HomeMy WebLinkAbout3104 COOLIDGE AVE - Building Permits� �
PHOJECT RUOPESS: � 1 O 4 COOL IDGE AV
OWNEP'SNpME: HIRON, GLENN H
aooxEss: gIRON MARY S
3104 �OOLIDGE AVE
�s COS'fA MESA CA
`AHCHIENGINEEfl: � 714 � 979-3�37
aoox[ss:
UNIT:
92626
sec.No.:
. uxiT:
PEHMITTEE: LEE ROOFING � ( 714 ) 642-7223
AOOflESS: S G S 3 SUPER IOR
CM CA 9262�
LICENSEO CONTHNCTOX DECLANATION: I hereby aHrtm �ha� I am licensed untler pmvisions of Chap�er 9(commencing wi�h Section
7000� o� Division 3 oi Ihe Business antl Pwlessans Goae, antl nry license is in full force anC ellect.
cirr uc.: 0 2 7 51 STFTE LIC.: �} g 6� ��5� C- 9-
oa�e�. -� ' � /Sgnature.— _�C�i...( �/
WOBNEXS' COMPENSpTION OECLANA7ION: I here�y aftirm ihai I have a cenilicate ol consem m sel4insure or a cenificate ai workers'
Compensalion Insurance or a ceni�ied co y Ihereo� (Section 3800. Lab. C).
roucvNo.:.400624.191"l� cxr.oaTe: p6/30/92
I camvaxr: USF6G CO.
� Certi� copY is hereb�Wmishe4 �tl copy� d w�cily Bui in ivision. /
Uate: � / _ / POlicanC
E%EMP710NFROMWONREBS'COMPENSATIONUELIABRTION: (Thi55ectionneeAnotbecompletetlilthepermitisloronehunOretl�5lW�qfless�.
I cetltly thal in Ihe petlormance al Ihe work lor which �his permit is issueq I shall nol employ any person in any manner so as Io become
sublect lo Ihe Warkers' Compensa�ion Laws o� Cali�omia. ' .
Oale: Signature:
NOTICE: If. a�ter making this 4eclaraiion, you shoultl become sublecl �o �he Worke�s' Compensation pravisions af �he Labor
CoOe. you must lonhwiin compry wilh such pmvisions or �nis permit shall be deemetl revoketl. '
CONSTflULTION LENOING RGENCY: I hereby a�lirm �hat Ihere is a con5imc�ion lending agency �or �Ae Dedormance ol the work lor
w�ich Ihis permi� is issued (Section 3097. Civ. C�. •
LENOEB: REROOY OF SINGLE FAMILY
aooREss: DWELLZNG & ATT/GARAGE.
OWNEN BWIOEB oECUBR7lON: I here6y affirm ihat I am exempt imm ihe Comracrors' Slate License Law for ine tollowing reason
�Sectian 7031.5 Business and Prolessional Code: Any ciry of county whic� requires a permil b consimct, alter, impmve, tlemolish, or
repair any S�mcNre, prior to Iis Issuanco, also rtpuires �he appllcanLtor such permi� �o tlle e signed 5laiement iha� helshe is licensed
pursuam Io Ihe provisions oi ihe Contracmrs' S�a�e License Law (Chapter 9 �commencing with Section 7000) of Division 3 0� the Business
and Pro�essions CoOe) or �hal he/she is exemD� Ihereirom and Ihe basis br ihe allegetl exemp�ioa Fny violation ol $ection 7031.5 by
any applican� �ar a permii sublec�s Ihe applicanl to a civil penalry o� no� more Ihan tive �unUretl tlollars (5500�.
❑ I. as owner oi Ihe pmperty or my employees with wages as �heir sole compensation, will do ��e work, an0 the
s�mcmre is nal imen0ea or oifereA lor sale (Sec�ion 70aa, Busine5s and Pm�essional Catle: T�e Cantractors' State Litense Law
Does not applY �o an awner ot a pmpetly who 6uiltl5 or impmves ��ereon, and who Aoes suc� wo�k himself/herself or [hmugh
his or her own emplayees, pmviactl thai such impmvements are no� in�entletl or o��ered to� sale. I( howeve� �he building or
impmvemen� is sola wnhin one year of com0letion, �he owner will have Ne burtlen o� pmving he/she di0 no� build or improve
_ lor Ihe purpose of sale�. .
I, as owner a� �he pmpeny, am exclusively conlrac�ing with licensetl con[ractors to conslmct tAe pmlect (Seclion 7044, Business
❑ antl Pmfessions Cotle: The Cmtraciors' S�aie License Law Does nol appty to an owner oi propeey who builas or impmves thereon
an0 who coniracis �or such pmlec�s wi�h a contractor�s)license OurSuani to the Coniracto�s' Sta�e License Law�.l am aware
I�al pwof ol �heir Worker's Compensalion insurance ShoWd �e pmvitletl to me.
�. I am exemp� under Semion: B. 8 P. C.
loi �his reaso¢' '
�ale: Owner.
I Oo hereby certdy ��ai I am aware of anA unders�ana Ihe requiremenls oi Califomia Health antl Sa�ery CoOe Sections 25505. 25533. antl
2553a antl �hai I or any iWure �uiltling occupani will/witl not (circle one) need ro camply wiih said state codes ana ihe requiremen�s �or a
permil lor cons�mc�ion or mo0ilita�ion �mm ihe Air Oualily Management �istricl Residential canstmdion applica�ions are exempt fmm
Ihese provisions. .
�a�e: Npppca L'
I hereby ceridy I�at I have reatl t�is applica�ion a slale �hal Ihe abave inlormation is correct. I agree Io comply wil� all ci�y and cou�
ortlmance5antl5talelawsrelaunglobuilOmgco mclionanaherebyaN�orizerepresenlativesolihiscirytoen�eruponlheabove-men�ione0
property''l'o7r�i�ns�pe'c7tio�n pqurp/oses.
Dale- �/� Signa�u�/�-�""' � ��
Driver'sLicenseor5ocialSecuri�ya�
i6aL46 White—Builtlinq: Green—Gotle Enlorcement: Canary—Ap0lican�; Pmk—Revenue: Go�tlenrotl—Assessor
CITY OF COSTA MESA - BUILDING PERMIT rPERM NO: B 052866
PERMIT NO; B 052$66 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRtI,CTION TYPE: 5-N PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION ; REROOF WITH FIHERGLASS SHINGLES SQ FT: 4,600
CLAIM VALUE; 4,600.00 CALC-VALUE: 4,600.00 GROUP OCC: R-3 /M-i
COMMENTS: SMO}tE DETECTOR(S) RE�iIIRED IN HOME, t�pq pyc
�*************�t*****��******** **x����***�****r***x*�r****�f�1��*L�1������
Z O N I N G R E Q U I R E M E N T S
; S E T B A.0 K S �������,�� �
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAFt; FT IN FRNT; FT . IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PRUV;' PARCEL: 19165523 ZNE;, REF NO: �
�PLANNING NtSTES>
>
ir*x*���t*•*�**���� x�r�**��x***+�*�r�****+��t*�*�***�r��*��r*��t*********�r**�+��*����x�
D n V E L(� P M E N T S E R V I C E S R E Q U I t� E M E N; ;T -S-
.°3
20NING APPROVED BY DATE:
BUILDING APPROVED HY .: DATE:
APPLICATION ISSUED BY• �1��,��'� DATE• �:' �
iE1fiFlEikiE#4#EjFiFitiEiElE3EaFi(�ik*iE�E3EiFifTF7F�4�f3E7FiF3F'iE�F#'IE 'iF TF�F'iF3F�FTFiFiF�fiFi(�iEiEiEiFiFiEifaE�F ikiF
if it iE iE ak iE if 1E if if iF aE IF iE iF if iE iF 1F iF iE if aF 1E iF !E iE iE 3E iE �F iF iE if !E iE 1F if if If if Ik �E iE if iF 3E iE iF iF 1E iF iE iF iF ik 1E iF iE iF iE 1E �F iE iE if iE if 1F iF iE 1E iF iE iE iFiE iE 1F
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 72.00 .50
SMIP/NON-RES
PLAN
ISSUE F.EE
BUILDING-DIV-> PERMIT SSSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 72.50 0,00 0.00 72.50 �2.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 72,50 OVER/SHORT: . .00
BL�PM��T PL�ING ELECTRIC'MECHANIC FIRE SMIP/TO�T GRADING PLAN-CH£CK
�f iE iE iE fE ik iF if if iE if iE 3F iE if iE aE iE if * k iF 1E iF iF 3E iE ik iF if 1E iE iE iE it 3E if aE if !E 3E 1E if jf IFlf iE IF iE jt # iF k IF jF if if k iP �Eif iE if iF aE if 3El4 �E iE'iE 3E k 1E �)E ik iE IF i6
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 4600 REROOF BY. VALUE RESIDENZAL NOZONE
. END OF FEES
� :���= '�
� i
� `' Ju= � 1 1�91 � ��
Ct i't' v� COSiA �ESA
1.00 4,600.00
CONSTRUCTION AND PLANNING � POO :PA ��.. �� -
. APPR�OVALS Permit #� Date Inspector APpROVALS Permit # Date Inspector
1. Temporary Electrical S¢rviCeor Pole . -52.•,Pool & Equipment Location ✓
2. Soil Pipe-Undrgrnd. �'. - � 53. Steel. Reinforcement
= 3, Electrfcal Con�it�lhility�Undigrnd. •� - : ��;,�4. Forms� - �
_ 4;:,flectrical Conduit-Undrgrnd. ��'�; _�55. Electrical Bonding � -
' 5. St�el�Reinforcement � ' - � ' 56. Rough Plumbing & Pressure Test , �
: � i• � �
�- 6.�,Elec[rical UFER �Grnd. � - . � �
' .57. APPROVALTOCOVER�GUNITE
-. �7..�Foatings � � �.� . . -�158. Electrical Conduit-Undrgrnd. •
� � 8. Foundation -• �I�-• � � �� � ` 59. Gas Pipe, � Undrgmd., Test . � ,
;> 9. Water Pipe-Undrgrnd. t, J�� �60. Backwash Lines, P•Trap, O Undrgrnd. � . _
70. Structural Floor System �,s - � _'.-61. APPROVAL TO DECK
11. Property Sewer Line�& �House Conriection - ,�62. Backwash & Receptor-Final . ��
12. Sewer Cap � �_ 63. Heater & VenbFinal ; "�
73. Roof Drains rc , � 64. Plumbing System � Final
14. Rough Plumbing � 65. Electrical-Final � .
15. Rough Electric`a��Conduit �. 66. Sotar.SYstem-Final
i6. Rough ElectricWiring 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::kough Factory �ireplace r ± . - �J APPROVALS: ��.Permit # � �
� '
21.'_Dutts, in.Structu�e' j '.. . ;. K � .-� ,.. ;. = Z70. l�ndergqountl' Hydro . �
22. Ducts, Ventilating r � � r � 71. Producr Biping ��G9s ❑�Oil
23.-Gas PipefRough & Test �, i ' ,,, •,. '- � ' * '72, Underground FI Js'. F ' `
24t�Roo'f Framing >� , � � �. - .r �: �73PUndergmd:StorageTank �Gas ❑Oil -
_
25. Roof Sh,gathing ., x -�. �� _ ; „ � ' ��74. Overhead Hydro ~' ' � . ��
26.�;f�Bar Ceiling (Strucwr81) &�Monocoat '� � � ���v • 75: Dry Chemical . � - c � - -'� �-i
�. - �
27:�-Freme and Flashing ; • . � ' � 76. Dry Stanc7pipe ��' • �` � • � '�' � h �
•c s: . �A �, i . - .,.. - 1 ..�
-'f �t� : � v�l�. � . � � p . '1, .. • �� I,'.4• f.^ `lJ
28. Laihinca,&Sid�ng , , _ s,•{ �i. � 77:. FIXEDSVSTEM�F.INAt '� . -
. «t . - . .. i ; ��, � .� .. -. ... � ��.�: i�.
�29. Insulation ' � � -� �.. � 78,.FIRE PREV. FINAL - . ; � _
''30. Drywall,j.Vailing t-�.�. ' ' , � , HEALTH.bEPT..REQUIREMEN�"�� � `';�,
,.37. Plaster Brown Co'�aty � ti, � � �: -� � 79.� FINAL IN$eECT10N �. � � ' �c_.'_"
�.
�32.-Electrical Power,MeterFinal,' � _ . =' > -SO.,,FOOD CERiIF�CATE ISSUED �
33. Final Electric T�+ ' � -' Nofes: ' - � "
- n
"�34, .Finel Heating'& F.ir Co�ditioning. ,- � � . '; x '� � '�� . � �
� � •�
35.'Final Gaf Pipe�Test, �- � " ' • •" .
�36.rHo dor�Cano `" �' ' � ��v ' ` ���
r. 4. PV��- , i � N x - - o ��c•
37.-Final Factory Fireplace� ' ;�'" ^ �" I 'R"' - � '-n
-38. Final PI mbing - � .� , •. •, ,� . ' � � <� ��- .: t ` .
;.39. Watar Service-Fina6 �� � ? . - �� �'
11 + I� I Y �
-, 40. Gas Service-Einal ' � , �, x .,., � � "�� �. �. � V � �
�� . n � - . .. .
-�41. Solar pomesticFinal<; ' •• . , � �' � s
��n
- 42`Backflow Preventer � ' � ' ' � ' c�
x - •
43. Backflow Irrigatio� � % � `. �+ ' . - + _ -�
r
� 44. Landscape Iriigatio.n SYsteml' " ,- - - ; .,, _� - - , � t .- ,_
>.45.=Sound Atteduation � . • . � '� � �
� �+- � -�
�46. Handica,n, Reyulatlons �� ' '� � ' fi , " , ` `
�47:FINAL STRUCTURE & BU('LDING � - �.ic,J
i� °I� Q E_ � .
48._�INAL'PLANNING �'�� ` , � ' �� - � "
{ � �! 1 .a.
� 49 �Electric Release toEdiSon i � . �: . ��� `V � . "
. „ ,,: -
'.50., Gas; Release to Southem Caltfornia Gas Co i� ` ; ,. ,,
".51. CERTIFICATE �F,�CCUPANC _; ; „ 4: � , ;, :
No. Dat�
PXOJECT�OONESS: 3�.04 COOi.IDGE FiL�
OWNEB'SNAME: BIRON, GL�NN YI �
aoosess: �IRON, MARY S
� 3105 COOiIDGE A����
COSYA MESA CA 9:.'626
UNIT:
. � ,
RHCHIENGINEEfl: XEG.NO.: ' �
A�OHE55: � I1N1T:
PEPMITTEE: G..�ENN BIP.��N ( 714 ) 979-3237.
noosess: 3104 COOiIDGE
<,�M CA 92626
UCENSE� CONTPACTUB OECLNNATION: I hereby aifirm thal I am licensed unGer provisions ot Chzpter 9(commencinp with Sec�ian
7000� of �mision 3 0� �he Business and Pmfessions Cotle. anA my 6cense is in �u0 �orce antl eflem.
CITY LIC.: STPTE IIC.: CLASS: •
�ate: SignaWre:
WOBKEFS' COMPENSATION �ECLAflAT10N: I herehy aflirm IAai I have a te�ilita�e Oi ConSen� to Sell�insUre or a ceni�ica�e of Workers'
�ompensallon Insurance. or a certAletl copy thereoi (Section 3800, Lab. C).
ag}ICY NO.: � E%P. OFTE:
�'�,OMPANY:
� CeNhetl copy is hereby fumishetl. ❑ CenifieJ copy is file0 with ihe cily Builtling Oivision.
Ja�e: Npplicani:
EXEMPTION FflOM WOflNEHS' WMPENSATION UECLAPpTION: (This sec�ion neetl not 6e cample�etl it Ihe permi� is �or one hunAreO (51W) or less)
I cenify thal in ine pedormance of the work for wnich this permit is issued. I shall not employ any person in any manner so as to �ecame
suble�� �o �he Worker5 Compensa�ion Laws o� Califomia. •
�aie: SignaWre:
'NOTICE: II, al�er making this declara�ion. you shoul0 become sublec� to �Ae Workers' Compensa�ion pmvisions ol �h¢ Labor
CoAe. you must lorihwith comply witn sucn pmvisions or this permit shatl be deemetl revoke0.
CONSTFUCTION LENOING RGENCY: I hereby affirm ihat t�ere is a consimction lentling agency lor IAe pedormance oi Ihe work for
whiCh �hi5 permii i5 issued (Set�ian 3097. Civ. C).
LENOEN:
aooecss:
OWNEB BUILUEB DECLl�BRTION: I Aere�y a��irm �ha� I am exempL�mm the ConVacloK S�a�e License Law br �Ae following reason
(Section 7031.5 Business and Pmfessional Code: Any cily ol counry which require5 a permit �o consimct, alter, impmve, demolish, ar
repau any simcture, prior Io i�s issuance, also requires the applican� for such pe�mil Io file a signed slalement �ha� he/she is licensetl
pursuant m �he pmvisions oi ihe CONradors' State License Law (Chapter 9(commencing with Section 7000) at �ivision 3 ol ihe Business
antl Pmiessions CoDe) ar tha� helshe is exemp� �heretmm antl �he basis lor ��e alleged exemp�ion. Fny violation o� Sec�ian 7031.5 by
applicant lor a permit subjecis applicant to a civil penalty of not more ihan live huneretl tlollars (�+`00).
I, as owner of t y or my employees with wages as t�eir sale compensalion, will tlo t�e work, ana ihe
�/ slmciure is not inte rea for sale (SeClion 70a4. Business an0 Pfo�essional COtle: The Con�ratbrs' Sta�e Litense Law
tloes nol apDly to er � a O�operly w�o �uiltls or impmves thereon, and who does such work himself/herself or �hrough
�, his or her own e e, provitle0 t�at suc� impmvemenis are not imentletl or oflered lor sale. If, however Ihe 6uil0ing or
� impmvemen� i m one year ol comple�ion, �he owner will have Ihe burtlen o� pmving �elshe tlid nal huiltl or improve
�or ihe purp sale�.
/ � owner ol Ihe pmpetly. am eecWsively coniractinq wi�h Iicense0 conlractors to conslm ' - , usiness
I I ane meuions o. ' icen ��� ero pmDenywhobuilOsorimpmvesihereon
anU w�o c i a conirac aware
nl tFoir Wnr4ni c Cmm�nnofinm m�nanw cM1niA� ho nrnvidotl �n ma
� I am exempt untler Sec�ion: 8. 8 P. C. �
�or IhiS rea n '
�aie: � Ow . '
I tlo here�y cer ly ��at am aware ol and undersland the repuiremen�s Calilomia Heal�h antl 5a�ery Code Sec�ions 255U5, 25533, and
25534 and ��at I or any tulure builtling occupant will/will not (circle one) neetl to compty vnth said 51aie codes antl �he requiremen�s for a
permi� for consimction or modificatmn Imm �he Air Ouality Managemen� Distri 5i4eniial con5imction aDPlicalions are exempi imm
I�ese provisions.
oate: Aoplicant:
I here6y cetlify Ihal I have reatl Ihis application and slale Ihai Ihe above inlormation is correcL I agree lo comply with all ciiy and county
o�DinancesanUslatelawsrelatingtobwltlmgconsimctionandherebyauihorizerepre nl rvesafihisciryto uponlheabave�men�ionetl
pmpetly lor in/specliYn purpases .
� Date: `•� ((�_ Signaiure: �"'d`~�
/ `/ L [
onver'sLitenselar5ocialSecumyp:
AOPlicanL Pink—Revenue: Golaenroo—Assessor
. _ I
CZTY Or COSTA NE�F - BUIL'DINGfFERMiT PERM Nq: � G5I6UE
�
PERM3T NU:.B 051606. PiAN CHnCK NO: O1U34-91 S� 1 GOVT: N SDPP: N
CONa3RUCTIUN TYPE: 5-N PERMIT- �P.YPE: s'TR • FJRPOSB: .t�D
-. , ,
JUB D�SCRIFTiUN ; F�uD 91.3 S�i FT kECREATION ROOM� . 5Q F1: ?LJ'.
CLATM VALUE:' CAi,C-VALJE: ,,'18,49�?.00 GROJP UCC: R-3 /M-1_
CUMMEr7iS: SN,OKE DnTECTOR(S) RE�UiRED. IN :iO,u�.,
rt�a:�+t�*3t��x��c�k��e�t�:�i�x-*�!�x�it��tt�*�t��E�t���x�?����* :#����*l���t��t�lFx�?i-*x�3�u�*��v���..rt��a[�x*ttur��±�:�=u*�r.�k+t��;.�ar.w��x�it��t�k��t�
,L O N T N G R'E Q J I k E M E h T S' �
5 E T B A C R S ' ''
----------- MAIN 3UILDING ---------- -------- ACCESSOnY tlUlLD1NG ---------
FRNT; 56 FT' IN REAR: 17 FT IN Fr�NT; rT IN RLAR; FT I.N
LEz'T: 6 FT IN RGi-IT: 33 FT �Iv • LEiT: FT TN i(GHT: ,, �N
PARKI?dC3 REO• PROV: PARCEL: 14165123 LN^c: R1 RE? Nf�:
PLAt3NING u15TES> PROPOSED '413 sQ,FT, RECREATION RM ATTACiiED TO EXISTING S,F.
• > - - . _ .
3f i6 3t� dE }. {(� dF �tE 1E #� ff aS � iF�k 3i� �K Y.� 3f 3E if iEl4le it�:4 iE �E 3F #: 4E 3E Y�iE iE )F3F iE 1E if !6 if 3f if 1E if � i6 3ElE j(� 3E iF 34'r. i(�?f +c fE iF 1E?i. if V� iE Y aE !E'i! !i� ! a�- i@ 3f �7F 3c iE 1f ii�
D E V E L O F M.E N T 5 E R V I' C'�. S R E Q U I R c M E N.T S
ZONING APPROVEU HY :_(�J C� IL �� . DATE: �tk p� �l L
BUILDING APFROVED BY : _ DATE: �
APPLICA'tION TSS[]ED BY; ?)ATE: . �,
!Fli�i4N�K��3FiF343'riFiEiFi%itifN�ifi'r3f#�lf � . -r ."iriF'f.'F3i�3t'?Fa:�(�#+f>i3i-3�i'r:: x-�i"r'F�i'��k�
iF4iF1'r1Ei:jFi(�i'riE3Fif�iiK�Y�ifK1EY�i-}�.1E�fi�:i(�%�ih+'..}'.. ...- if�#-�3F?f' kff#iF3i�N�it9p#�1i�Fif:\�}'.�(�ff?Ei(�#+'.u.7E1�'�ii�ii�aEiflP>r.�l!�#'�iF?i�#lkiE#i+.-Z�17P
LEGAI.IZATION:iv � F E E S U M N A R Y. STRUCTJkAL SEGM,�;;Y
Bi.DG PN,T PI.UMHING ELEC'iRIC M�CHAN?C F'iRF. SN.IP/R�� G:�t:i�ZNG
PERMIT 278.00 � � 1.99
, SMLP/1�ON-r-tEc
PLAN � 180,"10: �
•TSSUE FEE �
BUILDING-DIV-> PcRN,IT. ISSJE PLAN-CHnCK,? T03AL PAiD DUH
TOTALS---->' 7.79,99 0.00 180,7Q 460,b9 460.69 .00
REVENilE DIVISSON TOTALS--> COLI,ECTED• � 279.3° OVERISHOR'i; 00
BLDG PMT PLi7N,BING .=i,.ECTRSC MECRANTC �IRE . S�,EP/TO'C GRALII�C� PLAN-CriECK
2'18 ,.0 0 1. 9 9
��*�**�x�+r*��**����r��x**��*�ta�x*����c�*��x�**�����**�.+r���.;�x*��a,:�v�*kr�;:.+�.>ra �;u*�:��
I N D I V I D U A L F E E•' � R E A K D Q W N
'fYPE ' (ZTY D•E S C R I P T S O N � �.` UNI,'P COS'T iOTAL COSY
SrR 913 DWE-TYPE V-WOOD FRAMn -GOpD 69.OU 28;997,00
END Or' rnES. ,
'/
e
� 'r� .
0
� i
' Ui �OOET4#S-9UOE44-;0 T Cnl' � ,'a.q4
� � DA?E: 04:D4/91 7i"E: ?O:i9
i.'' �
�
►i
� � ��i�il & ,a
CONSSRUCTION AND PLANNIN6 _ �
APPROVALS Permit # -" Date Inspector qppROVAIS Permit # Date Inspector
1. TeTOorary, 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-Undrgind.
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 & ReceptorFinal , � -+
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. Rou9h 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. DuMs, Ventilating 71 . Product Piping � Gas ❑ Oil
23. Gas Pipe-Rou9h & 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 �. -
2S. Lathing & Siding � � � 77. FIXED SYSTEM FINAL
29. Insulation ' � . 78::FIRE PREV. FINAL
30. Drywall Nailing � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 7g. FINAL INSPECTION
32. Electrical PoWer Meter-Final , ,80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: ' .
34. Final Heating & Air Conditioning A/� f � ,
✓i ,
35. Final Gas Pipe-Test � '
36. Hood or Canopy ' � � . . �
37. Final Factory Fireplace � . ��(O�-G�'�,.. G� ` a
'38. Final Plumbing � � � �,w�
39. Water Service-Final � �
40. Gas Service-Final '
41. Solar pomescic�Final
42. Backflow Preventer
43. Backflow Irr�9ation �
44. Landscape Irrigation System � . �
45. Sound Attenuation
46. Handicap Regulations � , ,
47. FINALSTRUCTURE&BUILDING _ � G,t�,,,�j� �
48. FINALPLANNING '
49. Electric Release to Edison -�
50. Gas Release to Southem California Gas Co ' ,_ ,
51. CERTIFICATE OF OCCUPANCY
No. Date
(/
PHOJECTAODPESS: ;j1O4 �.D�Ll���F. AV
OWNEH'S.NAME: �TIZO:��� Gl.�L�IN H
ROOflESS: �T,ROiV, ++SARY S
. 31'J9 CUt�LTDGc. AVr.
COSTA McSP.,CA 926Z6
NHCHIENGINEEN:
AOONESS:
HEG.NO.:
uxrt:
UNIT:
PEflMITTEE: GLENN HIRt)N (714)979-3i37
aooeess: 37 04 C'UOi.IDGE
CM CA 92626 �
LICENSEU CONTBACiOfl��ECLRBATION: I hereby a�hrm Iha� I am licensetl untler pmvisions of C�api¢r 9(cammencinq with Sec�ion
7000) of �ivision 3 0� Ne Business antl Pmfessions Co4e. antl my license is m fu0 force antl eflect.
CITY LIC.: $TPTE LIC.: CLnSS:.
�ate: SignaWre:
W08KEFS' COMPENSp710N OEClABR710N: I hereby ailirm ihat I have a certi(iwte of consent to sel4insure or a certificate ol WOBers'
Compensalion Insurance, or a certilied copy thereoi (Section 3800. La�. C).
41CY NO.: EXP. DATE: �
OMPFNY:
�] Ceni�ietl caDY is hereby Wmishe4 ❑ Cenilied copy is tiled wi�h t�e city BuilAing Division.
�ate: ApphCant-.
E%EMPTION FROM WOBREBS' COMPENSRTION OECLAflATION: (ThiS section neea no1 �e comple�eU i� Ihe permii is br one huntlrea (5100) ar less�.
I certify I�at in ihe pertormance oi Ihe work for which Ihis Dermi� is issuetl, I shall not employ any person in any manner sa a510 become
subleq �o I�e Workers Compensa�ian Laws of Ga6fornia.
Da�e: Signaiure: '
NOTICE: II. a0er makmg this tleclaralion. you should hecome suble�t to the Workers' Compensation pmvisions oi Ihe Labor
Catle, you muslfotlhwi�A comply wi�� such provisions orlhis permii shall be deemea revoked.
CONSTPUCTION LENOING ACENCY: I hereby affirm thai �here is a cons�mc�ion lentling agency �or the pertormance o� the work �or
which Ihis permi� is issuetl �Sec�ion 3097. Civ. C�.
LENDEN:
aooness:
OWNER BUILOEB DECLAflFTION: I hereby allirm IAat I am evemp� irom Ihe ConVac�ors' $late License Law br �he �ollowing reason
(Section 7031.5 Business ana Protessional Cotle: Any cily of coun�y which requires a permi� �o cons��uct, atler, improve, tlemolish, or
re ir any slmcture. D�ior lo ils issuance, alm requires Ihe apDlican� lor such permit to lile a signetl s�atemen� Ihat he/she is licensetl
rsuanito�he pwuisions o�lhe Conlraciors' S�a�e License Law�Chap�er9(commencing with Sec�ion 7000) oi �ivision 3 ofthe Business
na Prolessions Code) or Ihat he/she is exempl iherefrom antl ��e Dasis lor �he allegeE exemp�ion. Any violation o� Section 703L5 by
ny applicant for a permit su0le��s t�e aDPlicanl to a civll penalry oi not more Ihan five hundred dollars (5500).
I, as o er � f Ihe property or my employees with wages as iheir sole compensation, will Oo ihe work, antl the
simcmre nAetl or otfere0 for sale (Section 7044. Busmess an0 Professional Catle: The Coniractors' State License Law
tloes n a p I an owner o� a pmperly who builtls or impmves Ihereoq antl who Ooes such woB himsel�/hersel� or Nmugh
his or � r mployee5. pmvitled Iha� such impmv¢men�s are no� intentled or oHereO for sale. Ii, however the building or
impmv t sald wi�hin one year ol campletion, Ihe owner will have �he 6ur0en of pmving he/she tli0 no� huiltl or impmve
lor ihe uroose of sale6 � - .
. r nt Ihe omoetiv. am exclusivelv coNraclina with licensed con iness
of
ihereon
`� antl who coniratts tor - i�h a contraclor aw . I'am aware
that r orker's Compensa�ian insurance 5hou10 be pmvitle0 �o me. , .
� I am exemp� under Sec�ion: B. 8 P. C.
�or Ihis reaso •
Oate'. Ow r ^'��
I tlo hereby cetl fy Iha am aware o� antl undersiana �he requiremenis ol Calibmla Heal�h antl Sale�y od¢ Seciions 25505. 25533, antl
2553A antl �hat I or any lu�urt huilU'mg occupanl willlwill noi (cimle one) neetl to comply with saitl state codes antl ��e requiremenis tor a
permil lor cons�mc�ion or motliliwtian Imm Itle Air �ualily Management District. flesidenlial cons�mclion applicalions are exemp� imm
Ihese pmvisions.
�aie: � ApPlican�'.
I �ereby cerlity Ihai I have reatl ��is application antl Slate ihat ��e above iniormation is mrrecl I agree lo comply with all ciiy anA counly �
ordinance5andstalelavrsrelalinglo�uilaingconslmclionan4herebyaNh 'ereDre5enlatrveSafUrsmt nleruDontheabove-meniionetl
pro0eriy for Insp Iion urposes. '
�-j' �•_ �
Oate: � ( Sig �
Oriver's L¢ens or Social Secunry n.'
164L46 Whue—Bmltlin9: Green—Cotle Eniorcemenl', Canary—ApPlicanl: Pink—Revenue; oltlenrod—AssaSsor
CiTY OF COSTA MESP. - dVILDING PgKMIT P�RM NO: EM 0=100;
Pfi'RMIT NO: ._M 051607 PLAN c:HECK NQ; N GOVT'; N SUPP: N
CONSiRUCTION "TYPc; 5-N P�RMIT TYI�E: ELE ��C PIIRP05E: P.DU
SOB AESCRTF'TION :,F,DD S13 SG FT RECREAT-iON r�00M ��(i'-r'P:
CLAIM VALUE: CALC-VALIIE: ' C;ROUP OCC: R-3 /N-1
COMMENTS: REt' HS?606 ' �
�KibY���%7E7C•NY-�k#1e%��fM§fdF#E�rtYriE�EiE�kifN�7EiEf4�7EaE�7f�ii�Icif3EN..�.7F.K.K.1E.li..�f}i.iF.1i..7fd4iEiF1F+f#k.](.X..1(..k.N..x,.le�%��9EiEk9E'3EiF�H�l4d(•iF�?f�K��CiFY.� �
Z O N I N G R E Q U i R E iK E N T S �,
S E 1 B A C K S -
------------ MAIN BCiiLC7ING ---------- --�----- ACCESSORY bi7TLD7:NG --------
F'Ri+IT: FT AN REAR: FT IN FRNT: FT TN RF.AP,: PT IN
LEFi: FT TN RGFiT: F'i IN LEPT: � F� 1N RGFIi: F1 iN
P!'eRR's�iG kEq• PROV: PAP.CEL: 14io51�3 ?NE: REF NO;
YiA.NNIN� �b�•�s>
> �
Y.� i't jf )f if 3f i; �}:� # If ?e at If -1'r if }.� i'r ie iE iF ie ?f iE ie R iE ii� if M� 1't �k iF 4#E i4 iF f') it� 1F %� Y� iE 3f }y icli� aF Y� Y.- if 3E ih iE iE 3i 3� i'� r. 3E if iP f� iF jF �E if i!-}'.±E iE Y?(� ih jE?t� �1i?f �#:�
D E V a L U P M E N T S E�R V I C E S R E Q U I R E M E N T:,
?.O!vIt3G APPftOVED BY ; �/���� ' L� ��- �7AT�: � �_����
3Uii,DTNG AFPROVcD BY ; _ DATE; �___
APPL'TC�TION IS�UcD B DATE,;
W�M�iiif3f�lPiE#3f3fi6i'�iE14VEffiF+:�if1E �1.` � c. ��� � 'T.3'ri�iFlfic3'tliE%?Eii���f+�F��i�
iF1EiF:li'i:lfi6if14)EiF'1YaFii36iei4i!�'ri'r3i� 1t .!xr- �IFiFi�1fY'iE'1i?f�f'1i#'iilEl4ili('iFY.'iFi%iI'i�'i("Y3:iF'1i'�`:�?%ifif�M'�i%iE'kif'i!'�i'r:E-Y�T'3t"%'±('R'#'r`%.
LEGALIZATICiN:N r E' S U ay M A R Y S'.FRi7CiURAi, 'a'ErMgNT:N
BLDG PMT �'i,GMFiING LECT�I'C NECiiANiC FIRE 5MIP/r�nS Gr�ADIN(;
PcRMIT 16.50 4.5c0
: 5U� . ��J� � J��.vil��1�Q�-f�L.s
YLAN
ISSUE rEE 15.00 15.00 '
3UILDTNG-DiV-? PERNIT ISSi1n PI.AN-CHECK TOTAL � PAZD D'u'E
TOTALS----> 2i.00 ao:oo o.on ;i.00 si.00 .00
kEVENuE DEVYSION ?'OTALS--> COLLECfED: 51'.00 OVERISHORT: 00
BLDG PM7' PLF7MBING cLECTkTC MECiiAiIC FI�n SMiP/iC�T (=rZAUI�G PLAN-C3c:CK
, 31,5U 15,50
N� i(-1'r �M 1'r %Y� fF 3F Y l'e iF if�� I(� ii� i6 ik ic 3f %� iF ?e if iE 1f 3i� �F ib if� )E #� 1k Y ie iF fF ie �(�!F 1F N� �Y 3F 1E !f if�?!.% 1f if ii� IF IF if 3f �(� i61E iF �I'r iF?'r 1E �1i� N� �iE Y.-�!' #'� i"r af �7'r iF }�kk it iE d(� 3E
I N D I V I D?J A L F E E H R� A I! D O W�
TYPE QTY D E S C R S P i S O N i7t3TT' COS'P TOiAi� COST'
=LE� 4 FIXi'v'R�S LIGiiTING 1 ST 20 EA. .75 3,00
ELC. . SO R�CEPT/O{JTi,ET 1• ST 20 c,A, .75 7,5U
ELE 4 RECEPi/SWI'tCH 1� sT 20 EP.. .75 3,00
ELr. 1 Mt)TOR/POWR APPARATUS 0.0 - 1,0 HF� 3.00 3.00
MEC 1 VEtdTILATION rAN CONN TO SINGLE DUCT 4,50 a.SU
END Or cEES ,
0
k
O1 OOOE44di'-bi:�844SB "� E V� ;,i.+�?
QRSE: C14lC�4/93 TIt;�: IL�:23 (
. 1
CONSTRUCTION AND PLANNING , ,- - P�<\� & �; A
APPROVALS Permit # Date Inspector pppROVALS 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
i
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding '�
5. Steel Reinforcement 56. Rough Plumbing & Pressuie 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; O Undrgrnd, '
70. Structural Floor System 61. APPROVAL TO DECK , �
71. 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 Plumbin9 ' 65. Electrical-Final .
�•
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access ApProval •
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � -
20. Rough Factory Fireplace � - '' APPROVALS Permit # ,
27. Ducts, in Structure .. _ . 70. Underground Hydro
22. Ducts, Ventilating ' 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test , . 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing ' . 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat '• 75. Dry Chemical '
27. Freme and Flashing � ,', ' 76. Dry Standpipe - ,
28. Lathing & Siding - � � 77. FIXED SYSTEM FINAL
29. Insulation ' � 78. FIRE PREV. FINAL
30. Drywall Nailing _ ,1 HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat �• 79. FINAL INSPECTION .
32. Electrical Power Meter-Final ' 0. FOOD CERTIFICATE ISSUED
33. Final Electric ;� �s: ' " ,
34. Final Heating & Air Conditioning �EO Q{ f�/? ' . . �
- 35. Final Gas Pipe-Test , - , �
36. Hood or Canopy , . � . � -
37. Final Factory Fireplace , � .
38. Final Plumbing �
39. Water Service�Final � � '
40. Gas Service-Final , � , . �
41. Solar Oomestic-Final � �
42. Backflow Preventer
43. Backflow Irrigation �
44, LandscapelrrigationSystem,
45. Sound Attenuation �
46. Handicap Regulations ' ; � �
47�. FINAL STRUCTURE & BUILDING � �
48. FINAL PLANNING
49. Elearie Release to Edison
50. Gas'Release to Southem California Gas Co .
51. CERTIFICATE OP OCCUPANCY ,
No. Date
p����
COSTA MESA BUI�DING-SAFETY DEPARTMENT
�P. O. BOX 91] COBTA ME9A, CALIPOPNIA
For Applican� fo Fill /n Comple►ely
. TYP� OR PRINT
oaeS3 31OZF (�O� f�OPJ Us'
, COSTA MESA. CALIFO NIA � . .
OWNF
MAIL
SIZE / � . I No.01
OF LOT �a NOW a
USE OF
EXISTING BLD6.
BETBACK LINE FROM �• ' ' �
CENTER OP BTNEe"f S� REAR YA
SID6YARDI LEFT .� � 'RI6HT' -
DESCRIPTION OF WORK
BUILOING?7�
SIZE JV
EXTERIOR WAI
1 NEqEBY �CKNOW {
AND BTATE THAT
PLY WITH ALL Y O
BUILOINO CON H IC
SIGNATUR
PERMITTE
AUTHORIZED AOENT
1
FEE �RECEIV�D
AN�LI�TION& OR PERMR
RECtIM! NO. � PEptaiTJ�O�
. ..�.. _ � ���
OV �p R6 V8D DATEIBSUED
/ //I—/,S—(3 JUL � i i
�
�/G ZONING
zans no. ov use or xew sin� j'a
R� . PLANB CUILD�NG
�eaw�
D@8Cp1''1'ION
�
A. P. NO. � T10 '
� NOTE: NO EAV6 OVERHAN6 SHALL BE LE38 THAN
30' TO 31DE fl REAR P. L.
EAVE9
. 'ALLOWED (U.B.C.RHQUIREMENT:
YARD6MPROVED YARDSAPPROVED
�MAINBWLDIN6 ACCESSORYBUILDING
REAR �`�
DISTANCE BE
MAIN BLDGB.
VAR. �
�I
DATE
@
�_ s �s��s4. �. y� p � �
'PLICATION�— THB AMOUNT 9HOWN IINOER VALUATION �e FOR TNE F
H'TO COM• PUHP09E� OF 86TABLI6HIN0 A PERMIT FEE ONLY. 0
eouun �� � . '
vA N PERMIT FEE $�� j
m
S/� / �`— LA C C� / SO ¢
_ o