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HomeMy WebLinkAbout3019 COOLIDGE AVE - Building Permits(7/4) 754-5273 • Farz (714) 754-4856 • www.ci.costa-mesa.��LDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 Job nddress: 3019 COOLIDGE AV Suite: Status: ISSUED Applied: 06/21/2005 Vicinity: 4-UNIT APT BLDG & ATTACHED GARAGE Issued: 06/21/2005 Primary Occ: R-1 Hotels/Apts/Res >10 Occ Type of Construction: V-N Parcel Number: 14114154 Zoning: Applicanr. SMITH, KEN - Address: 11236 WESTERN AV - . � �� " � � ISSUED BY: STE F-8 � � ; ' � � ' � - Phone: (714) 3913754 � � STANTON, CA - - , - � ' Zip: 92630 ; , .' ' . ;.; . - .,i ,� , � �- �'� Owner: BERGER��IRINA �- � � t '� �- � / �� ` ' Address ,92�GOLDHURSTTERRACE- _ - , ��=� ; �. � " , - � ENGLAND - �� : � - .- -. Phone � �_: - � V � ' � `���LONDON � . - ZIp NW63HS � �`. � ,� . �- . Contracror: A-OK ROOFING & RENOVATIONS � �Address 11236 WESTERN AV � `\\ � , " - , . STE F-8„r � ,.' Phone: (714) 3913754 • '; . � . • . . �.;.:�� '� ` i ;; .s. - �� STANTON, CA � � " �,. � ..Zip: ��92630i �-License: 639447 . .'-� ��. . '•�,t .. . �i �, . 5;� �. _ _...� � . - ' ' . ',�� . ' . . Arch : � ' Address: � , Zip: r!.., ,. .�- Phone: ., .. _ .. _.. � .' License: Eng: , � � ?,,.. _ . . Address_, � �, � - - �� � � . - '� � % \ Phone: � � � �'� � � License: ' ' ..;-,,,•r� .,�SCOPEOFPERMIT,. ,.', •'.'��• REROOF 4-UNIT'APARTMENT BLDG AND ATTACHED,PLAT ROOF�GARAGE: /�_' ; �_�, " ' � '-- ' �' PITCHED ROOF:-T/O COMP ON ROCK�, REPAIR/REPLP.CE SHTG�AS NEEDED, 2 LAYERS 15Si PELT, APPLY "30-YEAR,OWENS CORNING COMP SHINGLES." 24 SQUARES �-' � , ', FLAT ROOF: T/O B.U.R., APPLY "CERTITEED SELF-ADHESIVE 3-COURSE SYSTEM." 6 SQUARES � - . -�,-._ ' _, , . - ' 'j . � /� � � FEE SUMMARY� ,,'"� � %' � � � ' � Plan Check: $0.00 Calc Valuation: ;j'` �,\ Ss,zoo.00 � �Permit: $139.25 . Claim Valuation:; i/, ' ' gs,2oo.00 �,, , ' � SMIP Res:� ;$0.62 " � - ' �G�� _ `' ; ` .' SMIP COm: t `,$0.00 � ;-..�>�_t;:._ ./•�Ij �� � ! � , � � Other. � $0:00 2=: :.a•: i; � �' , , �� ,�� �� 0 Inspection: , $0 00 '`' " _ /-�%' � ` '� . A. ' � � a � . . G + '�:'.y, i�� �; � / Total: 5�139.87 � � ' - � > � ' � � %� /;,� � � V��;� U: ,'; ��, � , ���/ /,?��i% i/�, ��. �'; . , ��' '���-.,,PLANNING'SZONING:-;."� \.,^,� /� j SETBACKS V` = � _ , , � - - - ,t � � - � , � > - � /-: , MAIN STRUCTURE Fmnt � 0 0��� � �Rear 0� 0_ .} Left 0 0�_ ; 1. ` Right �0�0�/=�; , , _ } �.�._ � . J' � . � '( ' �, _��.� � .. ACCESSORY Fmnt 0-0�'-2', Rear 0=0-_� ,�c�Lefl ;'Oi0_, --" RighC� :0-0 .. . .. '� , ' � . ,.�,. �_ , PARKING Ezistinq: 0 Required: 0,: r�- -- Proposed:,io= ;' NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetlons and final epproval must be obtained. Failure to obtain inspections and final approval will rasult in the ezpiratlon of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaas�ae (doo) WORKERS'COMPENSAnON DECLARATON: I hereby affrtn undar penelry of parjury one of the tollowing tleclarations: ❑ I have entl will maintain a ceniiicate of consent to self-Insure for workers' compensation, as provided for by section 3700 of iha labor Catle, for the performence af ihe work far which this permil is Issued. � I heva entl wlll mainlain workare' compensation insurence, es requiretl by seclion 3700 W the Lebor Code, for the peAortnance oi the work for which ihis pertnit is Issuetl. � rkers' wmpensatlon Insurence carrier end policy numDer ere: �/ �/l ^� � Cerrier. w_ �AJ`l Policy.Number i � O� (7hls secfion eetl not be compl�0ermtt is valued ef one hundred dollars ($100) or less.) ❑ I certity thet in the pertormanceW the work for whlch this permit is Issued, I shall not employ any person in any manner so as to become subject to ihe workers' compensation laws oi Celitomi (antl agre � at If I shoultl be ome subJect to ihe workers' compensetion provisions of Section�o� e Lab�e, I shall forthwith complywiththese vislo �. � , � Appic-%Ipne�' � �t� l..J WARNIN�: FAIW E TO SEC EWORNERS' COMPENSPTION COVEMGE IS UNIAWFUL M1D SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FINES UP TOONE HUNDRED TTIOUSAND ,000�, IN ADDITION TO THE CQST OF COMPENSATIIXJ, DAAMGES 0.5 PROVIDED FOH IN SECTION 3IO60F THE LABOR CqDE, INTEFEST, rWD ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm ihat I am Ilcensetl u r�P5� n o 9(commencing with Section 7000) ot Dlvision 3 ot the Business d P�nt����F Code, and my license is In full force entl anecL L a.i� ��/� da ���i ( cotn,r� z:synacare: � J CY� y d� r— c` c CONSTRUCTION LENDING AGENCY: ❑ I herehy aHirm ihat thera is a wnsWction lending egency for ihe peAortnance ol the work for which Ihis pertnit is issuetl. (Sec. 3097, Civil Code). Lendefs Name: Lender's Atltlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby attirtn Ihet untler penalry ot perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe tollowinq reason (Sec. 7031.5, Business end Professions Cotle: Any ciry or counry which requires a pertnit to construct, alter, improve, tlemolish, or repair any siructure, prior to its issuance, elso requires the applicant for such permit to fle e signed statement Ihet he or she is Ilcensed Dursuent to Ihe D�ovisions of ihe Contrectors License Lew (Chepter 9(commencing with Secllon 7000) of Division 3 ot ihe Business end Professions Code) or Ihat he or she is eaempt therefrwn end ��e basis tor the alleged exemption. Any violetion o� Section 7031.5 by any appllcant for e pertnit subjects ihe epplicent �o a civil penelry oi not more than five hundred dollers ($500).): ❑ I, as owner ot ihe properry, or my employees wl�h weges as Iheir sole compensation, WILL DO THE WORK, and ihe structure Is not intentlea or oHeretl for sale (Sec. 7044, Business and Professions Code: The Contractors License Lew tloes not apply to an owner ot properry who builds or improves ihereon, and who does such work himself or herseH or through his or her own employees, provided ihat such improvements ere not intended or aHeretl far sale. H, however, the building or improvement is sold within one year of completion, the owner-builder will heve �he burtlen of proving that he or she did not build or improve for purpose of sele.). ' ❑ I, as owner oi the property, am EICCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, eusiness end Professions Cotle: The canirectors License Lew does not epply to an owner ot property w�o builds or Improves ihereon, end who contrects for such pro�ect with e contractor(s) license pureuant to the Cantractors License Lews.). ❑ I em e:empt untler sec. Business and Pratessions Code for this reasan: SignaWre: Date: Owner ID verified by drivers license. ❑ Yes ❑ Na Driver's License Na. Expires: Verification of Ownership by (rype oi daument, I.e. - property taz bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I �ereby cerlify the� no excevation five (5) or mare leet in depth into which e person is required to descend, will ba made in connection with work euthorized by this pertnit, and that no building siructure, scaXolding, falsework, or demolitlon or dismantling Ihereof, will be more Ihan Nirty-six (38) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle 8, Califomia Adminisirative Code). ❑ As owner-builder, I will not emplay enyona to do work which woNA require e permit from the Division ot Intlustnel Safery, es noted abave, unless such person has a permit to tlo such work from ihe division. Signature: Date: Division of Indusirial Salery Pertnit Number: CERTIFlCATE OF COMPLUWCE AND AUTHORIZATON OF ENTRV: I certity under penalry of perjury Ihat I have read this application and state ihat ihe information given is correci. I ag�ee to comply wl�h all stete laws antl city ordinances releting to bullding construction, end euthorize representatives of the Clly ot Costa Masa �o enter upon �he ebove-descnbed property for inspection purposes. I agree not lo occupy or ellow occupency of any building euthorized by ihis permit until final inspection. 1618 1268 200 201 202 203 Fixetl System Final Fire Preventlon Pool Spa Finel Finel Re-Roof Finel BIacWRetaining Well Finel Fectory Fire Place Finel Slpn 204 Flnel Demolltion PAg 1tIIID9L@ �V ` ' � CODEt �xsrecnoxTrve 206 Final Mechanical 208 Final Plumbing 270 Final ElecMcal 212 Finel Fire Prevention 220 Finel Plenning Approval 222 Finel SI�9 250 Finel Bulldlnq/Occupency PAIE Iti�L9 Pronosed location for Dumnster at 3019 Coolid�e, Costa Mesa, CA Property Line Street Unit A Unit B Unit C Wooden dumpster cnclosure: i��r 5' width x 8'length x d� Garagcs 6' height :�,t Paintcd to match house/garugc Allcy AP PRO�'ED CITY OF COSTA MESA PLANNING DIVISInN SUBIECT TO BLDG. f�F.PT. REG. NOTE: ADDITIONS, DF:LETIONS, OR CORRECTIONS SHALL BE APPROVED BY THE PLANNING DIV. �� 0 AOp���ant to fill in all spattz eace0� those wit�in heavy borGer lines anE sign all approp�iale Ceclaretions. �p5�j '2/178/acJ' t PERMITNO. � � TRACTNO. LOTNO. . ' - - � -.- r - .- -- ,,- c'Q.oO_ .Tl ci7YOF.COS7annEsa �CONSTRUCTION'PERMIT ;�, , � ;; , uNitrve. , ' , _ : 3014' � CCo�' � DC�E `' -.0 p:,� , �, , _ , , � � _. � � .� �. � .,,,- . . . •. ., < � Prolec4 Address • .. • � ' , . , . . • . � . � , . .. _ • . ; i �`-' " ' TYPE OF CONSTRUCTION' ' NEW ' ADD ALTERATION". � REPAIR ' " � r' � n � � �- � . ApplicanYs Mailing Addreu � � �� - ' i . . _ , , Mp�. ���,`y'q , ; �Q� I ❑ CONVERSION ❑ DEMOLISH ❑ OTHER'• � p� p #.. � ; � ' ' Zp�e I , Owner's Name Phone " - � `� � � . ' � - ' � ' - ' ' ' .�DESCRIPT.ION OF WORK/USE OF'BLDG.� � ' '' - . � Address . ' " � � - . � .' "' ' ' '.' • 1 ' � " - S Main Building: '- i ' � � ' Accessor�y Building: ' i Arch/Eng. ' � - License�No. � ' I ^TVPE OF PERMIT � ' GRnoIrvG FOUNDATION� �iSTRUCTURaL ' _ _ 'T' Front � ._ i ' ' _ � • • 1 .p ' .� . � r Addre55 �- -� 'J C� - I' �/ �� ' `'' o' ❑ TENANT ❑,ELECTRICAL ❑1PLUMBING��❑-MECHANICAL _ : �B R2df � � = � - � ,' ' �. � �N c��O�_I • O',OTHER ' . . '. . . . . I ' � ' 'p' . ' ' _ � 1 Con[rector'sName `�. �.Tttt FUAII.C. � phone � - - ' � : � oCCUPANCV ' ' C Right � � L ' � ,G �+�pry� �;PHOJECT DESCRIPTION � 54.'FT. � ' � � ' _ � ' 'A�ACJIESSIf*� I 1 ���'c]G!�P%�� �.DUF.-1 ' �J • 'K" - . . ' ' � : � i , -' ' Sq_� , CONSTRUCTION TVPE � � . � VALUATION $ %SCb.� � 'g Left � � � + � � � . � � ' City L�cenu No_ '" �-xA � ZONE � � ' GRA�ING CU. VOS:� � ACRES � ' ' i p i LICENSED CONTRACTOR DECLARATION � � t _ PlnyiR2f � � � Pa�king Req./P�Ovid2d � E� � I hereb affi�m that I am licensetl �untlei �ovisions of Charte�'9 commencin � , � , f ' ' � • - '- n � v o ( s rtemarts: �,-- ( � ., 'PlanningNotes. � '' ry� with section ]000)i oi �ivision 3 of the Business antl Professions Cotle, antl -, '� ' mv license is in (ull ( rce etfect. p��Q ' . ; � � � , . , .�' � i , �. ' • � ' _ j � I � T License �jazs � �' �� � � l" 5e�f7fq `�TL�.'+.�� . . . , , .- S . � oat 1'" a ' � c eoa� . 'Y• ,r'l.�.d/� F�C � i � �- I PLUMBING ' . � � F,EES� � � � I ' I � . �. � . t �WORKERS'COMPENSATIONDECLARATION�, � ��� � � Bd�'Sink � � � ShOW¢R ��- � I ' � � � ' � 1 nereby Sftirm Ihat.l have a certificate ot mnsent to selhinsure or a certiticate � � ELECTRICAL , , � �FEES �nf Worke�s' Compensation Insurance, o� a;certitietl coOY,thereot (Section gackflowPreventer ' ; ServiceSink � � - �� � 900. Lab. CJ._ . _. � . ., _. . ., _'_� .... ... . .,.. _ , . __. _ ' " ' -' ' ' ' --1 .. � ' - - p-' Automatic Washer . �__..__'{ - Transtormer ❑ 15-50 KW.-- - " ' i oliq No. - Company - • ' � Backflowlrrigation � SewerCa � � - � . � ' ❑ 50+KW ' � , � P Construction Pole Su6. � 1 Certitietl copy is h¢reby tumishetl. , � ' ' � �� Ccrtified copy is�filetl with�the city Builtling Division. � � • Bathtubs ' ' Sewe� Connection � Cooking Unit � � � , Meter ❑up to 100 amps' . � � Date' � ' Applicant � � ' � - ' - - ' ` ' � EXEMPTION FROM WORKERS' COMPENSATION DECLARATION� ' Cla�ifi¢�5 - � � . � Sola� COII¢ct0�5 � � � Di5hWe5h¢i � � ' M¢t¢� ❑ovE� 100 drt1p5 � � �(This section neetl.not be wmple[etl if the permit is for one huntlretl ($100)'or ._ - ' _ � � �Iess). � , . � � . � � � � Dishv.asher' � � � '-� Solar Pipin9 ��� � Dryers ❑Gas '�Electric Sub Panel I I certi}y that in the performance of the•,work to� whicR this Oe�m�t is issuetl, I ' ' � � �shall not;employ any person in any manne� so as to eco�+ e Sub�eci to Ihe ' D�inking FOunt21n4 i � SOIa� Tank � � F2n ' � � � � � � Workers, C�n D ion Laws of Calitorp�e� ') `n � � Motois OO-7 HP O i%- 8 , �, I . Date `�a-�� � Signature !-�� r' �K Floor Drains � � . , Swimming Pool w/Spa ' F.A.U. ' � �NOTICE:iH, atter making thiz tleclaration, you shoultl b¢come subject m the ' , ' ,.�vl crowav 09-15 HP 016-15+ Warkers' Compensation jprovisions ot the Cabor'Cotle, you must fortnwitn . Floor Sinks � � � ' Urinal �� ; � Fixtures ' ' i ,compry�-with such provisions or�.this pe�mit-shall-be tleemetl-revoketl. � - =- - -�---- --- -' `—'-- -' -' "''- ' '-"" '-' '� "�' " '' '#-"' - - -- -- - -r - 1 �CONSTRUCTION LENpING AGENCV � � ' - � � GasService ' Outlets ' WaterCloset� � ' ' - � � ' ' I hereby aifiim t1i5Ltnere is a constructiori lentling'agency for t�he per(ormance i� - Device Boxes Pole LighT � � •of the work� for which_this permit is issuetl (Section 3097-Civ. C.) Interceptors i � Wa[er,Heater `� Outlets Lentler's;Name- - - , - Range . � Lentler's Aaaress `� � � " ' '� � Kitchen Sink � . � I - Water Service; = Switches ' � ' Sign . ' ! ' OWNER BUILUER �ECLARATION ' ' - - . - ' ' � � . I hereby p(fi�m that I am exempt'finm tfie Contractor'S�•License Law for the� , , havatories - .. �.� � Auto-Wash � F � Garbage Disposal ' � � ; Standing Sections � ' � following reason (Section'7031.5 Business.and'�Professional Cotle: Any city or: - � � county whiCh'requires a permit'to�con5truct, alte�, improve; tlemolisb oPrepai� ' P_-Tfdp' �� � .C2u0d� T�a 5 -�� � �❑ - � ' i any structure, prior to itsissuance, also requires the applicant for such permit ' Y � i� � � Generator 0-5 KW �5-75 KW Srash Compactor to file a signetl statement that he/she is IicenS¢tl pursuanYto the-p�ovi5ion5 of � f� � � , ,+ -' �� . T '- , - � t�e Contractor's License;Law,(Chapter 9.(commencing with Section ]000) of ` Roof Drains • �` � - -t . � , ' i Division �3. ot the Business antl'ProfeSsions,Cotle) or,that'he/she;is exempt • �. . , - _ � � . , i � therefrom antl tne�basis tor the alleqetl exemption.,Any�violation of.5ection � __ � � . � ' � ' � i , � . , ' �931.5 by any,ap0�icant�for a pe�miYsubje[ts-the applicant to a Civil - � ' � � ' - �- - ' ' ' � ' Odlty ot noPmore than tive;huntl�etl Qollars (E500j.� , .: •, � _ , � � � . ", ^ - i _ ' _ � , � I;�as �owner aLthe iproperty ormy employees' with�vua9es;as tM1eit sole 'RBinSpettiOn Fee $15 �'. Isue Fee : �, �$ 3, � ; ' � � � compensition, will'tlo the work, antl the structure is' not•intentletl or otteretl ' ' Reinspection Fee $15 Issue Fee � , �$ 3 � ' for sale �(Section �044; Business�antl Professional Cotle: •The Contractor's' i, �� '�-� � � MECHANICAL• i .'• i, '� FEES� ' � ' 1 � License Law tloes not apply to an ownei of a property wbo bulltls o� improves ° V � , . thereon, antl who tloes'such'work nimselt/herzeli or throu9h his or her own � _ - • i DEVELOPMENTSERVICESREUUIREMENTS:' ' � � employees, provitletl that such improvements are not intendetl or afferetl fo� BOiI¢�� �`.;� �e. � i �HOOd O� Typ¢ I,❑ � � -• � � � � sale. I�, however, tne buildin oi im rovement is soltl within one ear of com- , , � . -, �2oning Approved By • � Date � 9 P Y CanOpy � Typell �❑ � . � pletion, the owner will have the bu�tlen Of provinq he/she tlitl noi builtl or im- � : Duct - Under Ground' � � '� I '; @uilding'Approved By � � ' Date � ' � prova for,the purpose of sale). �,. ,� � � � � 2� 2 , � I, as owner ot the pr,operty, am exclusively contracting �with licensetl mn- Duct ,Structural � 1 ' Refrigeretion System i ,Applicetion luuad By � ' Datn os tractarsto construct Ihe.project (Seciion 7044, Busine55 antl Professions Cotle: ` , . - � ' i , � The Contractor's License Ww tloes not apply to an owner of property who . Duct - Ventilating �; ❑0-100,000 BTU ❑100,000 BT.0 , � SUMMARV OFlFEES ' ' � � builtls'or improves,the�eon, 5ntl who contracts for su[h_projects with a con- � i � • ' � , � tractor(s) license pursuanE to.the Contractor's License Law). I am aware that Exhaust�System ❑ MWtiple ❑ System Repair/Alteration BUILDING PERMIT �$ '2�•CD SMIP �$ �'�� i proof of; their Worker's Compensation� insurance shouitl be provitletl ro me. ' ' P�AN CHECK .$ PERMIT ' � L7 I.am ezempt unaer Section � e. & P.'C. for this reason � Firepl/Fact. BIL ICBO # Fire,Dampers ; � � � ' ISSUANCE �$ � � � 1 ' - ; PLUMBING! � �$ � ' Date+ ' � ' owner � ' � Hea[ing System & Ducting � Registers � ' � PLAN CHECK 25% �$ ENERGV P.C. $ I hereby certify ttiat I have reatl this�application antl state that tne above ❑0.100�OOOBTU �100,0008T _ _ ' i GRADING� $ ' information isi�orrecT.-I:agree m comply with'all'city antl'countyordinances' - � ' - i' - - ' -- - - ' ' � - "- '� ' - ' ELECTRICAL . $ antl state' laws relating to builtling construction, antl hereby authorize repre- ' ; � . i i � i PCAN CHECK 50% $ 1 MICROFILM �$ • � sentatives of tpis city -to ente up the above-mentionetl Property for ' � i ; ' , � � �inspection pur 6 e . . � � .L_p,�g5� � ; � - � MECHANICAL • '$ � TOTAL FEE �$ �' SCU I �Siqnature. Date � ,' Reinspection Pee $15 � � luue Fee i � $ 3 i , PLAN CHECK 25% $ � � ' ' � Drivers' License or 55 �� � � � . � CMF 0865-46, rev: 10/84 - White - Builtlinq;� Canary - Applicanh Plnk - Accounting; Goltlenrotl - Assessor ' ' ' ' '"� ' ' '"" �""' ' ' " " " ' - ` ' -''"- " -' t.. . _. �__ _ _ _ . �_ .4 ._ _. ! . . _ ._ . __ �_ ...1 . _ / __, . _ _ _ � . � CONSTRUCTION AND PL•ANNING . - - " � - ' POOL, .PA . " . � - ° ' s ' ' � '. Date I nspector - " r� ' � � ' � - Date � I nspector � .,APPROVALS - Permit# . . ' �APPROVALS � .Permif�#.' - „ � � • � 1. Temporary Electrical Service or Pole ' _ ' _ _ �� '52. Pool & Equipment Location � -. - � �, 2. Soil Pipe-Undrgrnd. � � � , -'53. Steel Reinforcement ' � " � - � 3. Elecfrical Conduit Utility-Undrgmd. � ' 54. Forms. � "� - � � � 4. Eiectrical Condult-Undrgrndi . - � 55. ElectncaPBonding-: � � ' � ' � . � ��5.'SteelReinforcement � - -56. Rough,Plumbing&:PressureTest � �' 6. Electrical UFER Gmd. • ' - 57:� APPROUAL TO COVER-GUNITE " •' 7.jFootings � , • � ' , 58.� Electrical Conduit-Undrgmd. • - � �.� ` '' � 8: Fou'ndation � - _ - 59. Gas Pipe,:O Undrgrnd.; Test . � - � � , " - � � t 9. Water Pipe-Undrgrnd. � i` ... . 60. Backwash Lines, P-Trap, O Undrgmd. -., � 10. Structural Floor System � � : 61.. APPROVAL TO DECK �" - �.' - ' i t. Property Sewer Lioe & House Connection `, 62. Backwash & ReceptorFinal � . 5 . ' � 12. Sewer Cap - * , . . � 63: Heater �& Vent-Final , ' � • � 13.'Roof Drains ' "" '� � 64. Plumbing Syetem: Final ` . . • � �_ 14. Rough Plumbing - ' � � 65. Electrical-Final - ' � � ` � 15.' Rough Electrical-Conduit�-_ � �. 66. Solai 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 FINAI � �, � 19. Rough Heating & Air Conditioning - ' FIREDEPT. REQUIREMENT, � .� �' i _ 20. Rough Factory Fireplace �' APPROVALS . Permit# * � , 21. Ducts, in Structure � , . � 70. Underground Hydro . , - " � �- 22. Ducts, Ventilating �' � - ' 71. Product Piping OGas OOiI � ' ' 23. Gas Pipe-Rough & Test� � � , � . ' 72. Underground Flusti �-� : ' • � � 24. �Roof. Framing ' � 73. Undergrnd. Storage Tank � Gas O Oil 25; Roof Sheathing � • , � 74. Overhead HYdro -� 26..T-Bar Ceiling (Structurall� & Monocoat � - ' , 75. .Dry Chemical - . " - � 27 � Frame and Flashing � - � 76. Dry Standpipe - - ' - '28' Lathing & Siding . ; � , 77. FIXED SYSTEM FINAL � ' 29� Insulation . . 78. FIRE PREV. FINAL n �30. Drywall Nailing ' „ ; . � . HEALTH DEPT. REQUIREMENT • � � 31. Plaster Brown Coat � � � 79. FINAL INSPECTION , 32.� Electrical Power Meter-Final � � 80. FOOD CERTIFICATE ISSUED � .. . - _. . --�� - . 33: Final Electric � I�, , � . NoteS: } �, a � � 34. Final'Heating& Air Conditioning ' � � , � � � � � 35. Final Gas Pipe-Test - `, , _ � � ` .+;. , : 36. Hood or Canopy � • � . � . ' ' _ �, . - __ : � - 37. Final Factor,y F.irepl0ce � � � � � • �- . . ' � . 38. Final Plumbing� : � ' . � ' � . . � 39. Water Service-Final ' i ' ' � � � 40. Gas Servlce-Final ' � ! � � � ' ' , ' � � � 41. Solar pomesticFinal ` ' , • • - -- -� - - -- % � � -- ' , � � 42. Backflow Preventer � - � ' ' . � . � � ' . , . .._ ;_ . . . . _ .. ' ' .. � �. , . . 43. Backflow Irrigation . , ' - � � , ' ' ' 44. ,Landscape Irri,qation System , � ' � 45. Sound Attenuation � - � . - ' � � � � ' � �. , ,� . 46. Handirap Regulations� � � � � ' , � � = ' 47. FINAL STRUCTURE & BUI'�LDING � � � � ' • " � ;� . ,_ � � � r 48. Special Requirements Completed t , t ' � , � - ' � , 49. Electrie Release to Edison, � � - � � � r � �, � - " i - ' , '" `' . � 50. Gas Release to Southern 6aliforniaGasCo � ' ' '' • �� � � .i 51. CERTIFIEATE•OF OCCUPANCY • . �- � - - - � , ' � No. r,. + . . • Dafe , � � - - -. . . - - - - - -- - . . . - . _ . . _ . �_ . _. . . . _. .:. . - . � AVPlicantto fill in all spaees excev� tnose within neavY boraer lineo-ana sign au appropriate tleclarations. - - � � �- - — — --- O O - PERMy� N.O.� � � , TRACT•NO. �� LOT NO. � • UNIT_NG:` . ,Y ` ,' - - � . �, 6544 � 6%02786 ; ` : � 25.rJ� .� T� • CIT.voF'coSrameSA -CONSTRUCTI NPERN1IT , ' Gp J oc Froject Address . . ApplicanYS Mailing Address � � - � TYPE OF CONSTRUCTION�. . NEW ADD ALTERATION REPAI R � � - T �� OwneYs Name.. Phone -� CONVERSION ❑�DEMOLISH, ❑ OTHER q,p, � , r 'i . ' . Zone . ,- � q, � . _�. ��f— DES IONO -WORK/USEOFBLDG. . � Add�ess �- -s�`; � , '�K���. ^�,���� � / � - E Main Building: � ' Accessory Builiiing:' � - - . Z . � ArchlEng: License No. � � TVPE OF PERMIT '� � G AF DING. FOCIN�AT N STRVCTURAL � T Fron[_ � - � -- _ ��� 0 � Addre55 � ❑.TENP.NT ❑' ELECTRICAL ❑ PLVMBING ❑ NIECHANICAL' � � B Rear � � ' ' -� � N � ' Contracmr's Name � r hone � 3 ` � �OTHER� ' . � � � '%� _ � - -' � � C ` - PROJEC7 DESCRIP.TION SQ. FT. V � � OGCUP CV C Right . _ :;'� , N ' Address (mailing) �7 7 K31 ,f A i_ / • � � _K , , , , _ _ . G' '� - � . ���G� ' � . - , CONSTRVCTION TVPE _ VALUATION $ ��m � S Left � � _ � � • _ � Ciry License No. � � • � - . , , . ' zoivE GRADING CU.vDS. ncae5 � Ping. Ref. # Parking Fieq,/Provided' "� �' E LICENSED CONTRACTOR DECLARATION ' - . Q � I.hereby atti�m that I am licensetl untler provisions o( Charte� 9�(commencing , Remarks: � � f �{ _ _ Planning Notes: i . ' � I' M witn section �000) o! Division 3 oi the Business a tl Professions Cotle, antl � my license.is in iWJ (or d eitecL � � � � , - ' ' ' . '• , �• " � T� • License` Cl�s `-'' nse No. � ' � � . , � , S' oate'(p �� Signature� ((LC. ' � ' PLUMBING. - � �FEES ' � � ��� WORKERS' COMPENSATION OEGLA ATIO . By�Sink � $hOW¢�5 � � � � � � ' ' � � ' ' hereby�aitirm that I have a certificate� f consent to self-insure or a certiticate � i ELECTRICAL , FEES Workers' Compensatiom�insurance; or a certifietl copy thereot•(Settlon'i' — - -' -- � ^� • � - , � . ' - - ,00, Lab. C.) , , , � , � Backflow Preventer Servire Sink Automatic Washer Transformer ❑ 75=50.KW � ' Policy No. � Company � � � � Backflow Irrigation � Sewer Cap� . ' � , Construction Pole Sub. � ' � ' � 50�v KW i � � BCertifietl copy is hereby furnishetl. • ' � ✓" 1 �Certifiea copy is filetl with the city Builtling Dlvision. ' ' Bath[ubs � � Sewer Conn¢ction ' i Cooking Unit � � � ' Meter ❑up to 100 amps � � � Date � Applicant � � � � � , , � ' "`� ..EXEMPTIONFROMWORKERS'COMGENSAT�ION�DECLARA ION- � CI3fIfiEfS . _.� . .$OIa�COIIecLOYS -� - -- Dishwasher—;--� �-----� Meter-Dover100�amps - - ��� ' (Thissection neetl not be completetl it Ihe permlPiS for e hu retl ($300 or � - � - � iess). , � Dishwasher " . '. ' Solar Piping � � � Dryers OGas ❑Electric Sub�Panel ' • � ! ! I certify that in the performance'oi the w for th' ermk is Issuetl, I. � � � �� t' � ' shall not employ any person in any ma er s me subject to the � Drinking Pountains Solar Tank � ' Fan � � Mo[ors DO-1 HP OL% -,8 �' � I Workers' C9� pe at'o Laws ot Californ a: I , ' ' � Date f�7` . 5ignature Floor Drains Swimming Pool w/Spa ' � F.A.U. � . � � 'NOTICE: If, atter making ihis decla�ation, y u shoul become iubject to th¢ . � I�C. Sola� O9ii5 HP 016-15+ Warkers'�Compensation provisions of the/ bor Cotle, you must forthvulth _ FloorSinks� ��� �� Urinal , S � Fixtures � � Microwave compry with such..provisions or.tnis Qermit shall be� deemetl revoketl. � - � CONSTRUCTION�LENDING.�AGENGV� " � - GdSSC�vicC; !Olitl2ts -Wet¢lCI052t '� ' ' Device Boxes ' Pole Li ht 1 hereby'at(irin tM1at the�e is a construction lentling a9ency fo� the perto�mance . 9 � . of the work �tor which, this permit is Issuetl (Se<tion 309] Civ. CJ • � � - - . � � ' ' • , . . Interceptors - - _ Water Heater Outlets � Lentler's Name,- � - Range ' Lentler's Atltlress � ' ' ' Kitcheri Sink .E � - _Water Service . ' Switches , � � ' - OWNER BUILDER �ECLARATION ' � _ Sign � I hereby afti�m�that I am exempt fiom the Cont�acto�'s Llcense Law for the � L3vato�ies- � � � AUtO-WdSh ' . G3�bd ¢ Di5 0521 . iouowing reason (Section 7031.5 Business antl Professional Cotle: Any ciry or' _ 9 P ;$tanding Sections . munty which requires a permit to construct, alter,-improve, tlemolish or repair� p_7�ap ' � '' Laundry Trayi ' �' . _ Generato� DO-5 KW �5-15 KW � � any sVucture, prior to:its�issuance, also �equi�es [be applicant fo� such permit • TfdSh COR1pdCt0� , �[o file a siqnetl statemenY.thaf M1e/she is IicenSetl pursuant folhe provisions of ' � Roof.Drains � � " �� � ' 1he ConVactor's License L:aw (Chapter'9'(commencing with Section 7000�,of ' - ' . ' • ' � � ' , Oivision 3 ot the Business and Profe55ions Cotle) or [hat he/she is exempt • ,� � , � �erefrom'antl the basi5 (or the allegetl ex¢mption. Any� violation o( Section � ' - � . _ - � .. - ' ' ' - � � , J31.5 by any� applicant for a permit subjects-the aOP�icant to�a civil • - ' - - ' endlty ot not more than five huntlretl ilollars ($500). �- � � � ,�� ' � �� I; ai owne� of the prope�ty o� my employ¢es with wag¢5 as [h2it 15o1e' ReinSpeCtiOn"Fee � �$15 � Issue Fee' $ 3 _ � � i � ; 'mmpensation, wiu Go the work, antl the'structure isnot intentletl or oiferetl ' '� � a � Reinspection Fee $15 Issue Fee � � � ;$ 3 for sale (Se<tion']044, eusiness antl Professional Cotle: The Contractor's' . _ � � ' � � ' � MECHANICAL '1 FEES ' ' Lirense Law tloes-not apply to'an owner Ot a property wno bdiltls or�improves - ' - � ' thereon, ana who Ooes such work himself/herselt;or throu9h his ooher own � -i � �� , � DEVELOPMENTSERVICESREQUIREMENTSi employees, provitletl [hat suth improvements are nol' in[endetl or off¢retl for � , BOiI¢� • _ � � HOOd O� Typ¢ I ❑ �' i • ' � ' zale. It, however, the builtling o� imprbvement is soltl'witbin one year of mm- � --,. � 1 ��pP� 7ype �� � . ZOning ApproV¢d By ' DBte ' pletion, [he owner will M1ave the burtlen of proving he/she tlitl nol builtl or, im- Duct - Und¢� G�Ountl � . � _1 1 � � ' � �/ove for tne.purpose of sale). ; ' ' � � . ' _ ' ' � ' ' • Building Approved By ' Date Ll I,'as�owner of the property, am exclusivety ContraCting wi[h licensetl Con- � Duct- $L�uctu�21 ( � Refrigeration System i, ApplitdtiOn ISsuOd By � Date � a�b t�actorsto mnstruct the project (Section ]044, Business antl Professions Gotle: ' ' i . -' - T' .The ConVactor's.:License Law tlaes not appty to amowne� oi property who . _ � Duct ��Ventilating ---� - - �0-700,000 BTU ❑100;000 BTU • 1 -- - ' � ' ,SUM�`A�R �O� FEES � i � � builtls or improves thereon, antl who conVacts fo� such projects wrth a con- , ' • , tractor('s) license pursuani to tnetContractor's License Law). I am aware,that � ' � � ! � BUILDING�PERMIT '$' a� V SMIP, , '� $' � p�oof of tM1ei� WorkeYs Compen5alion insu�ance shoultl be provitletl to me.� ' Exhaust System ❑ MWtiple �� System Repair/Alteretion � � 1 . . , � ' I ' - � � � • � � � PLAN CHECK � � $ � PERMIT � � I � } i ❑;1',am'exempt urider Section B. & P. C. for this reason i � FirepVFact. Bit. ICBOI# • Fire Dampere i � � < < pLUMBING �$� ' ! ISSUANCE $ � � �ate � � ' ' � Owner' ' � � ' ' � Heating Sys{em & Ducting : � Registers ' � � e � � PLAN CHECK 125%� $ � � ENERGV'P.C. $ ' � � �' . -I hereby�8ertify thaf i h ve r`atl uiis�applicatlon antl sfate fnzt Ihe above � � �0-100,OOOBTU��700,OOOBT � I � 3 . j information is correct. I re o comply witn all city antl county ordinances � i ' � � � ' � ELECTRICAL ,$' � 1 GRAOING �$ antl�state laws b Itling mnstruction anC;hereb authoriie re re- , 1 � • • ' ' � � � � � � sent5tives of' is• , enter upon the above-mentioned ;property pfor . � � � i � � • � I : PLAN CHECK 50%� $; MICROFILM i$� � � inspection pu'p � � . ' � F { ' � � MECHANICAL I � $ � � � TOTAL FEE ' $ .as- Siqnature . ' ' Date � - F , � . r , � Reinspection Fee �$15 � • ' luue Fae $ 3 PLAN CHECK 25%� � � Drivers' Licens or 55 � � ' ' _ � � � _ . _ _ _ _ � � $ 1 / CMF 0865�46, rev. 10/B4 White - Builtling; Canary - Applicant; Pink - Accountin9: Goltlenrotl - Assessor • � �� �ONSTRUCTION AND PLANNING POOL ,PA _. � ��APPROVALS Permit# Date � Inspector p�ppROVALS, Permit# Date Inspector �. ��i. Temporary Electrical Service or Pole - .�. 52. Pool & Equipment Location - ' 2. Soil Pipe�-Undrgmd. � ' . . � 53.=Steel Reinforcement ' ' 3. Electrical Conduit Utillty-Undrgrnd. - � - 54. Forms � ., - .- � , ' . 4. Electrical Conduit-Undrgrnd. �. . .. � 55.. Electrical Bonding � � 5. Steel Reinforcament , ' . - 56. Rough Plumbing & Pressure Test ' - � � � 6. Electrical'UFER Grnd. . 57. APPROVAL TO COVER-GUNITE - � ' 7. Footirigs' - ' - 58. Electrical Conduit-Undrgrnd. � � 8. Foundation . - , 59. Gas Pipe, �-Undrgmd., Test '� � 9. �.Water Pipe-Undrgmdr . � • 60. Backwash Lines, P-Trap, O Undrgmd'. - ! 10. Structural Floor System . 61. APPROVAL TO�DECK � '� � 11 . Property�Sewer Line. & House Connection � 62. Backwash & Recepfor-Final ' , 12. Sewer Cap �, . ' 63. Heater &.Vent-Final � ' ' � � - ` , 13. Roof Drains - . 64. Plumbing System - Final . • � . , ' 14. Rough Plumbing � .� 65. Elect�ical-Final . _ . ' '. � • � � 15. `Rough Electrical-Conduit - - . 66. Solar System-Final� - - � - - -"' � ' � � r 16. Rough Electria Wiring .- ., ' 67. Fencing & Access Approval .' �� 17. Rough Wiring 5ign : . , - ' 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 HYdra , � , - � ' 22. Ducts, Ventilating ' ' 71. Product Piping � Gas ❑ Oil � ' ' � � 23. Gas Pipe-Rough & Test _ � 72. �Underground Flush � 24. Roof Framing � � � , 73. Undergmd. Storage Tank � Gas �� Oil � � 25. Roof Sheathing � � ' 74. Overhead Hydro ' � � . . , . 26. T-Bar Ceiling (Siruciurai} & Monocoat ' 75. Dry Chemical � , . 27. Frame and �FlaShing ' ' 76. Dry Standpipe , ' � 28. Lathing & Siding . - � • 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�ISSUED ' , 33. Final Electric � Notes: , � � , 34. Final Heating & Air Conditioning � , � , . 35. Final Gas�Pipe-Test � ' - : 36. Hood or CanopY � � � . � - - ' - - 4 . 37. Final Factory Fireplace � � + �. ,- . . � . , � 38. Final Plumbing . � �� - ' , � ' � _ " ' 39. Water Service-Final i � ' , � � ' � �i � 40. Gas Service-Final . � - � ' � - . . . , . 41. Solar pomestic-Final - ^, _ . , ' ,.• .. 42. Backflow Preventer ' i ' � � . �43. Backflow Irrigation - , � . � - . , . � :44. .Landscape Irrigation SYstem - , ; .� � . ._ �45. Sound Attenuation �� ' , , ' � • .�6. Handicap Regulations � � , `. - � ' , � . , , � 47. FINAL STRUCTURE &.BUILDING 5',�G �j ' � ' ' ' . , " 48. Special Requirements Completed � � ' , , , � �- ' , , , 49. Electric Release to Edison �- - � - - - . � � -- � . ' ' . . �60.` Gas Release to Southem Califoinia Gas Co � . � ' � i51. CERTIFICATE OF OCCUPANCY� ' - -- -� - No ' � Date � - - - . � � � ' 1 . _ LOT 4� TRACT 4ZU� osa�� ;.OSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 817 COSTA MBBA. CALIFORNIA For Applieant fo Fill in Completely TYPE OR PRINT COSTA MESA. CALIFORNIA . .�.. KENNETH W. KOLL ICI7Y NEWPORT BEACH_—CALIFNo.MI-6 Z ARCHITBGT TEL. OR ENGINEER NONE NO. A��RFC4 12O� � � NO. OP BLDOB. X O NOW ON LOT C lLDC.. - �NONF 16 PROM mte¢r 67 � REAR YARO 25 � I �F7' �J � I RIGHT H � DESCRIPTION OF WORK BUILD C�.a�+R: SF NO. OF BIZE �U I LD: SF ROOMB� 2 6TOF PXTERIOR WALL IROOF COVBRING JCCO COVERING R� USE OF BUILDING AND WORK TO BE PERFORMED 1. HHRBM' ACIWOWIPDOE THAT 1 HAVE RlAD THI6 ApPLIWTION AND 6TAT8 TXAT THL ABOVE IB GOIiRHCI' ANO AGREE TO COM� PLY WITX ALL CITY OPDINANCEe ANO BTATB LAW! REOOLATING BUILDINO CONBTRULT�IOjN.�. � � J �/ ;IGNATURB OF p / / �� /`�lnO// FEE REC�IVED �J �Ar�,f, ,ss2 � FIIVANCE DEPT. CIIY OF COSTA MESA APPLICATION FOR PERMIT• BUILDING ' For Office Use Only RECE�PT rvo. re@t@ 40.1 1 BUILDING COSTA MESA. FIRE ZONING ZONE NO. OP U96 OF N6W R�I. PLANS 2 BUILDING 4 4 LEGAL oescairrwx IAt iFl� TI'&Ct A. P. NO. nnno YARDS •� EVES APPROVED ALLOWED ICCNTBR LINC 9T.] . _ APPROVED � �G .j!" ,i THE AMOUNT SHOWN UNOER VALUATION IB FOR THE PURPOBE OR, EBTABlIBHINp A PERMIT FEE ONLY. VAWATION L PERM17 FEE $ .'1 U � $ �G .� �f � PLAN CHECK $ � � i C iOTAL FEE � LL