HomeMy WebLinkAbout1044 CONCORD ST - Building Permitsy
iRESSZF BUILDING: 1044 CONCORD ST
rSq EIFhNG: RICK CULP
AODRE55: 1044 CONCORD ST
COSTA MESA,CA
ADPL.I HUNG ADDRESS:
ARCNRECT OR ENGINEER:
RICH. OR ENG.'S ADDRESS:
92626
UNIT:
FLOOD: X 47
I.C. Ni
UNIT:
CONTRACTOR$ MANE
CONTBACTOITS MAILING
ADDRESS: LIC. NO.:
UIR:
LICENSED CONTRACTORS DECLARATION: I hereby affirm urdeapenaLy of Perjury NM I am I'cen.nd under I rovieiwn of Chapter 9
(commendip with Section 7000) of Division 3 of me Business and proemial. Code, Net my Ihcame is in full face end eNed.
CITY LIC. NO.: LIC. CLASS: LIC. NO.: EXP:
J'
OWNER BUILDER DECLARATION: I hereby affirm under penalty of per ury that I wo exempt from the CaNredore Lican.e law la the
fdlowkp reason (Sedion 7031.5 Business end professors Code: Arty cUy or county which requiem a parm t to pawtlVd, after, improv,
demolish, or repay any structure, prior to he awwoe, also routines the applicant for such parmh to file a signed Melamed flues her or she
is linereed pursuant to tat provisions of Bis Contractors License law (Chapter 9 (oommemdrq with Section 7000) d Oyekn 3 of the
Buyers end Profession. Code) or that M w she is war -PI tMrehwn end the thesis fm he waled eaemptlen. My vblat on of Brasher
7031.5 by any applicant for a permit a,hpaa that epplicad to a cva penally of not more Ilan five hundred ddlan [$500D.
-] 1, as owner of the progeny or my amployaea vdh wages as their We compensation, will do the Werk, end Uro stmclure b not intended
or offered for says (Section 7014, Business and Professions Code: The Comrsdors License Lew does not apply to an barren of Impary,
who Wada or knord m menton. and nd doer such work NmmN a hareaE or through he a her own emgoyme, pr evidnd that such
imaovmmb
we not intended or fibred IN says. U. however. the Wat ing or hnptwernem is Will within aro year of completionr rhe
oymw4Wiww, win have the Widen of pravim M or We did not Wikl or impute IN the arrnesa of wile).
❑ I, as ovror of the wopeey, am redusivey mntraamg siilh licensed contrNewas to cmMmct the gojed (Sedian 7044, Business end
Profemiorts Code: The Contradon Lkawoe Lew does est appy to an owner of property wM Wilde or imawm thereon end who
caereCls for mdh projeas with a wntiedor(s) Iaensad Wnuent to the Commdore, licanse Lew).
❑ I No ism t undo Section: B.,$ PA., la this r es
Date: 9— a.3-9?' owner: .a —
I its hereby cxtd, that I we swats of seal understand hot requiremerneI CMm
aas, Ilest
afth d BMmn. nd
My Code Seo25505, 25533..
25534, end that I or eery More Willing aaupam will I will rot (dreb l mad to compy wih show "a ondm end the requiremama ler
epermht«o tmun mmMiGmtionhanlhe Ai ueaTityhranegenhenl Distad. ReadeMkd oonMeuaion eppicatianaers exemgtmm gross
provisions.
Data: Applimd:
WORKER'S COMPENSATION DECLARATION: 1 hereby affirm under penMy of pwjury one d the fullordm dedwmbn.:
❑ I have end oil matntab a mndkate d � to seff4mm M wwkam' canpeneatton. m aovkled fa by Section 3700 d the Labor
Coda, IN the pedmmrce d the wok fa wNch this pemhh is ®ued.
❑ hereendsal this khworkers'mmpanwManinm"nmrequiredrays0aysn 37a0 dice Lebo Code.lerthe peaormnmmdits
work for wAich the permit is impel. My waken' mmpensation inaurerhr carder cad polity number her:
Carver:
Poky Number.
(Thi; in tion need nor M cempeled f the Former is ler one hundred de9are (SIMI or this.)
❑ I panty that in the performance of IM work to witch this permit is iswed. I Wall est employ wry penin in eery manner w as to
ownere subject to the workers' compensation area of CaMorna, end agree that N 1 shouts biome subject 10 the anthems'
mmpersation provisions of Seaian 37W of tat Labs Code, I shall fonhwhh mmpy with truster provisions.
Dema'. APpiwanl:
Waminp: Fa/lule to sacun wodrws' pomp.don c..v li unlawAlL and alulf acted an himplayseW ahNmh panaldm anti
civil Meu ty he oro handrail thousand distant, ($IOXODOA In addition to tiro coat of cempwhaatbR dwmapas has provhthd ler In
S.H. 37M of the Lobo, Code, InfwasL and .11.1, '. fess.
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of mrNty time mere is a construction bating spare, IN the
performances of the oak for whits the pwmi is lowed ($sd'on 3097, Civ. C).
LENDER'S NAME:
LENDER'S ADDRESS:
I cenly that I here reed the application end Mata that her above information is Conor. I agree to comply with MI cry and county odinences
and state hews rete rat, to WiNkq conmrution end hweby a thorpe repramntatives of Ma dty to WIN upon the ethova mentionnd property
for immersion purposes.
KPAEN PARRISH-CULP
Data: d
c....w...0 rats...m,...rrs..,.x�.,.ur:•..r.e.r �7
(5151,utmp) Whits-Buildip 8 SMey; Greer -Fla; CNary-Apps ant: Rnk-Revenue; Goldemod-As.
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 084820
PERMIT NO: B 084820 PLAN CHECK NO: 03715-97 L GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ADD
JOB DESCRIPTION 348SF ADDITION — FAMILY ROOM SQ FT: 348
CLAIM VALUE: 20,000.00 CALL—VALUE: 20,636.40 GROUP OCC: R-3 /U-1
COMMENTS: SMOKE DETECTORS REQUIRED
*iE*iF*dh**dE crit 9P aF***df**dE iE iF**dE**dh dh iE iFiE dF 9F dF 9F dh dh 9E***dh 9E dF 9k 9E iE it ib*BE iE 9F �E 9E*dE**iF**aF*iF iE iE dE df iF ih iNiE 9E iEiF 9F 9h
Z O N I N GS E R T E B Q A U C I K R S E M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------
FRNT: FT IN REAR: 26 FT 6 IN FRNT: FT IN REAR: FT IN
LEFT: 40 FT IN RGHT: 6 FT IN LEFT: FT IN RIGHT: FT IN
PARKING REQ: PROW:.; PARCEL: 14165102 ZNE: R1 REF NO:_-,,
PLANNING NOTES> FAMILY;ROOM-ADDITION(348SF) TO REAR OF HOUSE.
> r
1E dh iF ip*dE*ih*dh***iE*it dF 1E*iE dh iE-iF**%iF•iN*,*iN*iE BF iE dP dhdF*iNdE*ih dh*%iF BFMiE*9P ore dE ore 9h iF 9h 3F****iF dE 9F*ih 9h dh IE BF*BE iF 9h 9tiE*
D E V E. -,-L O P M, E N T S E R V I C E S R E Q U I R E M E N "-'T S
ZONING APPROVED BY „ : TSL DATE: 9 Z3 G`t 1
BUILDING APPROVED BY 'ry aDATE: ra
APPLICATION ISSUED BY: ' A JIFA DATE: � Z3I 7
dh dFdh iF***sip lE dE dE lit iE*�������� �*
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 299.75 2.06
SMIP/NON-RES
PLAN 194.84
ISSUE FEE
BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE
TOTALS ---- > 301.81 0.00 194.84 496.65 496.65 .00
REVENUE DIVISION TOTALS--> COLLECTED: 301.81 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK
299,75 ;', 2.06
*k*dF*dF dF*if*kif ih***dh*******dh****df**fitdE**iF*cif it ah dh 9F 9t dF ih dE it*dh it*9h*3h dh 9t oft it****ib*it ih*9t dF ib 9t 9E 9F Bb!!*9E 3F
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 348 DWE-TYPE V -WOOD FRAMET� -AVER 59.30 20,636.40
END --OF FEES
r,
' A9 -23-i937; Gi:1.19 6,1;:3�i. o1
DER, eCiF!-0imr V
I !
CONSTRUCTION AND PLANNING
POOL & SP,
APPROVALS Permit #
Date
Inspector
APPROVALS Permit #
Date
Inspector
- V. Temporary Electrical Service or Pole
-
52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd.
53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd.
54, Forms
74'.' Electrical Conduit-Undrgrnd.
-
55. Electrical Bonding
'
•�5r.-•Steel Reinforcement /ff
- t
56. Rough Plumbing & Pressure Test
7
�'-6.'Electrical UFER Grnd.
57. APPROVAL TO COVER-GUNITE
_ w
s
/
7;� Footings C
T6W
58, Electrical Conduit-Undrgrnd.
_
8? Foundation
-g -b
59. Gas Pipe, 0 Undrgrnd., Test
ie
,5,
' 9. Water Pipe-Undrgrnd.
60- Backwash Lines, P -Trap, 0 Undrgr rid,
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
j:4. Rough Plumbing+f
65. Electrical -Final
151.. Rough Elecfrical-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 Cond'++[ionrg
F69E,9,EPT,,.REQUIR.EMENT
ri, _
x
y
-.
Permit # y
20. rough Factory Fir,eplace,-.APPFjOVALS:,.
_
21. Ducts-, in'StruEture• i. •• •• -+�
.'
=
<' i
70. �Vnderggrou.,, Hydro
_ , I
•,
r, �;
22. Ducts, Vgntila{ing ,;g I .L a�
T -
c -.i <;
71. Product .P,iping 0•Gas 'Oil
23. Gas Pipe -Rough & Test T,_
s +1 r
=� n%';'
72. Underground FJiisfi
TY
.. a
24. Roof=Fram9in " � -
-
r A -.
v n -^
73y Undergmd.Storage.Tank•-OGas ObiI
..
25. Roo66heathing 111 2 /�Q�LY?-
G
74?-0vef�iead Hydr11 Q�*
✓
26. BiOceilin Str t ral) & Moriocoat
- 9 1 v,C
x
y
j ;.
" -
75:, Dry Chemical
27. Frame and Flashirr^g z--';:-�
76. Dry Star@ptpe
-1�,.��'R-7
: ' 1
.
28. Lathing $�'Sidmg �
�
" INAiL
7tng FIXED MTE•�Tp
r
G`IGGW�
'
;•.-
Insulation •`,
-110
!U -C
7 TIRE PREV. FfNAL29. ' '^
30. Drywall Nailing
l!
I�IgALTN'DEPt. REQUIREMENT
Plaster Brown -Coat) n .:, •^+*' j�-��r�?
Z_r
79.E FINAL INSPECTION y
32. ;5IectricaLPotiti2r MetrFi{ral
"'
I rK
t 8QT FOOD CERTIF:iCATE ISIAED_
.c
I
`
g _
C 33. finalrElectric +-I
Notes:
'j 34. Final=Healing& Air Conditioning=
35. Final Gas: Pi pe: Test ., Cr •:z
= -+ f
jr
_r �. _ _ y rr
= 36. Hood --or Canopy
i rti
.R
I
Lei //Z- V
Z
37. Fina(Faerory Fireplace+ -.
x
4
2
ll
_ 38. Final Plum - -+�
t
Is,
S _ + N• _
39. WatefService-Final r
_
'• •
,
,t 40, Gas Service -Final ?;r-• S
.+ ;r•
f<
z.
•_ _
••'`
-41. Solar Domestic -Final ; - r
;
,,. j ,-
Y
42. Backflow Preventer
; J
43, Backflow Irrigation
$:4. Landscape IrRgation'System 'p •7
tri -
-_ '�K
:} ". 0.+ _.
45,. Sbund Attenuation
m
46. Handicap -Regulations
47. FINAL STRUQTURE & BUIf_DING
48. FINAL PLANNING +
1 4
d9. Electric Release to Edison
t
t+
50•easReleaseto-Southern CaliformaGasCo
r
_
51. CERtDIFICATE OF OCCUPANCY
No. Date
�. \.OSLd WI17JA, 1JVPdFl111CIIL VI rkllJr Rw OCrvwca
,--,,rlcation and Permit 4nr Work Described Below
VENDOR NO. F
Address or Location of Work 104•1
Type of Work to be Done
Start Date 09/2.?/ 97 Per tiLNol Valid After 1 1 / AO L Y Z (Expiration Date) Plan
Cehlractor's Name 111,1NI=R (bri �'I., r') Address 4iAN
Telephone No. (Day) 4*A' --31 17 (Nighip:i )— i 1 1 7 City and State
Stale License No./Class City Business License No.
Applicanfs Name R r (' f 4 : h0 t t C 2 _- I Address
Telephone No.
Name of Insurance Co.
24 -Hour Emergency Contact
Developer's Name
Insurance Cert.
PERMIT I t_r 1 -1 (. L -)I
..
NO.
014417
^
Bond S
•v#;.d t A
'
Cash Deposit
"Fvk-)0A4L-C
Yra 3G
Date 09119Y'SF2--
ixsuance s
Oale
E. a'r�,
Telephone No.
Telephone No.
FEES
CERTIFICATE OF INSPECTION
I hereby certify that the street work
PERMIT APPROVED FOR CITY ENGINEER
48 HOURS MINIMUM REQUIRED
_
Bond S
FOR PROCESSING PERMIT
'
Cash Deposit
"Fvk-)0A4L-C
By .1,f:L (1111110 !�
..
ixsuance s
Oale
Date 09/19/97
_
Inspection S 0.00
Account Is
TOTAL f 460.00
Underground Service Aled ID No. t•!/A
Families shall contact the City Inspectors office (7545025) at least 24 hours prior to commencing any wade. Failure to obtain proper inspections prior to commencement of work may
be cause for its rejection. THIS PERMIT WITH APPROVED PLANS MUST BE ON THE JOB AND AVAILABLE TO CITY REPRESENTATIVES AT ALL TIMES. You are guided by Municipal
Code Sections 1-33.15 -25-,15-27,15-27.1, 15-39 and 15 -48 -
THE UNDERSIGNED PERMrTTEE HEREBY CERTIFIES:
1. That all work shall be performed In accordance with the Standard Spactflcations for Public Works Construction (latest edition); Standard Drawings or the City of Costa
Mesa; special agency provisions; and all applicable laws and ordinances.
2. Control of traffic shag conlonn to the Work Area Traffic Control Handbook (W.A.T.C.H,) (latest edition). The permittee shall fumish and/or Instal all signs, tights, barricades,
traffic control or warning devices, gagmen and gashing arrow board. The ponnntee shall obtain approval of the Transportation Services Engineer for all street closures, detours,
Nm restrictions, parking prohibitions and methods of omommoliling Italic. The permittee shall ratify Emergency. Fire and Police services and iesklents or businesses twerdy-
four (24) hours In advance of any access limilatinn or traffic ustddions.
3. That a maximum of lane(s) may be closed it necessary to perform work within the public right of way during the hours of 8:30 a.m. - 3:30 p.m. Monday through
Friday as long as traffic can be maintained in each direction with flagmen unless otherwise approved by the Transportation Services Engineer.
4. That throughout all phases of construction the work site shall be kept clean and free of rubbish, debris and dust and drainage steal be m llmakred. .
SUBJECT TO THE NOTES BELOW: (Inspection teas over Na basic Inspection me oil be billed at the approved hourly rete.)
1. City will provide inspection between 7:30 a.m. and 3:00 p.m., Monday through Friday (except on City observed holidays).
2. Prior to placing Portland Cement Concrete or Asphall Concrete (A.C.), the following will have been Inspected and approved; nature 0 and Imported 0.
3. Curb and gutter shall not be removed on the day prior to a weekend or a City observed holiday.
4. Fill in areas tell by curb and gutter removal flush with the adjacent pavemerd on the same day that removal occurs.
5. Rom under all streets, curbs and gutters, sidewalks, cross -gutters and driveway approaches. Tunneling Is not allowed.
S. Open excavations must be backfiged or plated with spikes and A.C. lacked around edges during non -working hours.
7. Sidewalk shall be constructed per City of Costa Mesa Standard Drawing No.
S. Driveway approach shag be constructed per City of Costa Mesa Standard Drawing No.
9. No traffic allowed on concrete for minimum of seven days for curing. See traffic control above.
10. Trench compaction and resurfacing shag confomt to City of Costa Mesa Standard Drawing No. 813.
It- Trenches exceeding five (5) feet in depth require a permit horn the Division of Industrial Safely, Stale of California.
12. Permittee shag pay for all S.E.. compaction and materials tests deemed necessary by the City.
13. All trenches shall be permanently patched within len (10) days of completion of work below subgrade.
14. Penninee span provides the City with record drawings of permitted work b tom final inspection by the City.
15. Pemrinee understands and agrees to the hold -harmless agreement required by CMMC Section 1527 and printed on the reverse of this application.
16. Other.
'e,>� Nonce
Contractor must ratify the following Utility Companies two working days before starting work
Costa Mesa Sanitary District
• (714)631-1731
Mesa Consolidated Water District UNDERGROUND SERVICE ALERT
(7141631-1200 Toll Free -1-604422-4133; After Hours & Holidays - (714) 739-3031; (213) 621.3111
INSPECTION RECORD Inspector of Records:
CERTIFICATE OF INSPECTION
I hereby certify that the street work
Date Remarks
allowed by this permit has been
constructed according to the plaps
_
and specifications and 1 hereby
accept the work in this manner.
eT
InspxdGr
Oale
f 018382 wx, rev.51%
While - irspeclars: I certify I have read and understand all of the above and that all statements made are correct and complete.
Cxrary - Engirwwing: .'
Pkw-France - ,+
Gorew.od - Aragcara Applicant's Signature ,r- i � i l%",zd'47 i Date "r -
3 COPIES OF SKETCHES OR PLANS ARE REQUIRED PRIOR TO PERMIf ISSUANCE
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED AND VALIDATED
IUDRFRy BUILT '_ 1_0_44 CONCORD 51
OyINERSTUAEIFIWO": RICK DULY
r ADORERS: 1044 CONCORD ST
COSTA MESA,CA
APPL. MAIUNG ADDRESS
AXIIITECT OR ENCONEER:
ARCH. OR ENG.'S ADDRESS:
CONTRACTORS NAME:
CONTHACTORSUNUM
ADDRESS:
UNIT: CITY OF COSTA MESA - BUILDING PERMIT
FLOOD: X 47
92626 /1°� PERMIT NO: M 085460 PLAN CHECK NO: N
CONSTRUCTION TYPE: V -N PERMIT TYPE: MEC
UC NO.: JOB DESCRIPTION 348SF ADDITION - FAMILY ROOM
UNIT:
M NO,
UNIT:
LICENSED CONTRACTORS DECLARATION: I hereby affirm under penalty of perjury then I am licensed under pr0viebm of Chapter 9
(commendM with Section 70gg) of Division 3 of the Dustiness and Professions Com, and my license is in lull force and atm.
CITY LIC. NO, LIC. CLASS: LIC. NO, EXP:
Data Cadmew:
OWNER BUILDER DECLARATION: I hereby affirm under Wally of perjury that I am exempt from the Omtreaon Lio me Law for the
following reason (Section 7031.5 Business and professions Code: Any City «county which rv,iree a permit to c0mlrud, filer, impose,
demolish, or repair any structure, prior to its ieausrwe, oleo m uirm the applicant for such permit to fib a signed statement the M or me
is licenaed pursuant to the vmnsions of the Contmeors License Law [Chapter 9 (commencing with Semon 7000) of Chrism 3 of the
Business and Professions Codej or that M or he is exemp t1swehom and IM basis for the alepnd exemption. My violation of Sesion
7031.5 by any appiram for a permit subjects the app'rant to a civil penalty of nes more than Me hundred Miss (55001).
r] I. m owner d the property or my, employees with we0ea ss their sole amaranaion, will d0 the work, and dw.tmdum a net intended
w offered W sae (Section 7000, Butimes end PMessom Code: Tho Contractors License Lawdoes cwt appytOm bwnmd property
who bold. or knprovea thereon, and who does such woof himself or hem4 or through he or bar oven employees, provided that such
improvements, we not intended or offered for sae. 1. hansom. the building or inproaemma is sod within one year of c0mpmfon, the
owner -0 ildw sell have the burb n of proving he or she did M Wild «improve 1« the purpose of nab).
❑ 1, se owner of the properly, am wduavety centramkg xith licensed cnntrmdwa in nenmru, IM project (Saa on 7000, Business and
Profeesions Code: The Connemors License Lew dinner not apply, to an . of propend who Wilde or imposes Ihareon and wino
contmpe for such projasa with a comamods) licensed pursuant to the ContranOws License Law).
❑I em uem.? under Semon/
Dae: B. E PCforth
O 0 - 'q %
j
I do hereby ceddy that I am swats of and understad the reeuimmmm of Callomb I(esdh and Seely Code Sedum 25505. 25533. and
?5530, and ew I ur my Mum Wilde,, ooamam will /soil not (acb me) need to comply wAh and! mate codes and IM mRuimment, for
e pemN f«ormammion«moddimtionhwntMAi anapement Deems. RatimdwmMrudion epplaiducmana exempt Imes Owe
povisiona.
Dae: Appiram:
WORKER'S COMPENSATION DECLARATION: I hereby afirm unclear penalty of perjury one of the following dmaretiwn:
❑ [have and sou mannan a.enir m.a�«memmaml:�rm lwwwkm:nwnpmomion. a, amlaed l«bysmw137aodtM ran«
DOm.lw Rhe pedormanwe d Um work Iso which this permit b issued.
❑ haste
wwk 1«andwrmyh mtthisimpewdmsoltwa
issued. Mrornswm«bkenrscompensation at mRi�nInsurance nnyc,scarrierccarriercarriere 3wed! poky nLwabn«ban r ame:. f« int pedwmanwe d tM
Carder.
Pobcy Number.
(This aw une new, nwl be cwnplaed r Me permit a rw wm bendrsd dollars /s fool «less)
❑ I candy that in the Wom roes of IM work for which the permit is i»ued. I she5 not employ any, person in any, manner sem to
become subjem to the workers' cwnpemaon Is. of Ca ornb, sees Mae tlw 1 1 should became subject to the w dose'
compemmon proas. of Sector 37M of the Labor Cam. I shell forthwith owl with those praifum.
Data: Appian:
We niV, Fail. to eeours wcdrers' onrrpmuatton eovem9e lir unlawful, and Gell sold f an employer M mlm'ml pemMea and
Clvll 6n,a w M ons hundred Ihouserd dollars fdIMM), he acklimm W Me eat of rompmusda , damage as probed M In
Section 3706 of the Labor Com, Interest, and attorney. yam.
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is e cmmruden IwdyW Merry tor the
'a... of the wnk for whkh this permit Is baund (Semon San. Cb. C).
LENDER'S NAME:
LENDER'S ADDRESS:
I candy IME I hese food this applicaion and more that the shove iawmation is arms. I apfee to comply with all city end county ordination,
and state lows mwiq 10 tai di , anmadion and hereby aulhorba represemaives of this city In enter upon the anise-romemsed «nam
for liteph�t `! ypYfpme9.
�/ jl:ip�YL[T0.117-CULP
V I-
Dae: V • ��
Signature of O.mer/AgenvApplianuCantmsor
(515148 WP) Whit".ildinp 5 Seery; Gmw,R1.; Canary-App!iranl; Pink -Revenue; Gn1c nrad-As.
PERM NO: M vb546"
GOVT: N SUPP: N
PURPOSE.: ADL
SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /U-1
__ _—
COMMENTS: SMOKE DETECTORS REi�uIxEL xEF:B-a a[v
+E iaxiiif iE iE it�x*xis ii•iF iF iE riiexie ii iF iExiE ii•ii ie fit ii ie iexirxxilxii-ii ii iFniexicwvi iv iE ii ii -x ii iE it iti de ix if i6 it ii•ie i2 iFxit.jr it ie iE xis ilxx
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------MAIN
BUILDING
----------
---------
ACCESSORY BUILDING ----------
FRNT: FT IN
REAR:
FT IN
FRNT:
FT IN REAR; tI IN
LEFT; FT IN
RGHT:
FT IN
LEFT:
FT IN RGHT; FT IN
PERKING REIN:
PROV;
PARCEL:
14165101
ZNE: REF NO:
PLANNING N TES>
TOTAL PAIL
DUE
TOTALS ---- >
12.25 22.00 0.00
>
.00
f
34,25 OVER/SHORT:
.00
•N"%t' 1! It 1! %F d� •lt jt"Jt ft fl' 1f'A"�yE'R %L• jt
tt 1t `!t ft tt'k 3f fit if 1t fl' ft' R'!1"R'R'!(-!t YF')t' X 1F f!')! tt")t'll' 1F 1' lFl!'It
tit 9t'%t 9t 9l't!'R x x i!'R R 9l' lF'R'!t'h'F'Il' T")!'lF'rt'lt"It R � It w
D E V E L O
P M E N
T S E R"yv' I
C E S 11
E Q U I R E M E N T 5
ii iF i4rixie iFxxii ii ifxiE ii
it iixiA itxirx ix ixxxxix ie iF ie ie iE ie ie ie iexxii i4 Tie
iF ie if iE if if ie fait ix ie ie iE ie iE ix ii iFrisi iE iF ix it ii
v?it ix it vrxxix iE it
.ZONING APPROVED BY
B R E A K D O W N
TYPE QTY
LATE:
ni7ILDIhiG APPROVED
BY
f
REPAIR/ALT HEATING UNIT/SYS
LATE:
12.25
IO
ISSUED
APPLICATION 1SSUtU
BY:
DATE: l%
T'T'1l1t ft It lt'R 1t lh It Yt'R'lt 1!!! R'h
ll**'R R*RkY *l lir, It It ft Yt It 9t'R 9t aFhat Yt 7 'R'R tT 9E'1l
IS
lFfihhYl'h=/t'%11F 1tRR1!'It'It'R 1t'R lT 1l"h'R'R 1Y It '%!'lt'
LEGALIZATION:N
F E E U
M M A R Y
STRUCTURAL SEGMENT:N
BLDG
PMT PLUMBING ELECTRIC MECHANIC 'FIRE SMTP/RES
GRADING
PERMIT
12.25
25t SMIP/NON-RES
PLAN
ISSUE FEE
22.00
BUILDING -DIV->
PERMIT ISSUE PLAN -CHECK
TOTAL PAIL
DUE
TOTALS ---- >
12.25 22.00 0.00
34.25 34.25
.00
REVENUE DIVISION TOTALS--> COLLECTED:
34,25 OVER/SHORT:
.00
BLDG PMT
PLUMBING ELECTRIC MECHANIC
FIRE SMIP/TOT GRADING
PLAN -CHECK
334.25
ii iF i4rixie iFxxii ii ifxiE ii
it iixiA itxirx ix ixxxxix ie iF ie ie iE ie ie ie iexxii i4 Tie
iF ie if iE if if ie fait ix ie ie iE ie iE ix ii iFrisi iE iF ix it ii
v?it ix it vrxxix iE it
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
MEC 1
REPAIR/ALT HEATING UNIT/SYS
W/CNTLS 12.25
12.25
END OF FEES
10-28-1997/03:28-PN%$34.25
ROT1,81-0014586
PERMIT:085460
E' •=CONSTRUCTION AND PLANNING
POOL & SPS
{ ' APPROVALS Permit #
Date
Inspector
APPROVALS Permit #
Date
nspector
+ 1• Temporary Electrical Service or Pole
52. Pool & Equipment Location
2- Soil Pipe-Undrgrnd. -
53. Steel Reinforcement
3. electrical Conduit Utility-Undrgrnd.'
54, Forms
4: Electrical 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
59. Gas Pipe, O Undrgrnd„ Test
9. Water Pipe-Undrgrnd.
-
60. Backwash Lines, P -Trap, ❑ 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 Electrlcii-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
y FIRE DEPT. REQUIREMENT
APPAOVA'L Permit # K
_
20, dough Factot�j Fireplace '� '' '
-
-' `_
21. Ducts, in Structurei
70. -Undergrou d Hydro
22. Ducts, Vantilatin 9,
_
- -`
';
71. Product Piping�]rV`as r7 Oil
23. Gas Pipe -'Rough & Test - _
n
72. Underground Flush f
24. Roo£Frammg'
73; UndergrtSd. Stofaae Tank 11 Gas ❑Oil
25. Roof Sheathing
74;. Overhead Hydroy !
26, --Bad Ceiling (Structural) & MdhoCoat
75, Dry Chemical
27. Frame and Flashing
7fi. Dry Standpipe-� -
- 28, Lathing & Siding
77, FIXED SYSTEM --FINA): -
' 29. Insulation - :
T
!i
78; FIRE PREY. FINAL.
•' 30, Dry' 0 Nailing
i
'� �:
;HEALTH DEPT. REQUIREMENT y
31. Plaster Brown -Coat-; -;
�
l ��
79: FINAL INSPECTION
32, Electrica_Power Meter. Final
80'{ FOOD CEHTIPICATE ISSUED =
_�
- 33. Final Electric
Notes:
• 34. Final.Heating & Air. Conditioning
36, FinalGasfPlpe;Test:,-
�k
. 36. Hood or Canopy ! _ ' 7 -
-
!
:-
_�•
.' 37. Final Factory Fireplace
i
,38. Fina LPluinbing ! -
°
•'�• ^ --"
Y39. Water'Service-Final
K �
I
-.40. Gas Service -Final
*;
(i
_
'41. Solar Domestic -Final"
42. Backflow Preventer-
-43, Backflow Irrigation-'
i
� r
44, Landscape Irrigation 'System r
_
-
451. Sound Attenuation' ' '• -'
" `- -
-
-. - --
46. Handicap Regulation's
i
47l FINAL STRUCTURE & BUILDING
Ir
-
48'. FINAL PLANNING,
--
49', Electric Release to Edison
r
60. Gas Release to Southern California Gas Ca
-
51. CERTIFICATE OF.000UPANCY
"
No. Date
_ADDRIssaBMLDwD: 1044 CONCORD ST
OWNERS NANEIF l0i0lyN: RICK CULP
.AOBRESS 1044 CONCORD ST
COSTA MESA,CA
APPL. MAIIDa ADDRE34
ARCNITECT OR EAGEEER:
ARCK OR ENG.'4 ADDRESS:
CONTRACTORS NADP.
CONTRACTORS MAADIO
ADDRESS
UNIT:
FLOOD: X 47
92626
Uhl NG:
UNIT:
UC NO,
UNIT:
UCFNSED CONTRACTORS DECLARATION: I hereby affirm under pereny of pmpy that I are Doer nee urWar, pr.vei. a Cheper 9
(commenciN with Section 7000) of Division 3 of Ne Business end Professions Cade, and my liomw is in full broa and eMw.
My UC. NO.: UC. CLASS: UC. NO, EXP:
Date: Context.:
OWNER BUILDER DECLARATION: I hereby affirm under timely of perjury thal 1 am exempt from IM Cantrwon Lloema Lew for the
Idmwng reason (Swion 7MI.5 Bminaa and Pmroeaam Cade: AM cky .manly w'hicA ntquintm s Perms to OPmmxd, alter, impwa,
demolish, or repel any htmctum, prior to its beuenoe, also requires IM applicant for such Perch to fib a of storemem thet M or she
is licensed Wrsuant to IM provisions of the Contrwore License Law [Chapter 9 (mmmenoiN w0h Section ]000) of Dmaim 3 of IM
Business and Professions Code[ or tel M . she is exempt Iherehom and the basis for the slbpd exemption. My violation of Session
7031.5 by any eppllmnl for a permit subpss the aPplimm to a civil penny of w more then two hundd dollars [5.001).
cr3 I, as owmr dthe propend. an,, empoyeea with we9es as their ads compensation. sill do the work, and Ne slr lee b rwl imended
or dfernd Nor sale (Section 7044. Business end Professions Cade: The Contrwont License Lew does not epplyto m owner of popery
wW Wids or mptowa thereon, and Who dose such w himself. herself or through M. her Own empbyoee, Provided [het euoh
'Unproernrxus ane not We"or Offered 1. eels. 9. howeer, the WAdi, or inpr0 mi is sold silhin ane year of complain. the
owmr-0 jWss WII Mw the Wreen a pwinp M or she dol nal bald or impoa for the papme of sale).
❑ I. as owner OI IM propend. are exausivey mntrmip wnth liosnsed contrmton to wm os the propos (Swop ]044. Bmone eros
Pmm
feo se Code: TMarws
Cow Lases Lew dap
oes not apply to se, d property who Wprov.
Wilts . Im. thm; a end Who
mnuecte for sudh projws wnth a mrxtwor(h) ficerued pursuer to the Lsom/ss/ Leer).
oxempt u der Nb re
oae: 0 � I 9 owner: Q� //�j)�SM, !. /�•_
ty c.nt that I em swans d and undermWd IM ntgaremmn d Cdfmrie N.ann std sway cod. Swiorrs 25505, T.S533, ane
end mor I a enY Munt WOe'vmp omrpw. WA / wR rhe (srcb ore) mad m mrrmpiY wit said arca aodn end IM rogaramanb ler
apemml. o.uwclianormodifwionh.nlMMi ane9enwa Disdd. ReaieertlNa.WrWon appk�oman stamp homtws
pw®.rm.
Date: AppiMem:
WORKER'S COMPENSATION DECLARATION: 1 hereby aff.m under pmft of perjury ore of Ne 165.v&O dmareoro:
❑ 1 hers eros WI meintab a cettcore d mmmt to selfinsunt hx workers' mrmoemoron, o provided for by Swim 3]oD d int labor
Code, for the p ormance of the wish for w this parent is issued.
❑ [hew and Wl meoteb warkw'opmlerdaon uemrence.mrsquvnd by5wion SNOdiM Lobar Cods. brtM prhamatwatM
work 1. slmism orb parent is lsaoed. MY xakerh' mmpamorion imuntrce merrier vol OolkY number vs:
Cerner:
Poticy Number.
(Thi. swan reed not M mmpbped d the peen is Nr on. hundred ddbrs ISIO01 or ion.)
❑ 1 caney Thor in the Womenee of the work ler shah this mrmnt is themes, I ehdl not employ any person in any manner so as to
become subjw to the works' mm,emmion lass of Caii.nla. end sperm that it I ahsAl became sub[ad to 1M waters'
mmpemaion pwiscm of S.tion 3700 d the LebOr Code. I mall forlhwnth mmpy wish Ihme provisions.
Wmm/n9: Falmm to.ecun workri can emselfpn mvsre9e la unlevrf✓l, and SWl.Meal N employer ro .Im'rW Per.M" and
c/NI Ons w no, ore hrndrsd House xf dollen (SIDOD39A M soblds, W Me coat of mmpemeUsn. denest u provltl d ler In
S.H. 3106 0l the Leber COW, torrent, end ammey'e les..
CONSTRUCRON LENDING AGENCY: I hereby elfum Under Pm0ir of Pansy thel Intra is e mmrwion lerdnh9 epenxY ler the
pedoreae s d the work for Whidr the permit is bad (Swan 3097. Cer. C).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify thin I ave sal this eppfiomon and sone thet Ne above olarm cion is cored. I stints to comply With ao cry end comm/ md.
and store less restimp nwudi.m to WitdM coa l hereby mancrce namosentorives d this ohy to enter upon IM abova-mentionee properly
I. impetlon purposse.
KA EN PARRISH—CULF
Print
rDona:
S:,nam dQww/ eM/ADofunLConlrw.
(515149.WP) WaeLBuTIbO•A'SdaY; Gema ilio; Cm y-Appkem:P k-Rewmro: Oaderuod-Mmevor
CITY OF COSTA MESA - BUILDING PERMIT
PERM NO: E 085331
PERMIT NO: E 085338 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V -N PERMIT TYPE: ELE PURPOSE: ADD
JOB DESCRIPTION 348SF ADDITION - FAMIL"Y ROOM SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /U-1
COMMENTS: SMOKE DETECTORS REQUIRED REF:B-84820
wwwwwwwwwwwww�wwwwwwwwdiwwwwwwwwwwwwww�www#wwwwwiliiwwwiiwwwii#wwwwwwwwwwwwwwirieiiieiFiFii
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------
MAIN BUILDING
----------
---------
ACCESSORY
BUILDING---------
FRNT:
FT
IN REAR:
FT IN
FRNT:
FT IN
REAR: FT IN
LEFT:
FT
IN RGHT:
FT IN
LEFT:
FT IN
RGH'T: FT IN
PARKING
RE8(�:
PROV:
PARCEL:
14165102
ZNE:
REF NO:
PLANNING
NC7TES>
ELE
1 RECEPT/SWITCH 1
ST
20
EA,
1.00
>
END
OF
FEES
D
E V E
L O P M E N
T S -ER V I
C E S
R E Q U I R
E M E N 'T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY
APPLICATION ISSUED BY:
wwwwwwwwwwsirwwwwwwwwwwiiXX""�"'�rwX 'X'±e
LEGALIZATION:N
BLDG PMT PLUMBING
F E" E -SUMMARY
ELECTRIC MECHANIC
PERMIT 9.00
50%
PLAN
ISSUE FEE 22.00
BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK
TOTALS ---- > 9.00 22.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
31.00
DATE:
�+nT DATE: 9
x'TFXX1i 1i'RX X1i It It '1t R)l'XXII' X
STRUCTURAL EGMEN :N
FIRE SMIP/RES GRADING
SMIP/NON--RES
TOTAL PAID DUE
31.00 31.00 .00
31.00 OVER/SHORT: .00
FIRE SMIP/TUT GRADING PLAN -CHECK
wwwdiwwwwiiwwwwwwwwwwwwwwwwwiiwwwwwwwwwwwwwwwiewwwwwwwwwwwwwwwwwwitwwwwwwwwwwwwwwwiiw
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
ELE
2 FIXTURES LIGHTING 1
ST
20
EA,
1.00
2.00
ELE
6 RECEPT/OOTLET 1
ST
20
EA.
1,00
6,00
ELE
1 RECEPT/SWITCH 1
ST
20
EA,
1.00
1.00
END
OF
FEES
18-21-1997/11:28 RM/f31.88
RCPT8:81-8814182
PERMIT:985338
CONSTRUCTION AND PLANNING
-
POOL & SP,
APPROVALS Permit #
Date
Inspector
APPROVALS Permit #
Date
Inspector
1'. Temporary Electrical Service or Pole
-
52. Pool & Equipment Location
2- Soil Pipe-Undrgrnd.
53. Steel Reinforcement
3: Electrical Conduit Utility-Undrgrnd.
54. Forms
• `4� Electrical Conduit-Undrgrnd,
55. Electrical Bonding
• �5.' Steel Reinforcement
56. Rough Plumbing & Pressure Test
`6f'Electrical LIFER Grnd.
57. APPROVAL TO COVE R-GUNITE
-+ c
l: Footings
58. Electrical Conduit-Undrgrnd.
-
8. Foundation
59. Gas Pipe, ❑ Undrgrnd., Test
' 9' Water Pipe-Undrgrnd.
60. Backwash Lines, P•Trap, O Undrgrnd,
7
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
,;l, 3. Roof Drains
64. Plumbing System - Final
14, Rough Plumbing ,v
65. Electrical -Final
h. Rough Electrical -Conduit 13'
66. Solar System -Final
,1.6. 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
APP'@DV '0 P5^mit # f y
20. Rough Fjbto6 Fiib�lace c�Y S
T ; T
•�
21.:�ucts, in -Structure, Y ••••• •- S
S
7 '� `
70."UnderlFyU F[gdro k -
22. Ducts,, Ve{ttil; ting+t t
�: ,y
,�-�, ;.
71. Produej'iping drasLsl Oil
R
23. 'Gas Pipe=Rough &• Test -IS
,'"
1
72. Undergr6Lnd Ftussh -
^
24. Roof-Fraritin '
A' �- � �
' =
j
'� �
's x
73 Undergrnd. Siorgge Tank. ❑Gas ❑ Oi�I
J
p
�','
25. Roof -.Sheathing .r e 4 v
K 17
_ ^ 1:
741 Overhead Hydr& .r
26. T•Ban Ceiling (StruiL ural) & f.4oyiaciat
v - h
-
7. Dry Chemical " '' h,=t ;
,
._
27.,f,rama and Flashing 7+;,+�
ti
�� ,z is
76. Dry Sta VU pe z K -•'v T
c- '-1 11 ni"
28. Lathing ${Siding• i % .� '?
= "I
"i "I'.
� ,i,,
72, FIXED'�}_s E5�,M1�INAL,
14
�
29. Insulation u� �• ••
'�
..
(F
7& FIRE PREY. FINAL t: =• "moi
30. Drywall &failing n
, !k
'S 71itALTR DEP'f�.-REG'UIR3�IOT
I
i 37. Plaster Bvwn-Coa�,+,5 I it V
,
c n
79�. FINAL IDISPECTIDN J x
' 32.'ElectricaVovyer fvle
i, 1+
-
801 FOOD CERTIFICATE 1�$, EDy77
33. FinO};Electric,, k r
tJ. %/_
R'
_ l -
Notes: e•y= .1 -� - o n
34. AnCondiIioningS '�
'?
'< •1U - t -- -
_FinaCHeating-&
r+�
35. FinarGai�i pG)Test R - T'
3 36. Hood,or•Ganopy =" = % T' -'
r
T;71i
- .v'
Ti.�.
= 37. Fina(7Faclory FireFq&W _,.,
i
I '�
w J - X;
-1 38. Finat-Pluthbing "r -'
'
+'
= r r
_
39. Water' Service -Final
40. Gas Service -Final r T1 r;:+ 5
Tt
j I'
O -
41. Solar Domestic -Final•=
42. Backflow Preventer f
r l
I it
? 7 -•
- 43. Backflow Irrigation
-
A4. Landscape Irrigation Systema •r-��
+ -
7
V `� e '> > _'=
-45. Sound %tenuationt
46. Handicap-Regulationi
-
F
47. FINAL STRUCTURE & BUILDING
v
- �`
'
_ •
48. FINAL PLANININGr. .A
n
49. Electilic Release to Edison
50. Gas Releaseto.Southern California Gas Co
�•
'_ = + '
C r
51, CERTIFICATE OF OCCUPANCY
= �'
No. Date
'
ADDRESS OF BUILDING: UNIT:
OWNER'S NAME IF """RICK
CONCORD ST
RICH CULP FLOOD: X 47
PODRESs: KAREN D PARRISH—CULP
1&9jjQUCMORD ST COSTA MESA CA 92626
MCNITECTORENGINEER:
A 11. OR ENG.'S ADDRESS:
11C. NO.:
CONTRACTORS NAME:
CONTRACTORS MAILING
ADDRESS: I1C Ni
UNIT:
UNIT:
LICENSED CONTRACTORS DECLARATION: I hereby affirm under Forty of perjury that I are licensed under Provisions of Chafes, 9
(commadng with Section 7000) of Division 3 of the Bum. and Professional Code. and my license a in full law and ended.
CRY LIC. NO.: LIC. CLASS; LIC. NO.: EXP:
Data: Comma«:
OWNER BUILDER DECLARATION: I fereby affirm under pansly d parlury that 1 an eumq twit the Contmeas license Law la tat
idlowkg reaaon (Section 7031.5 Busheaa and Professions Code: Any city a oounly which mquima a permit to oona u , alta, impove,
demolish, or repair any structure, poor to he ewarlce, also mquires 1M applira rl for ouch permit to fib a signed statement that he or am
is Ilaenaed pursuant to the provisions of the Contractors License Lew (Chapter 9 (wmmenciM with Sadiron 7000) of Dlveion 3 of the
Busiwas and Prdeesions Code( or that he «she is exempt thaehorn and the basis he the alleged exemption. Arty violation of Section
7031.5 by any applicant for a parmn subjects the epplicam to a coil penalty of not more than fine hundmd dollen (55001).
1, as owner dthe popany or my employees with wages as their ache compensation, will do tat welt and the structure is not intended
or offered for sale (Section 7011, Bueineas and Profasaions Code: The Contractom Licen.e Lew dee rat appyto w &woad property
who bWda or inprwes thereon, and Mho does such work Mmseif m henel or thm gh he or her own employees, pwi al that such
improvement. Pre not imendnd or dlemd for sale. ff, howaer, the Mikli,q «nnpwaneN u sold within Pre yea of completion, the
owoer-buiMer MII have IM bonlan of pwmg he or she da not build or improve for the Puryoae of rale).
I, as owner d the Property an exclusively contracting with licensed contractors to construct the project (Section Toil, Business and
Prolusions Code: TM Contractor License Lew does not apply to on owner of popaM oho Milds or impowas thereon and who
conimcta for audh poos echo wits a conthaaor(s) liS. & P. Nor for thi to the �
em undo SaMn: B. E P.C., for this
reecon:
Dale: / ex / -7 Corner: /\
I do hereby carry that I am aware of and adastard the requirements of Cai oma Meath end Safety Code Sections 25505. 25533, and
. 25530, and im, I «arty Mu« boll, ing occupant will / will not (cmle ow) read to comply with wM state modes act the mquiremems for
apermntorwmtmctimormodili tmhomlhe Ai uC eTAiareganem Didrict. Reeidamial axutaction eppiralbneem exemgimmtheee
Dote: Applicant:
WORKER'S COMPENSATION DECLARATION: I hereby Affirm under penalty of perjury one of dre following dedaratiwre:
❑ I Moe ere Mtl maimaih a cMifnata d consent a uffinwn by waken' wmpansatlen, m povided 1« by Section O70o d tat labor
Code, for IM pedonmavm of the work 1« which this permit is ®ued.
❑ haw and MD this
worst
is issued.
My w bons' compensation
aeon inimd by Carrie 3700 d the labor Coda, W tat pedamence d tat
work for which this pemhn is issued. My w«kers' compensation insurance tamer and policy number aro:
Cerner:
Policy Number.
(This rection need not M complo ed i the perm[ is for ow hmd«d della, /$1001 o, leu.)
I o nsy that in the pedormahce of the work for which this pmmn is issued, I .hell M employ arty person In entry manner so as to
becnne whim to he worked compermhon lava of CaMomia, and agate that B 1 shouts become wbject to IM waken'
wmpsnaaldn «mas. of Section 37M of the Labor Code. I Melt forthwith campy with those prw®«e.
Date: Applicant:
Weming: Fallum M sevum work.' con senuffen coverage Is un/swful, end shell 10fact sit employs to plrmhal penalUas and
civil floss w m one hmairsd thousand cents" ($104000A /n adlides W the cost of comoassnfbM1 dental es Provhfed for In
Section 37(16 of Me Labor Cods, Interest, end ngomey s feu.
CONSTRUCTION LENDING AGENCY: I hereby affirm under penahy of perjury that them is a cotratNmlen lending agency ler IM
padonnarve of the work for which the wmr, a issued (Section 3097, Civ. C).
LENDER'S NAME:
LENDER'S ADDRESS:
I caniy ,hat I have mad phi Application and state that tat whoa information is cortin. I Agree to campy with All city end county ordinances
And state A" a
mlatng to Mi kq cmrhdructlen dhvabyaNM empewntaWre dthedpe
tytoentautMa -nwVu wopmry
I« in.pedan M,pow r (�`A(lt)N�e- n0- /
Signature d Owoer/AgendAppni tract«
(5151460p) WMe-SuiMiq 6 SAW: Green-Fle: Canary-App5wnt; Pink-Rewnue; Goldemad-baeaaor
\I
e r
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: E 084210 PLAN CHECK NO: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE
JOB DESCRIPTION : MOVE ELECTRICAL METER
CLAIM VALUE:
CALC—VALUE:
PERM NO: E 08421
GOVT: N SUPP: N
PURPOSE: ALT
SQ FT:
GROUP OCC: R-3 /U-1
COMMENTS: SOUTHERN CA EDISON SHALL PRESPOT NEW LOCATION
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Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ----------
---------
ACCESSORY BUILDING---------
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 RE& PROV:
PARCEL:
14165102
ZNE: REF NO:
PLANNING N TES>
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D E V E L O P M E N T
R V I
C E S R
E Q U I R E M E N T S --
ZONING APPROVED BY
i
DATE:
BUILDING APPROVED BY :
DATE:
APPLICATION ISSUED BY:
DATE:
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LEGALIZATION:N
F E,E S U
M M A R Y
STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING
ELECTRIC
MECHANIC
FIRE SMIP/RES GRADING
PERMIT
27.25
502
SMTP/NON—RES
PLAN
ISSUE FEE 22.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS ---- > 27,25 22,00 ,10.00 49.25 49.25 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 49,25 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
49.25
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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
ELE 1 SERVICES BELOW 600 V S BELOW 201 AMP 27,25 27.25
END OF FEES
06-13-1997/10:59 A0/549.25
07
PERMIT:084210
•, CONSTRUCTION AND PLANNING
APPROVALS Permit #
Date
Inspector
POOL & Si
APPROVALS Permit # ,
Date
Inspector
tx Temporary Electrical Service or Pole
52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd.
53• Steel Reinforcement
'
3. Electrical Conduit Utility-Undrgrnd. -
54. Forms
4. Electrical 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
-
59. Gas Pipe, ❑ Undrgrnd., Test
9, Water Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, ❑ 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 I -
68, APPROVED FOR PLASTERING
18. Rough Electrical.T Bar Ceiling
-
'69. POOL/SPA SYSTEMS FINAL
19, Rough Heating & Air Conditioning -
FIRE DEPT. REQUIREMENT
Permit #
20. Rough Factory Fireplace'APPROVALS
21. Ducts, in Structure ..
-
70. Underground Hydro
22. Ducts, Veritilating'-
- -
71. Product Piping Q Gas ❑.OII
23. Gas Pipe -Rough & Test
-
72. Underground Flush
24, Roof Framing
,.
73. Undergrnd. Storage Tank'0 Gas -El Oil
25. Roof Sheathing -
-
74. Overhead Hydro
26. T -Bar Gelling {Structural) & Monocoat
75.. Dry Chemical -.
27. Frame and Flashing '
76. Dry Standpipe -
28. Lathing & Siding
-'
77.- FIXED SY$7EM FINAL -.
29. Insulation
78. FIRE PREY. FINAL
30. Drywall Nailing
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
32. Electrical Power Meter Final
-INSPECTION
t-779, FINAL
80. 90. FI OOD CERTIFICATE ISSUED
33. Findl Electric
34. Final Heating & Air Conditioning •- -
{+
Notes: ,
-
35. Finai Gas Pipe:Test
36. Hood or Canopy
- -
37. Finel Factory Fireplace
T
-
38. Final Plumbing
39, Water Service -Final
40, Gas Service -Final
41. Solar Domestic -Final
'
42. Backflow Preventer
-
43. Backflow Irrigation
44. Landscape Irrigation System _
45r Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
,
48. FINAL PLANNING
49; Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
!9909
'.
1
W. r0d/1
' COSTA MESA BUIL MDEPARTMENT
COSTA
P.O. BOX 317 COSTA MESA, CALIFORNIA
L QLU.
ARCHITECT
OR ENGINES .S/
TEL.
,✓ NO.
For Applicant to Fill In Completely
R. E. AndMn
APPLICATION FOR PERMIT
TYPE OR PRINT
I HBREBY ACKNOWLED
AND STATE THAT T B
PLY WITH ALL C1 O
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SIGNATUREO
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TEL.
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ADDRESS
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Constr__uc on Co
CONTRALTO
I HBREBY ACKNOWLED
AND STATE THAT T B
PLY WITH ALL C1 O
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SIGNATUREO
PERMITTE
259E
ADDRESS--
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UNDER VALUATION
A PERMIT
STATE '�TEL. LIC. NO. NO.SIZE
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NG. OF BLOF
LOT v
NOW ON L
USE OF
SETBACK LINE FROM j�l REAR YARD r
CENTER OF STREET J
SIDEYARDI LEFT " I RIGHT
DESCRIPTION OF WORK
WALL
ZONING;
20X6 NO. OF UB80P N6
R_1 Fugs 2 BUILD(No W/ 8tt g7
LEGAL
..SCRIITION Lot 43, Tract 45364536
A. P. NO. none
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
90' TO SIDE 9 REAR P. L.
EAVES
ALLOWED (U.S.C.REOUIREMENT'.
YARDS APPROVED YARDS APPROVED
MAIN BUILDING ACCESSORY BUILDING
(FROM C/L 67REET)
W
DISTANCE BET. BET. 1
MAIN SLOGS. ACCE
VAR.* DATE
C.U.P.# APPRI
P0.0VfiD
BYW. L. D DATE
Gt/ r
ror
T� �Sj6
C— SQ
/–r s0. FT.
I HBREBY ACKNOWLED
AND STATE THAT T B
PLY WITH ALL C1 O
B UILDINOCO NET U
SIGNATUREO
PERMITTE
A
E 1
Al
A EAD THI APP ATION
R RE TO COM.
8 q GUIaT
THS -AMOUNT SHOWN
PURP088 OF ESTABLISHING
ID%(
^^77
$ /f ���"
UNDER VALUATION
A PERMIT
18 FOR THE F
FEE ONLY. O
L �J q
PERMITFEE $ S
X�y
PLAN CHECK $ '� ` a
4
AUTHORIZED AGENT
TOTAL PEE s\