HomeMy WebLinkAbout2268 COLGATE DR - Building Permits(714) 754-5273 • Fax (714) �54-4856 • www.ci.costa-mesa.ca.us 77 FAIR ORIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 2268 COLGATE DR
Suite:
Vicinity: RESIDENCE AND ATTACHED GARAGE
Parcel Number: 41908304
Applicant: CAMPOS, ELIAS
Address: 2268 COLGATE DR
COSTA MESA, CA
Owner: CAMPOS, ELIAS
Address 2268 COIGATE DR
COSTA MESA, CA
Co n tra cto r: O W N E R- B U I L D E R
Address:
Zip:
Aroh :
Address:
Zoning:
ISSUED BY:
Phone: 949-722-6575
Zip: 92626
Phone:
Zip: 92626
Phone:
License: 0
Eng:
Address:
Status: ISSUED
Applied: OS/16/2002
Issued: 05/16/2002
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
. COMPL�TE REROOF: 7/O EXISTING COMP SHINGLES, REPAIR SHTG AS NEEDED, FELT PER MFGR'S SPECS, APPLY
"30-YEAR" COMP SHINGLES.
1
Plan Check: $0.00
Permit: $8325
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $83.75
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0. 0
PARKING Existinq: o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEESUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Praposed: 0
Calc Valuation: Ss,000.00
Claim Valuation: Ss,000.00
Righl 0- 0
Right 0- 0
2
NOTICE: The work authorized by this permit shall comply with all applirable handicap access requirements under Calitornia statutes and related
regulations. (Ord. No, 92-28, § 1, 12-21-92)
EXPIRATION: This pertnit shall automatically expire antl become void it work is not commenced within 180 days, or if work is suspended or abandoned
tor a period of 180 days. _'
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspectiong and flnel approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 750-5626 .
2adG46(N00)
WORKERS'COMPENSAnON DECLARAnON:
I hereby attirtn under penelry of perjury one oi the lollowing tlaclarations:
❑ I have and will meintain e certifcate of consent lo sell-Insure for workars' compenseilon, as provided tor by section 3700 of the Lebor Cotle, tor the peAormence of Ihe
work for w�iCh thi5 permit 15 i55ued. .
❑ I have end will maintain wwkers' compensatlon Insurence, as required by sectlon 3700 of Ne Labor Code, for the peAortnance of ihe work for which this pertni� is iswed.
My workers' compe�n'sation Insurance cartier antl policy number ere:
Carrier. PWicy Number.
(This section need no! be completed i! the permit is ve/uetl et one hundred dollers ($f00) or less.)
❑ I ceniy t�at in Ihe pertormance of ihe work for which this pertnit is issued, I shall not employ any person in any manner so as lo becoma subject to t�e workers'
compensatlon laws of Calllornia, enA egree Ihet it I s�ould become 5ublett to Ihe workers' compensalion provisions oi Section 3700 oi the Lebor Cotle, I shell forthwith
compty wit� t�ese provislons.
Applicant Signeture: Date:
WARNING: FAILLIRE TO SECURE WORKERS' COMPENSATION COVERAOE IS UNUWFUL M1D SHALL SIIeJEGT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FINES UP TOONE Hl/NDRED
T/K%15AND OOLURE (5100,000), IN ADDfiION TO THE COST OF COMPENSATION, DPM4GE5 AS PROVIDED WR IN SECTION �O60F TME L4BOR CODE, INiEREST, AND PTTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I here�y aHirtn that I em licensatl under provislons of Chapter 9(commencing with Section 7000) of Division 3 ot Ihe Business and Professions Cotle, end my licensa is in full
larce end eHect Lic. N Class #
Gonirectofs Slgneture: Date:
CONSTRUCTION LENDING AGENCY: �
❑ I hereby aMirtn thet Ihere is a consiruction lentling agency tor ihe peAormence af ihe work for which ihis pertnit is issuad. (Sec. 3097, Civil Code).
Lendefs Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby eNlrm the� untler penelty of per�ury Ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe tollowing reason (Sec.7031.5, Business enG Protesslons
Code: Any ciry or counry which repuires a permit to consWct, alter, improve, demolish, or repair any strucNre, prior to its issuance, elso requlres the applicant for such permit
to file a signetl statement that he or she is licensed pursuent ta the provisions of the Conirectors License Law (Chapter 9(commendng with Section 7000) of Dlvision 3 ot Ihe
Business antl Professions Cotle) or ihet he or she Is exempt theretmm entl t�e besis for Ihe allaged ezemption. Any violation oi Section 703t5 by eny epplicant for e permit
subjecls the aDPliwnt to e civll penelry ot not mora then tive hundred dollars ($500).):
�' ��I, as owner of Ihe properry, or my employees wlth weges es �heir sole compansation, WILL DO 7HE WORK, and the sWCNre is not intentletl or otteratl tor sele (Sec.
7044, Business and Professions Code: The Contractors License Law does noI apply to an owner of property who huilds or improves thareon, antl who does such work
himself or herseli o� through his or har own employees, provided that such improvements are not intended or oHeretl for sale. If, however, ihe building or improvement is
sold within one year ol completion, the owner-builder will have iha burden of proving t�at he or she did not 6uild or improve for purpose of sele.).
❑ I, as owner of Ihe property, am EXCLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS ro consiruct Ihe project (Sec. 704a, Business antl Prolessions
Cade: The contrectors License Lew daes not eppty to en owner ot pwperty w�a builds or Improves Ihereon, antl who coniracts lor such project with a croniraaor(s)
license pursuant to the Contrectors License Lews.).
❑ I am e:e der sec. eusiness end Professlons Code for this reason:
.Signature: �i �% i'/i�'.� �Data:� ,r^/�O Z
�Ownar ID venfied by dnvefs license. � Ves � No roriver.s.uce�,se.N4 /'( / 6ryl` res:�,�J"'�—Q3 `O�
Vedfication oi Ownerehip by (type of tlocument, I.e. - properry tex bill or tleed): �
DIVISION OF INDUSTRIAL SAFETY PERMI7 CER7IFICA710N:
❑ I hereby certify that no excavation tive (5) or more teet in tlepih into which e person is required to tlescend, wiil be made in wnnection with work autharizad by this
permit, entl that no building siructure, scettolding, talsework, or demolition or tlismantling ihereol, will be more ihan Ihirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Ttle B, Celifornia Atlministretive Code).
❑ As owner-builder, I will not employ anyone to tlo work which would require a permit irom the Division oi Industnal Sefery, as noted ebove, unleu such parson hgs e
permit to do such work from the division.
Signature: Date: �
Division of Industnal Safery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AIffHOROA710N OF EMAY: I certify under penalry of perjury that I have reatl this epplication end stata thet ihe inlortnatlon given is
cortect I agree to comply with ell state laws end ciry ordinences relating to builtling construction, antl authonze representetives ot the Ciry ol Costa Mesa to enter upon Ihe
ebove-descnbetl perry for inspection purpases. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspeclion.
�i%S �'6//%Do S �' /,.r-� Z
Slpnature Ol.Capel.Owner(s)f Date
And/Or Auihorized Appliwnt
COOE I, INSPECTONTYPE
7616 Fixed System Final Fire Prevention
1266
200
201
202
203
204
Pool Spa Finel
Final Ra-Raol
Final8locWRetaining Well
Finel Factory Fire Place
Final Sign
Flnal Demolition
Pdg 1tlIID�65
� � �
COpE� INSPECTIONTYPE
206 Final Mechanical
20B Final Plumbing
210 Final Electncal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final BuildinyOccupency
PAg It�LS
Aoplicant to fill in all soaces exceo< those within neavy Oortler Iines anC sign all apDroorlate aeclaratlons.
�ETTTVdF COSTA M�-fESA (�(`�� N �T�RpU�CT�IOyN.,PERMIT PERMIT NO. _ TRACT NO. LOT NQ. UNI7 Nn
Froject Address �f_� � V liC-t_!JLlil..t.X�
Applicant'sMailingAddress ��S�.IA �������
Owner'sName �L �^� Phonesi—�+�_L3y
Address aa � ss Cp LG iq-7� —G ,
Arcn/Eng. � Licenu No. -
Address — '. �
Contractor'sNam �+% 4 Phone������
Address Imailingl �� � 6�� � y-�
ue i ' C; 1�
City License No. ����7-= �7 Y�
Lhc cby aDfCmN„R AC�TOR DEetl`untle?provislons of Cnarter 9(� commenci�''
with section ]000) of Division 3 ot ihe Business antl Professions Cotle, antl
my license is in full torce antl eftect. '
License Class �• � Licen o. �� q� -
Date Signatw
WORKERS' Q MPENSATION �ECLARATION
"'ereby affirm that I liave,a certificate of cons¢nt to self-insure or a certifica[e
Norkers' Compensation Insurance, or a certitied mpy tnereof (Sectlon ,
0, Lab. C�'Ll � / --- 1
PolicY No. —! �� Z�✓ CO ComPanY �'✓��N/
�Certifietl copy is hereby furnishetl.
Certii' opy tll tl with the:city il ing Divisia ,.
Da[e' �% APPIic
EXEMP ION ROM WORKERS�CO PENSATION OEC RATION
(Thissection neetl not be completeH ifthe permit Is for one huntlretl ($300)�orr,
I¢55). �
I certify thal in the performance o( the work (or wnlcn this perm�t is izsuetl,-1'
shali not employ any, pe�zon in'any manner So as lo become Subjec[ to ihe
Workers' COmpenSdtion Laws ot California. '/
Date' - Si9nature
NOTICE: If, after making this tleclaration. You sM1oultl becoma suEject to.the
Workers' Compensation pwvisions of the Labo� Cotle, y0u must fortttwl[h
comply wi[h such provision5 or this permit stlall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
1 hereby affirm tnat there is a constructlon lentling agency for tne pertormance
of the work �or which this permit is issuetl (Section 3091:qv. CJ
Lentler'S Name
Lentler's Atltlress
OWNER BUILDER DECIARATION
I he�eby dtfi�m that I am exempt f�om tite Contractor's Llcense Law tor Ihe
following reason (Section 7031,5 Business and Professional Cotle: Any city or
county which require5 a permit to construtt, alter, improve, Oemollsh or repair
any structure, prior to its issuance, also requires the applicant tor such permit
[O file a si9netl sta[ement that he/s�e is licensetl pu�suant to Ihe provisions of
the Contractor's License Law (Chapter 9(commentlng with $¢ction.J0o0) of
niyision 3 ot the 8usine55 antl Protessions Cotle) o� [hat M1e/she i5 exempt
•efrom antl the ba5is for Ihe allegetl exemplion. Any violalion of SacHon
1.5 Dy any applicant for a permit subjects the applicant to a civil
.ialty of not more than five nuntlretl tlollars (g500).
❑ I, as owner of lhe property or my employees with wages as eheir sole
Compensation, will tlo the work, antl the structure i5 not intentl¢tl o� offe�etl
for sale (Section 7044, Business antl Professional Cotle: The ContractoYs
License Law tloes not apply to an owner oi a property who bulltls or improves
[h¢reon, antl who does such wo�k hlm5elf/hersetl or throu9� his o� her own
em0�oyee5, provitletl that zuch improvements are not intentletl o� offeretl fot
sdle. I(, howeve�, the builtling or improvement i55oltl within one yea� of com-
pletion, [he owner will have [M1e burtlen of proving M1e/5M1e tlitl not Duiltl or Im-
�ove fo� the purpo5e ot sale�.
LI I, as owner of Ihe property, am exclusively contracting with licensetl con-
� tractoR to construct the project (Section 7044, Business antl Pro(essions Cotle:
The Contractor's License l.aw does not apP�Y to an owner oi property who
builtls or Improves cnereon, antl who con[racts tor zuch Oroiects witn a con-
Vactor(sl u<ense pursuant to the Contractor's License Law�. I am aware that
proof o( their Worker's Compensation insurance shoultl be provitletl to me.
❑ 1 am exempt untler Section B. & P. C. for this reason
Date Owner
I hereby certify that I have reatl thiz applicaiion ana state that the above
information iz correcL I a9ree to comply with all dty antl county ortlinances
antl state laws relating to builtli�m9 m�5buction, antl nereby authoriEe repre-
sentatives o( th,z city to eytC��upon_the at�e�mentlonetl property tor
Drivers'
GZ`T64-� 3 .�
TVPEOFCONSTRUCTION NEW ADD ALTERATION RE�AIR
❑ CONVERSION ❑ DEMOLISH ❑ OT ER q p#
DESCRIPTION OF WORK/USE OF BLDG. �°�d n=n
• S Main Building:
TVPE OF PERMIT GRADING FOUNDATION STRVCTURAL T Ffont
.❑ TENANT � ELECTRICAL � PLUMBING � MECHANICAL B Rear �L
'❑ OTHER C Right �
PROJECT DESCRIPTION 5a. Fr. pCCUPANCv
CONSTRVCTIONTVPE VALUATION$ /.Z �i3��`_ $ Le(L
ZONE GRADING CU. VDS. ACRES Ping. Ref. #
Remarks: Planning Notes: _'
' �` `• � �� i
Bar Sink
Backflow Preventer
Backflow Irri9ation
Bathtubs
Clarifiers
DISFIVYdShCf
Drinking Pountains
� Floor Drainr
Floor Sinks
Gas Service Outlets
Interqeprors � �
Kitchen Sink
Lavatories . �
P—Trap
Roof Drains
� OP i
Reinspection Fee
� s �s
PLUMBING
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors �
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
� Wacer Heater
Water Service
Auto�Wash
$15
Boiler
Duct � Under Ground
DuCt - $LrucLUral
Duct - Ventilating
ExhaustSysrem ❑ MWtiple
Firepl/Fact. Blt. ICBO #
Heating System & Oucting
❑ai oo,000 eru O i oo,000
Rainspection Fea � $15
CMF 0865-46, rev. 30/84 Whit¢ - Builtling; Canary - AOPlicanh Pink - Accounting; Goltl¢nrOtl - Assessor
Iwue Fee
Hood or Typel ❑
Canopy Typell ❑
Refrigeration System
❑ai oo,000 aru ❑ i oo,000
System Repair/Alteration
Fire Dampers
Registers
laue Fee
//
��.... _% .
Zone
Accessory Building:
Z
O
N
I
N
G
R
PTrkinq Req./Provided E
Q
, (;CC+ � M
T
$
ELECTRICAL
Automatic Washer ' Transformer ❑ 15�50 KW
Construction Pole Sub. � 50+ KW
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electric '
Fan
F.A.U.
Fixtures
Device Bozes
Outlets
Switches
Garbage Disposal
Generator �0-5 KW 05�15 KW
Meter LJup to 100 amps
Meter ❑over 100 amps
Suh Panel
Motors �0-1 HP 01 h- 8
Inc. Solar 09-15 HP 016-15+
Microwave
Range
Sign
Standing Sections
Trash Compacror
2 Oa
$ 3
Feinspection Fee $15 luue Fee
FEES
�DEVELOPMENT SERVICES REQUIREMENTS:np
2oning Approved By •«'
Building Approved By �
AppliCdtl00 ISSUBd BY �
�J
$ 3
FEES
SUMMARV OF FEES
BUILDING PERMIT $ YS � SO SMIP $ O• fP�
PLAN CHECK $�• Q 3 PERMIT
PLUMBING $ 7_/^� ISSUANCE $
PLAN CHECK 25% $ �• O b ENERGY P.C. $
ELECTRICAL $ d • �O GRADING 5
PLAN CHECK 50°� S 1. SO MICROFILM $
MECHANICAL S S d O TOTAL FEE $ �' Z
PLAN CHECK 25% $ O•�i b
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector
i. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms �
4. Elecirical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement �, �,/ 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. � 57. APPROVAL TO COVER-GUNITE
7. Footings � �/`� 58. Electrical Conduit-Undrgrnd.
8. Foundation , � �T�r1� 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK �
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final '
15. Rough Electrical-Conduit 66. Solar System-Final
i6. Rough Electric Wiring 67.. Fencing & Access Approval-
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
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. Storage Tank 0 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 & Siding �D �(�'� 77. FIXED SYSTEM FINAL '
29. Insulation �p � 78. FIRE PREV. FINAL �
30. Drywall Nailing p HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat • �,�y� N• 79. FINAL INSPECTION
32. Electrical Power Meter-Final '� 80. FOOD CERTIFICATE ISSUED
33. Final Electric �07�+��. Notes: � - '
34. Final Heating & Air Conditioning r _ '
�z'{i -
35. Final Gas Pipe-Test �
.�jJ! �' r .}'�
36.,Hood or Canopy .,y : B'�,,'�
37rFinal Factory Fireplace "; .
, 38. Final Plumbing fZ•(rJ-j(7 L�iO ' �' • � � �
��39. Water Service-Final ' � �' .
A
'.'40. Gas Service-Final � � ; ' , ' �
�, il.
41 . Solar pomesticFinal •% , � • '' • '.
n•. i i, y
42. Backflow Preventer � '" � � � �'
/ � �
� 43. Backflow Irrigation , � � • ..
44. Landscape Irrigation System �•; � �� �, i. ' " - ��
45� Sound Attenuation v � � '
46.%Handicap Regulations �, i
.
47. FINALSTRUCTURE & BUILDING � �3 ��, r' .�
48. �Special Requirements Completed � � . -
�
49. Electric Release to Edison .' ' � �
50. Gas Release to Southern California Gas Co
�
51. CERTIFICATE OF OCCUPANCY
. •
No. Date
r" -
AOD���ant to fill in all ipaces excep[ thosc witM1in heavy Dortler �ines anU si9n all apOroO/iate Ceclanlions.
CITY OF COSTA MESA CO�N+�ST�R�U�C�TION PERMIT PERMIT NO. TRACT NO. LOT O. UNIT NU.
Project Address ��G � qW�P1T�1 �L
ApplicanYs Mailing Address �rG % �����
Owner'sName ���/L �� Phone�3�sG
Address e�� l-�'l/'�%K�
Arch/Eng. �/Q-• License No. �-
Address �w,� c/_ /
Contracto ' N �`r � L=�� Phnna �-r ��p
�y /
Address (mailing) _f �
City License No. 3 �'�
LICENSEO CONTRACTOR DECLARATION
I hereby af(irm that I am licensetl untler provi5ions ot Charter 9(commencing
with section ]000) of Division 3 of the Business antl Professions Cotle, ana
my license is in full tor�} ana effect. �/y�.��
License CI j /� '� License No.�/ P��
Oale�/ ' Signature
'VORKERS' COMPENSATION DECLAftATION
hereby affirm tha[ I have a certitiCate of ConSent to self-in5ure or a[er[ifiGate
�f Workers' Compensation Insurance, or a cer[itietl copy thereof (SeCtion
3800, Lab. C.)
Policy No. ����5� Company
�rtifietl coPY is heetlbwith thehc f�Y B' i ision.
n / Date ���� Applicant ._
�� EXEMPTION FROM WORKERS' COMP ATION DECLARATION
I (Thissection neetl not be completetl it Ne �mil is for One huntlretl ($100) or
less).
I certify that in the perfo�mance of th¢ work for which tnis petm�t is Issuetl I
iM1all not employ any person in any manne� so as to become subject to the
Workers' Compensation Laws of Calitornia.
I Date Signature
NOTICE: If, after making this tleclaration, you shoultl become subject to the
Wo�ken' Compensation provivonz of [he Ldbo� Cotle, you must rorcnwim
�' Comply with zuch provisions ot this Oe�mit shall be tleemetl rewketl.
CONSTRUCTION LENDING AGENCV
I hereby afflrm tnat tnere is a construclion lentlin9 agency for Ihe performance
ot lhe work for whith thi5 permi[ I5 is5ue0 (Section 309] Civ. C.)
Lentler's Name
Lentler's Atltlrezs
OWNEH BUILDEN GECLARATION
I hereby a(tirm that I am exempt from the ConVactor's Llcense Law tor the
followinq reason (Section 7031.5 Business antl Protessional Cotle: Any city or
counry wM1ich requires a Oe�mit [o Construct, alter, improvo, tlemolish or repair
any SVucture, prio� to IIS iSSuante, also requireSlhe applicanl for Such petmlt
to file a si9natl statement that he/she is licenzetl pursuant to the provisions of
[he Contractor's License Law (Chapter 9(commencin9 with Section ]000) of
Dlvlsion 3 of the Business antl Professions CoCe) or lhat he/she is exempl
tM1ere/rom antl lhe basls for the alleqetl exemptiOn. Any violation of Section
]031.5 by any ap0licant for a permit Sublects tbe applicant to a civil
�enalty o/ not more than tive �untlretl tlollars (E500).
!J I, as owner ot the oroperry or my employees witn wages as thelr sole
wmpensaliOn, will �o lhe wOrk, antl lhe Siru<ture is not intentletl or offer¢tl
�OI SdIC ($ZC�10�1 ]044� BI1510055 dfld P!O/25SIOOdi Cotle: The CDOI(dC101�5
License Law tloes not apply fo an owner o( a properly who bulltls or improves
thcreon, antl wno tloes such wo�k himself/herseli or through his or ner own
employees, provitletl thal such improvement5 are noi intentletl or offeretl fo�
sdle. If, howeveq the bulltlinq o� improvament is soltl within one yea� oi com-
pletion, tite Owner will Itave the burtlen ot proving h¢/she CId not bulltl or im-
prove tor lhe purpose of saleJ.
❑ I, as own¢r ot the property, am exclu5ively cont�acting wlth IicenS¢tl Con-
Vactorst6 mnstruct tbe project (Section J044, Busine55 and Profezsion5 Cotle:
The Contractor's License Law tloes nol appiy to an owner of property who
builtls or improves Ihereon, antl who contracts for such projecl5 wilh a con-
ffdCLOI(Si IICCO50 pUISUdlIt LO 1h¢ COfIIldCIO!'S IICCOSE l_dW). I dT dWdl2 IM1d[
proof of their Wo�ker'S Compensalion insurance shoultl be provitletl to me.
❑ I am exempl untler Section B. & P. C. to� thi5 reason
Date Owner
I hereby certify that I have rea�
information is correct
antl sta[e laws re i q t buildir
sentatives of Ih y n[¢r
inspection purpos
Siqnature
Drivers' License or 5
this
tate [hat the abov¢
tl county orCinances
:by authotize repre-
ioneA propert�y /fo%r
Daie_/�,�/.. ''"' '
M '� I S �i °I � L/ ��
TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ OEMOLISH ❑ E
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT GRAOING FOVNDATION STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING MECHANICAL
❑ OTHER
PROJECT DESCRIPTION 5ct. F7. oCCU arvCY
CONSTRUCTION TVPE VA�UATION
ZONE GRADINGCU.V�S. ACR
Rema�ks: � (� '�G{ ��
••1 1
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers �
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Lavatories
P—Trap
Roof Drei
Reinspection Fae §15
Boiler
Duct - Under Ground
Duct - Strucmral
Duct - Ventilating
Exhaust System � MWtiple
Firepl/FacL Blt. ICBO #
Heating System & Ducting
❑o-ioo,000 aru Oioo,000
Reinspection Fee � $15
CMF 0865-46, rev. 10/84 Whi[e - Builtling; Canary - Applitant; Pink - Accounting; Goldenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Conm
Solar Collec'
Solar Pip 9
Sol ank
Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Laundry Trays
Iuue Fee
Hood or Typel ❑
Canopy Typell ❑
Re(rigeration System
❑0-100,OOOBTU ❑700,000
System Repair/Alteration
Fire Dampers
Registers
Issua Fee
$ 3
FEES
A.P. # IY '
S Main Building:
E
T Front
A Rear
C Right �
SLeft �
Ping. Ret. �h
Planning Notes:
�,, ,� r�-�
ELECTRICAL
Automatic Washer - Transformer ❑ 75-50 KW
Construction PoleSub. � ❑ 50+KW
Cooking Unit
Dishwasher
DryerS ❑Gas ❑Electtic
Fan
F.A.U.
Fiatures
Device Boxes
Outlets
Switches
Garbage Di osal
Generator �0-5 KW �5-15 KW
Zone // �
Meter Llup to 700 mp
Meter ❑over amps
Sub Pan
t� rs�0-1HP�1X-8
�
Inc.Solar �9�15 HP �16-15+
Microwave
Pole Light
Range
Sign
Standing Sections
Trash Compacror
I Reinspectian Fee '$15 I I luue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By
Building Approved By
ApplicatiOn IuuBd BV
SUMMARV OF FEES
BUILDING PERMIT $ SMIP
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE
PLAN CHECK 25% $ ENERGV P.C.
ELECTRICAL $ � GRAOING
PLAN CHECK 50% $ MICROFILM
MECHANICAL $ ( •� TOTAL FEE
PLAN CHECK 25% $
Z
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FEES
S 3
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit# Date Inspector p�ppROVALS Permit# Date Inspecto�
7. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. -" 53. Steel Reinforcement , '
3. Electrical Conduit Utility-Undrgmd. 54. Forms "
4. Elecirical Condui[-Undrgmd. 55. Electrical Bonding �� ,
5. Steel Reinforcement 56. Rough Plumbing & Pressur,e Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-Gl"1NITE - �
7. Footings 58. Electrical Conduit-Undrgrnd. . � ��
8. Foundation 59. Gas Pipe, O Undrgmd.,'fest! � ��� � "' �`
r; , a.. s
9. �Water Pipe-Undrgmd. 60. Backwash Lines, P-Trap�,'O Undrgmd. � �'� ;�� ;,
10. Structural Floor System 61. APPROVAL TO DECK ' ,�- �
i i. Property Sewer Line & House Connection 62. Backwash & Receptor-Final � ��
12. Sewer Cap 63. Heater & Vent-Final �..
13. Roof Drains 64. Plumbin9 System - Final ;. � .
�. .
14. Rough Plumbing 65. E�ectrical-Final � r� -
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 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. Lathin & Sidin t
9 9 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 ISSUEp
33. Final Electric Notes: � �
34. Final Heating & Air Conditioning /Z-!%..`�% L� �
35. Final Gas Pipe-Test
36. Hood or Canopy
�.. �.
37'. Final Factory Fireplace ' �
38. Final Plumbing '
39. Water Service-Final � • � ��
40. Gas Service-Final � i
41. Solar pomesticFinal ' " -.
42. Backflow Preventer �,�_ ,
43. Backflow Irrigation �` . . �
44. Landscape Irrigation System � • � ' �,
'A5. Sound Attenuation ' ' � � '
49._HandicapRegulations . ` � �
47.'�FINALSTRUCTURE&BUILDING . �,• i . ��
48.'Special Requirements Completed ' • _ � . �
49. Electric Release to Edison ' -
50. Gas Release to Southern California Gas Co ' ,
51. CERTIFICATE OF OCCUPANCY
No. Date ' '
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COSTA
MESA BUILDING DEPARTMENT
P. O. BOX 317
GOSTA MESA CALIFORNIA
C•L. OF STREET
' _��PROP. TINE _
r 10 FT. FOR 60 FT. STREET
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MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES ------
MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES
I '75`%1 I
FOR APPLICANT TO FTLL IN
BUILDING ADDRESS �C6 �Qf �� %'f' .
Mail
.Lc./ I /Ef n l/
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c�tY NF wG�� � l l�`�` Pi1 �-�/ Ph. No.
------��Fn--p 5���-------�-
Contractor � T Ph. No.��- ��33
6aa�e�� /'i �� Y_ �1 s �2 l ./_',
City Lic. No. State Lic. No.
Size of Lot �/1 I>X �� AP No.� OT 3�j ?�i �� %�
/ � ,i
Setbacks: C/L Street ��� '1� Rear
ir
Side Yard - Righ `-1• 1_ Left 3�
Type oE FencP� •1^'�-R�` � //'n�`�`'.�`"
.� � �!l' � ./ %
I hereby acknowledge that I have read this application and state
that the above is correct and agree to comply with all City' Ord-
inances and State Laws regulating building construclion.
Si nature � �
of Permittee �"`�"`L �v"�/��'y- ��'" f _
FOR OFFICE USE ONLY
'75'7�
- ll-sg
VALUATION
Permit Fee $ `
Plan Check
TOTAL FEE $�
USE REVERSE SIDE FOR DETAILS
OWNER KFTTTY�TI L1nL�S� 7N(' DATE (�_�h_KFi _
JOB ADDRESS 22fjR ('nl n��+a nri� BUILDING PERMIT NO. 7�
GENERAL CONTRACTOR u �,� y„�� VALIIE $ �2.790_00
AP. No. LOT 3�1 TRACI' j]b$�]2E ZONE
INSPECTIONS
L'inal Gas
DATE
DESCRIPT[ON OF WORK
SUBCONTRACTOR
PLAN NO.
PERMIT819SUED
r� . 'r '703�
COSTA MESA BUILDING DEPARTMENT
P. O. BO% 3 � �
COSTA MESA, CqLIFORNIA
FOR APPLICANT TO FILL IN
9UILDING __i� � . _i ..
COSTA MESA. CALIFORNIA
�n Homes. InC
Ipoi't B6aCg, C.S�. TNo�. OR
S W 1>�ll W�i4 W NO�
LEGPI L�T ^.
OESCRIpTION NO. ,/.
`T
A.P. NO.
SIZE /
OF LOT n� ][ q�
USE OF
E%ISTING BLDG.
$ETBACN LINE FROM
CENTER OF SiREET
SIOE YAftD RIGHT
l'„(TV LIC. ��
lA �+o.
rd♦ TNU. OR .
TRACT
NO.OF BLOGS.
NOW ON LOT
REAF YARD
DESCRIPTION OF WORK
NEW � ALTERATION AODITION
p� K a. �1' NO.OF
� ROOMS 6 STORIES Z
RIOR WALL ROOK
:RING 8tl](�'(.'� COVkpING iilC.k
OF NEW _ _ _ . _ .. ... ____
, '=
..,. ����u�: ..�
G_�` _54 J �
Fl�^.^�CE QEPT.
APPLICATION�rFOR`- PERMIT
BUILDING
FOR OFFICE USE ONLY
HECEIPT NO. PERMIT NO
BUILDING
ADORESS
COSTA MESA. CALIFORNIA
nPPaovEo
av
CORRECTIONS
/o? j�a2 "" .— �
I HEREBV �CNNOWLEDGE THAT 1 H�VE qE�D TMIS I�PPLICwTION �NO yy �' /
SiFTE THAT THE PBOVE IS CORRECT nND /�GPEE TO COMPLV WITH RLL / �
CITY OFDIuwNCES AND STATE LAWS FE6ULnTING BUILUING CONSTRUP
nON. VALUATION
SIGNATURE OF gendon Aomes InC♦ PEftMIT FEE S �Q �
PERMITTEE
$ � ^/ ��Q- PLAN CHECK $ ��-
O�
�� ��.� TOTAL FEE 5 ��� ���
AUTHORIZED AGEN /
�
DATE
\�
SUBCONTRACTOR
Service or
>wu Coat
Final Electric
e . '; 26 0
+� COSTA MESA BUILDINCrSAFEIY DEPARTMENT
P.O. BO% 1TJ0 � GOSTA MESA. CALIFORNIA Y78tE
For Applicant fo F711 In Completaly
TYPE OR PRINT
COSTA MESA, CALIFORNIA
i / _ . l . /
PIRQ
SEP -1-66 00 029 �*�*�h6.00
APPLICATION FOR PERMR
BUILDINf3
for Offlco Ux Only
2
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ZONINO ` /'^"' �g
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�� 1 �uru 'L ewto�no
% � � � . _ _ n��i��nex G [b� '� � � � � � �
No. o/ �LDO�.
py cCTewcK Lln[ IROY
DESCRIPTION OF WORK
NO.OR
ROOMH IITOII
WALL ROO�
i COVHRINO
I I LDIItY AND W0�1K TO !6 PRR�ORM[D
I XHIi6BY ACKNOWL6D06 iXAT 1 MAV[ 116AD TMI� AIPLIGTION
AND BT�T6 TXAT TN6 ACWi It CORN6R�AN0 AORHi TO COM-
PLY WITN ALL CITY ORO1NA1/CO AND RATt L11W/ 11[ODUITINO
GUILOINa CONBTpYCT10N.
BIGNATURB Ow �/�NJ g � �Q� /
PBRMITTHa- �
wurHORizeo �o�rrr � ��
��
A. P. NO. ( l�i ' � T J���`C
N0T6: NO UVt OV[RHANO BHALL �! LE88 TXAN
YARDH MPROVHD
MAIN BUILDINO
VM. SC
YARDSAPPROVHD
ACCEYSORY BUILDIN6
B6T. MAIN
ACCE8D.8
o�Te
—�—_ _ _ _ a
07
BQ. PT. �
0
TX6 AYOUM �MOWM UNO81i VALUATION IB IOR TX8 j
�UPPOOi OP [flADLIBNINO A FBPMIT I66 ONLY. ZS
VALUATION �(j ' BO �
PERMIT FEfi p
C
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TOTAL FHi � ,