR iE iE
ADDNESS:
OWNEN BWLOEP �ELIPHRTION: I hereby ai7irm that I am e�empl irom �he Coniracmrs' State License Law lor the lollowing reason
(Section 7031.5 Business anA Pmlessional Gode: Any ciry oi coun�y which requires a permit �o constmc�, aVer, impmve. tlemolish, or
repair any sVuc�ure. Orior �o its issuance, also requires I�e apDlican� lor such permi� lo file a signed stalement Iha� helshe is licensed
pursuanl to Ihe D�ovisions of Ihe Conlrac�ors' Sta�e License Law (Chap�er 9(commencing wiN Seciion 7000) of �ivision 3 of ihe Business
and Pm�essions Codel or �hat he/she is exempl lherefmm an0 �he basis for Ihe allegetl exemptian. Any violaiion ol Sec�ion 7031.5 by
any applicanl �or a permi� su�lects �he aOPlicant io a civil penalry oi no� more than live huntlred tlollars ($500�.
I, as owner ol �he pmperty or my employees wiih wages as Iheir sole compensation, will do Ihe work, and �he
❑ slmclure is no� intendetl or oftered for sale (Seciion 7040, Business and Professional Cotle: The ConVaciors' S�a�e License Law
aoes no� apply lo an owner ol a propehy who �uilds or impmves ��ereon, anA who tloes such work himSelV�ersel� or �hrough
his or her own employees, Dmvide0 �ha� suc� impmvemenis are no� in�enAed or oflere0 for sale. Ii, however Ihe builaing or
improvement is sold witnin one year of completion, the owner will have the burden of pmving he/she diA not huild or imDmve
�pr lh¢ purpOSe 01 sale�.
I, as owner o� Ihe pmperly, am exdusively conVacting wi�� licensetl conVactors to constmc� �he prolect (Sec[ion 7044, Business
❑ antl Pro�essions Cotle. T�e Cuntractors' Stale License Law does not apply �o an owner of propetly who builds or impfoves �hereon
ana who conVacis for such pmjec�s with a conirac�or�s�license Oursuan�to ihe Contrac�or5' $ta�e License Lawj. I am awafe
Ihai Omoi of Neir Worker's Compensalion insurance should �e pmvidetl �o me.
� I am eKempl untler Seclion: 8. 8 P. C.
tor I�is reason:
Date: Owner:
I �o hereby ceNty Ihal I am aware ol an0 un0ers�an� �he requiremenls ot Califamia NeaI�A and Safety Cotle Sec�ians 25505, 25533, antl
2553A antl ihai I or any Wlure bwl�mg occupanl willlwill nal (circle one) need �o comply wilh saitl sia�e codes antl Ne requiremenls lor a
permii for conslmciion or motltlicalion imm Ihe Air �uab�y Managemeni Oistrict. Resitlenlial constmetion apD�ications are exempt �rom
�hese pmvisions
Daie: Applitan�'
I h¢reby certAy ihai I have rea0 this applica�ion antl s�aie Ihai Ihe above inlormation is correcL I agree Io camply with all ciry antl cowry
ortlmances antl slate laws relating to �uilding con9mciion antl hereby authorize represe tti -1 vEn�er upon the above-men�ionetl
prOpetly �oi7n5p¢CIiOn purpO5E5.
�ale'. � r �— � � Signaiure:
�river's License oi Social Seanty d; �� �
ApphcanC Pink—Revenue; Galtlenrotl—Assessor
LEGALIZATION;N F E E �S-U M M A R Y STRUCTORAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 54.00 • � 50
PLAN SMIP/NON—RES
ISSUE FEE
BUILDZNG—DIV—> PERMIT ISSUE PLAN�CAECK TOTAL PAID DUE
TOTALS----> 54.50 0.00 •' 0.00 54.50 54,50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 59.50 OVER/SHORT: ,00
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADZNG PLAN—CHECK
54.00 .SO
jf if iE iE if if if iE it if 9F * fF if iF iE iE 3f if if jE iE iF 1E * iF ff fP iE iE iF 1E iE iF iE iElE 9ElE fE ff iE iE 1E iE iE iE 1E jE iF �c {�r jF �f if iE �f if iF jE iE 1E iE 1flE 9ElE i(-iE �E 1f iE aE * IE 3f iF 1E iF
I N D I V I D U A L F E E B 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
SFR 2091 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 2,091.00
END OF FEES
�i U�1602<7-00160248 T O T 5;,5Q
QATE= OS/10/94 TIME: 15:33
CONSTRUCTION AND PLANNING �
. �`� APPROVALS Permit # .
1_-Temporary Electncal Service oY Pole
2. Soil Pipe-Undrgrnd. . -
3. Electricai Conduit Utility•Und�gmd. �
- 4. Electricai Conduit•Undrgrnd. •
. 5. Steei Reinforcecnent �
6. Etecvicai UFER Grnd.
7. Footings � �
�8. Foundation �
9. Water Pipe-Undrgmd. _ '
, 10. Structural Fioor Svstem � �
71. Proper,y Sewer Line & House Connection
12. Sewer Cap � ' .
13. Roof Droins ' �
14. Rough f�lumbin�
15. Rough Electrical•Condwt '
16. Rough ElectrictNiring
77. Rough Wiring Siyn
t8. Rouyh Electrical�7 Bar Ceiling
TS. Rough Heating & E1ir Conditioning
20. Roug,h Factory Fireplace ' .
21, Ducts,in Structure .�._ "�
22.,Ducts, VPntilating' _ '
23. Gas Pipe-Rough & �Test '
24. Roof Framing
25. Roof Sheathing . 5
26. T-Bar Celling (Structural) & Monocoat
27. Frameand F�ashit�g.
28. Laihing & Siding '
29. Insulatio� �
30. Drywa{I Nail�ng -
31. Plaster Bro+vn Co�t _ _
32. �Elecirica! Power Meter�Final
33.'Final Electric .
34. Final Heating$i Air Conditioning
35. Pinai Gas�Pipe�Test � •
36. Hood or Canopy .
37. Finai,Factory FirBPlaca . `
38. Finaf•Plumbing
39. Weter $ervice�Final -
40. Gas Service-Final
41. Solar pomesric•Final
42. 8ackfiow Preventer � �•
A3. Backflow irrigation �
44. Landscape Irripauon System
45. Sound Attenuation " �
46. Handicap Regulat�ons � �
47. FINAL STRUCTURE & BUILDING �
48. FINAI PLANNING I
49. Electric Retease to Edison
50. Ga5 Release to Southem California Gas C
51. CEftTIFICATE OF OCCUPANCY
Date
Date
T
9
z
;/-9Y
( _ PO y SPA I
Inspector Date Inspector
0
�
�
APPROVAIS Permit #
52. 'Yool & Equipment Location
53. Steel Reinforcemeni
54..Porms �
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVAI TO COVER�GUNITE
58. � Electrical Conduit�Undrgrnd.
59. Gas Pipe, O Undrgrnd., TCst
60. Backwash Lines, RTrap, C Undrgmd.
6/. APPROVAL TO DECK
62. Backwash & Receptor-Final
63. Heater & Vent-Final
64. Plumbing System • Finai
65. Electricai-Final
66. Solar System•Fina!
67. Fe�r.ing & Access Approvat
68. APPROVEDFOR,PLASTERING
69. POOL!SPASYSTEPfSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS � � �Permit # -
7D. Undergrou�d HyUro
?t. PruductPipin9OG?s �Oil
72. Undergrourtd.Flush
33. Undergrnd.Storaye'7ank G Gas ❑ Oil
74. Overhead Hydro �
75. Dry Chemical
76. Dry Standpipe '
77. FIXED SYS7EiU1 FINAI' '
78. FIRE PREV. FINAC �
HEALTH DEPT. REO.UfREMENT
79. FINAL INSpECTION - �
B0. FOOD CERTIFICATE ISSUED
e
e
i
o� o j
� `�J
� ' '
o �
� ^
. �
� � a
� � C
J
_ �
1 . b �
� � V
. �n V;
m �
m �
� --
u
e
m .
�
L U B
� � p � . ;: �u�3 w•
,,�1 � 3035 ' ,�
� , ' � „n�l 7+'9 � ' � REV. 1 ' � �� �Q � m
J� ��
_ � '.R(V.1 • -..
� �
�� ..� -'� ' REV.1 j • 1 � { ^ 1 ����', :
� CASA BON 32�j3 � M � M
(L .�OA� \ ` "` ' � 3Q 31. — - — - � �
S
'!�'9 ` o ' Z8.' 29 em m �
� ,�51 � a \\ S — — —
� � '�p5� PE''. � , � u �
� r�
f�. 0" � \:l �. I�i a e�+1
30�� �5`'` `� � "� \ �4R�c.s�2 ' �- - " - �
\ � N u
o , ` �pS � �� 4, �
�` S�p�C �o �
CP 9 � i Poo� c
V I �( �
� ` Ci� << y W m
e Q . ` �i
I,l L � Q---- .�
` f�t��M�T y1upIM0 ' �� � . � ^
� t+ o
M
��„.: . 4t.so. _ ' u g6.��' –
. .. � – --
' . m. o
114 15 16 17 18 19 20 21 22 , 23 24 � 25 � 26 27
' ' � CASA DEL AMIG S'. I .I � � � � : I' N Q �
I m' M
� .. . . I . . .. _ . _. ..._ i ... .
__
' '""—_I_.. � 1 � . . i ..,.:-- � � �. i � � �
G � B I B PEV-I G REV. I B NEV I B I C. G. B�. I B PEV.I G,,REv. I b FEV. B _G- � __ `� �
m
3062 3060 3058 3056 3054 3052 3050 3042 304D 3038 3036 3034 3032 3030 v „ g
Q M
' �
. ...'I.- ... . .. � . r: ",:'-. . :.. . ' . 1-.�.:;:.. . -..:'.' '. ': �.. . � � .. .�.::... .: : . .. - �:.' .. ...: . . , .` .' _
' .
� H 0 U S E ' R 0 A D
j I
5,�� .,_ . . � .
16 4-1 ; .
,.�_.
__ ..�_._ __ . _ ____ _ __-- ---- ----- --
___ __, _ _ - ___
Applicant to fill in all sDaces except those within M1eavy Eortler lines and sign all aOVropriate
CITY OF C(�STA Mr�E�SA COqN/ST{�(��UG[�T/�I/O,N PERIi11T _, PER T NO. TRACT NO. LOT NO. UNIT NO.
Projpct Address �a_L�? /"A .�,( // / I/(fiS � � � -- 3a 9a ��. : �
� � �TYPE OF CONSTRUCTION NEW AOD ALTERATION
Applicant'S Mdilin9�dd^res�J C' /` �^y�n ❑ CONVERSION ❑ DEMOLISH ❑ OTHER
Owner's Name ���� % � Phone� %�, DESCRIPTION OF WORK/USE OF BLDG.
Address
Areh/En9. License No. �TVPE OF. PERMIT ❑ GRAOWG ❑ F NDATION ❑ STRUCTURAI.
AddresS ; �•TENANT ❑ ELECTRICAL UMBING ❑ MECHANICAL �
Contractor"5 Name '� , ( P on � ❑� OTHER , ;
Adtlress (ma'I'ngl ��3l./ nl ��� �PROJECT DESCRIPTION Sq. FT. � OCCUParvcY
�D'�� i�r�,u . CONSTRUCTION TVPE VALUATION $
City License No ZONE � GRAOING CU. VDS. ACRES_
UCENSED CONTRACTOR DECLARATION '
1 hereby affirm that I am licensetl untler provisions of Char[er 9(commencing�i ,Remarks ��
with section ]000) of Division 3 of the Business antl Pro(essions Cotle. antl
my license is in i ��ce antl efiect. �
License Cla N �
.Da[e � Signature ! :{+ ' � ' PWMBING • .
VORK RS' COMPENSATION DECLARATION - �` Bd� Sink �$hOWB�i
, hereby affirm that I have a certificate o/ consent to self-insu�e o� a cer[itiWte
of Workers' Compensation Insurance, or a certifietl copy thereof (Section g3ckflow Preventer Service Sink
3800, Lab: [�y�/n � . y��in - -
Policy No. ��'� �'1v' � Company-��Y(.f6����� �.x BackflBw Irrigation Sewer CaP '
ny �oertitietl topy is hereby furnishetl.
iJ �cer 'fie p s liletl with the city B 9JJJ�Ij�'f t� Bathtubs Sewef Connection
Date ' � Applicant ���, u , ��,� � 'r.� ' Glarifiers ' ' Solar Collectors
Id1
EXEMPTIONyS��RKERS'COMPENSATIONDECLARATION r. 'Y:... �
1 i5�ssection neetl not be completetl if the permi[ is for one huntlretl ($100) oy�� •a DiShWashE�' � �
) . ' _ , .Solar Piping
I certlry that in the per(ormance Of the work for whith this perm�t is issuetl, I
SM1all not employ any person in any manne� so as ta become subje<t to the � . D�inking FOunt2in5' $oldf Tank
Workers' Compensa[ion Laws of Califomia. - '
Date Signature - � Floor Drains Swimmin9 Pool w/Spa �
NOTICE: It, after makin9 this aeclaration, you shoultl become subject to tne —
Workers' Compen5a[ion Orovisions of the labo� Cotle, you must forthwith .� FIOo� Sinks U�indl
comply with such .provi5ion5 or thi5 permit shall be tleemetl revoketl�."
CONSTRUCTION LENDING AGENCV - GasService �OUtlets WaterCloset
I heieby aifirm that there is a mnstruction lentling agency fo� the perfo�rtiance
of the work for which this permit is issuetl (Section 30W ;Civ. C.) Int¢�c¢pt0l5 W3t2r H¢dte�
Lentler's Name
�entler's Atltlress Kitchen Sink � Water Service ' -
OWNER BUILDEH �ECLARATION
I hereby affirm that 1 am exempt trom the Contractor'S Litense Law for the Lavatories AutO-WeSh
following reason (Section ]031.5 Business antl Professional Code: Any city or
county which requires a permit to const�uct, alter,•improve, tlemoli5h ar repai� P—T�dp � L2undry T�ayS
any s[rutture, prior to its issuance,� also requires Ihe applicant for-such permit
(ile a signetl statemen[ that he/she is licensetl pu�suant to the provision5 of Roof Dreins
Contractor's License Lew (Chapte� 9(commencing witb Section ]000) of
,ision 3 of the Business antl-Professions Cotle) or that he/she'is ezempt -
..ierefrom antl tM1e basis for the allegetl exemption. Any violation of Section
7031.S�by any applicant to� a permit subjects the applicant to a dvil
�enalty of not more [han tive huntlretl tlollars ($500).
I, as owner of tlte property or my employees with wages as their sole Reinspection Fee $15 Issue Fee
wmpensation, will tlo ine work, antl the structure is not intentletl or offeretl
for sale (5ection J044, Business antl Pwfessional Cotle: Tne Contractor's MECHANICAL
' Lirense Law tloes not apo�Y to an owner of a property who builtls or improves
' thereon, antl who tloes such work himself/herself.or through his or her own �
employees, provitletl that such improvemenis are not intentletl or offeretl for BOiI¢� HOOd O� Typ21 ❑
sale. It, howeveq the builtlin9 or improvement is soltl within one year ot com- Canopy Type I I ❑
pletion, the owner will have the burtlen ot proving he/she ditl not builtl or im- Duct - Und¢� GfOuOd
p�ove for the pu�pose of sale). �
❑ I, as ownei of the property, am ezclusivery conbactinq witn licensetl con- Duct-Structural Reffigefation System
iractors to cons[ruct [he project (Section ]044, Business antl Professions Cotle:
The Contractor'S License lzw tloes not appry to an owner of property who DuCt- V¢ntilating ❑0-100,0006TU ❑100,000 BTl
bullas or improves thereon, ana who coniracts for such projects with a con-
tractor(sl iicense pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration
proof of their Worke�'S Compensation insurance shoultl be provitletl to me.
❑ 1 am.exempt untler Section B. & P. C. for this reason Firepl/Fact.8lt. ICBO # Fire Dampers
Date owner
I hereby certity that I have reatl tnis application antl state that the above
information is correct. I agree to compty with dll city antl county ortlinanres
antl state laws relatin9 to builtling construction, antl hereEy authorize reo�e-
senlatives of his city to enter On the dbove-mentionetl property io�
inspectian p ses �p�
0
Heating System & Ducting
❑0-100,000 BTU 0100,000
I Signature Oaic�._�L I I
Orivers' License or 55 �' Reinspectian Fee
CMF OB65-46, rev. 30/84 White - Builtling: Ganary - Applicant; Pink - A[coun[ing; Goltl¢nrotl - Assessor
$15
Registers
Iwue Fee
eeclarations.
R
FEES
A.P. # . .,
S Main 8uilding:
E
T Front
e Rear
A
C Right
K Left
S
Ping. Ref. #
Planning Notes:
Automatic Washer
Construction Pole Sub.
Cookin9 Unit
Dishwasher. �
Dryers ❑Gas ❑Elec�
Fan
F.A.U.
Fixtures
Device Boxes .
OuHets
Switches
Garbage Disposal
Generator �0-5 KW C
0
• ;6029 3/02/88
�
nq:
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
15KW
� 'f __ ' '
5.p� TL
Meter Llup to 700 amps
Meter ❑over 100.amps
Sub,Panel � - ' '
Motors �0-1 HP �1 %- 8
Inc.Solai �9-15 HP 016-15+
Microwave '
Pole Light
Range
Sign "'
Standing Sections �
Trash Compactor
$ 3 I "
�— Reinspection Fee $75 Issue Fee
FEES
� DEVELOPMENTSERVICESREQUIREMENTS:
Zoning Appraved By
Building Approved By
Application luued BY
$ 3
2
O
N
1
N
G
R
E
Q
M
T
S
FEES
$ 3
SUMMARY OF FEES
BUILDING PEFMIT $ SMIP � $
PLAN CHECK $ PERMIT � ' � �
PLUMBING '�$ �O ISSUANCE $ _
PLAN CHECK 25% $ ENERGY P.C. $�
ELECTRICAL � $ GRADING � S � _ -�
PLAN CHECK 50% $ ' MICROFILM $
MECHANICAL $ _ TOTALFEE $ �.
PLAN CHECK 25% $ _
CONSTRUCTION AND P.LANNING POOL & SPA.
"Date Inspector "" Date Inspector
APPROVALS Permit�# APPROVALS Permit #
_ . � �
� 1, �Temporary Electrical�Service or Pole � 52. Pool & Equipment Location , ,
i'
2.� Soil Pipe-Undrgmd. ��' . 53. Steel Reinforcement �
3. Elec[rical Conduit Utility-Undrgmd. 54. Forms �"�� ' �
4. Electrical Conduit-Undrgmd. 55. Electrical Bonding � _
5: Steel Reinforcement 56. Rough Plumbing�& Pressure Test '
6. Electrical UFER Grnd. �' 57. APPROVAL TO COVER-GIJNITE � '
7. Footings ;. �- 58. Electrical Conduit-Undrgr;nc�.
a; _ .
8. FoundatioR �; � � 59. Gas Pipe, � Undrgmd., 7est �
9. Water Pipe Undrgmd. 60. Backwash Lines, P-Trap, f�7�Undrgmd.
10. Structural Floor System 67. APPROVAL TO DECK '''-�
�.�
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final �
12. Sewer Cap • 63. Heater & Vent-Final
13. Roof Drains . 64. Plumbing System - Final
14. Rough�Plumbing - , 65. Electrica6Final
15. Rough Electrical-Conduit . 66. Solar System-Final � �
16. Rough Electric Wirin9 � 67. Fencing & Access Approval � - �
17. Rough Wiring Sign 68. APPROVED FOR PL'ASTERING '
18. Rough Electrical-T Bar Ceiling, -� , � 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning • FIRE DEPT. REQUIREMENT .' -
20. Rough Factory Fireplace � - APPROVALS Permit # _ '
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O�Gas ❑ Oil �
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil
� 25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical -
27. Frame and Flashing � - - 76. Dry Standpipe .
28. Lathing & Siding . � 77. FIXED SYSTEM FINAL
29. Insulation 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 s�'
33. Final Electric � ' Notes:3�lr 88 'L�Fr CAQO L.G.1� "+':
34. Final Heating & Air Conditioning ' (,� �'�� ��- �-Q� G'�I, J : �
35. Final Gas Pipe-Test b t,tf' fj� 'iiL$ /�E?,/nT
�Q$ �yCAl�qdi �FS
36. Hood or Canopy O1� 6[G• Zp•?,� V•P.G. L.�a '
37. Final Factory Fireplace � � � _ , �
38..Final Plumbing - � -
39. Water Service-Final " i �- .
40. Gas Service-Final � �
47. Solar pomestic-Final . • '
42. Backtlow Preventer � " , _
43. Backflow Irrigation - - � � . - - � . .
44. Landscape Irripation System � � ' �
45. Sound Attenuation � ' ' �
46. Handicap Regulations - . . • � •
47. FINALSTRUCTURE&BUILDING � ' � ' ' � � .
48 � Special Requirements Completed - - �
49..�Electric Release to Edison . ' � � •
50. Gas Release to Southern California Gas Co . �
51. �CERTIFICATE OF OCCUPANCY , � � � �
No. Date � ' / � � '
' , . ...1 .
JOB
or
Da[e
DESCRIPI'ION OF WORK
FIRE ZONE VA
SUBCONTRACTOR
and
'���� �, FEE RECEIVED
COSTA MESA BUILDING-SAFEfY DEPARTMENT 25 'I��5
P.O. 90X 91] C08TA M66A. �A���RN�. ��j�,�NCrEneTD�EPpT��.��
For Applicant fo Fill In Complefely ,��YICATIOICFt�R'PERMIT
TYPE OR PRINT . BUILDING �
BUILDIN6 for Offfce Use Only
ADDRE54. 3017 Clllb HOUSe Circle
�pQCi1PTN0. P qjQITNO.
� - COSTA MESA. CALIFORNIA . ?�4"y, �
NiC61V D�Y OAT[RHC6IVHD OATEIBSUEO
OWNER Mesa VErde Dev.Co. � ��' , a'��y—�✓ h�AR 4 196!
MAIL BUILDIN6 '
ADDR6D8 2850 Mesa Verde Dr. .+ooR S8
FIRH
C�.n, � Ci�Sti& Mesa - -�. No �5�+9�395 =ONE TYPB GROUP I& J
APPROVHD
ARCH7TEC7 E. Kaltenbach� re�.5�+78046 BY DATE
ORENGINEER NO.
ZONING
AD�RESS IpN NO.OP UB60PNSW ES• 1I S
Same as Owner R� •�••"' `2 eoi�cino -ggl.gge
'CONTRAGTOR ' .
� oeccR�rt�on LO't 3% Z.'T. 4660� �
ADDRES3 - ' - ,
CITY
. . ' � . A. P. NO. . R0I70 .
l�l�c..2 NOTE: NO EAVE OVERHAN6 SHALL B6 LE88 THAN
STATE TEL ' 90' TO 61DE 9 REAR P. L.
LIC. NO. N .
EAVES
61ZE No.OPBLDoe ALLOWED <U.B.C.REQIIIREMENTI
OFLOT O - NOWONtpT-O
YARD3APPROVED - YARDSAPPROVED
USEOF �� ___ MAINBUILDIN6 ACCESSORYBUILDING
EXISTING BLD6.
(FROMC/L�-S+fREE ) � �
6ET6ACK LINE FROM PR T t�I. J tT•
centea or einaci R6AR YARp /^
SIDBYAROI LEFT - RIG " - R.BIDfi V FT•
DESCRIpT10N OF WORK �. aioe � Fr. Fr.
NEW � AI�TERATION � ADOITION � REAR � F7. FT.
�18TANCE BET. BET. MAIN @
REPAIR M y�N6 DEMOLI8H MAIN BLD H. ACCESS.BLD68.
5 Z'ED1N6�.5�� � ROOM9 V BT�RIH9 2 CAU.P. -�J�I APPROVEDll��'�-��
j��� / ._/
COVERINGWALL S'ZUCC COVERING'"","tllp -AYPROVB DATE � �S-4S
U9E OF BUILDIIiG AND WpRK TO BE PERFORMBD ' .
F .^ ' CC
Res.w att.Gar. I� ,�a �e permit'on Lo 1 for conditio�
i513 s4. Ft? 440
I HEREBY ACKNOWLEDOH TNAT 1 HAVE REAp TNi9 APPLIC�TION TXE �MOUNT eHOWN 11NOER VALiIATION �e FOR THe
�ANO STAT T TH6 ABOV6 IB CORRECT AND AOREfi TO COM� PUNPOSE OP ESTABLIeHIN6 A PERMIT FEE ONLY.
PLv WIT ALL Y ORDINANC88 AND BTATQ LAWH H OULATINO ypLUATION' � �
eu�to�H corvsi � R�oN, pERMIT FEE $ (' .li �
SIGNAT S �D ^ ��y
PERMITT ]
v� PLAN CHECK $ ��� `
AUTHORIZED AGENT
TOTAL FEE �