HomeMy WebLinkAbout2492 FAIRWAY DR - Building Permits:ss'[�em�on,c: z492 FAIRWAY DR
""1E1P1Q'0�''"KRAUS, GARY W
nuoxess:KRAUS, JULIE A
2492 FAIRWAY DR
�. MESA,CA 92627722-8355
MCHRECT OP ElMM�IEEN:
�xcx. ow �c.•s �ooxEss:
u"T: CITY OF COSTA MESA — HCIILDING PERMIT
PERM NO: H 077603
PERMIT NO: B 077603 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR
�G"� JOB DESCRIPTION : T/OFF RESHT. W/COMP.
UNT:
���Ta+'S�SENTRY ROOFING COMPANY (714)751-7663
CRlfNRCTOq'SM/JLINO 3364 NEVADA AV
�ooness:COSTA MESA CA uc.ao: 678801
92626 uMr:
LICENSED CONTNACTOFS OECLAflAT10N: I hereby eltim uMm per�ely d Po�ury Ne� I em licenaetl u/er povisbns M Cheqer 9
(mmmeMiip xiih Sec�ion'l000) d Oiviaian 3 W �he Busimss end Prolaeaona Code. eM my licenee is in ry I brte uM ellea.
cmuc.No.06 42 �ic.cuss:C 39 uc.yNop.�:67 O1 XP: SO/96
ome: conveew: ///f
�OWNEF BU� DER 0 lAN4TI0N: I Mreby effiim undar penelly d perjury ihet I em exemq from iM Cantreaae Licenae Lew Iw iM
Iollowin0 �m^ (�ion ]091.5 Busiinae enE Prolemiona Code: Any cey ar munq vfiich raquirae e permil to conehuct, eller, impmve,
iemoloh, or repei eny elmcWre, pmr lo Bs oauenm, eho reQuime iha epplirant br euch peimu �o fila e aqrwd ete�emen� thel he a aM
lioenaed W��� �o Ihe povisim� d IM Conlredwa limnu Law [Chepx 9(eommaewiip wilh Sedion )000) d Divebn 3 d Ihe
usrwa vM Prdewians Cotlel a ihel he a eM ia exemq thaeM1vm eM iM beaie lar the eik9ed uemqun. My videiion d Sedion
)031.5 by eiry appliranl fw e permn aubptla tM epd�l �o a dvil penelly at ml mwe Ihen Irve �uMnE Edlen �55001).
� I, es ovmer ol �he properly ar my empbyeen wih wepes es theb eole compenaeiim. will do �he wuM, anE Ihe etrw.Mure o nd intended
w oMered br mle (See�bn ]Oai, Buainess erd Vmleasiona Code: The Conireelore lirense Law daea ewi epplyto en ownerol popery
who WdEs a inprovee �hereon, enE who doee vuM vroA IvmeeX or MneM or thrpph he n her ovm empbyeea, povked Ihea auch
o.�er� ue, v�nn n�e.e n w�ae� d�� e�n �«n'd,�a nd �a w a�«� mwwe r�« me w+m�e�� s�.la�e rear d canoie�on. u�e
� I, es o�mer ol iM1e D�GaM� � eadusrvey coniredip Milh licensed conirec�on to cmaVUC Ihe D�lad (Sedion ]046. Buair�roa eM
Proleaviona Coda: The Contreaon licenae Lew CoesrW eppN�o en ownerW propany who buiMe orimpoves�hareon arW who
convecta lor wrh O�M� ��h e comrmw�e) Ikensed pursueni ia lM1e Conlredon Liceme lew).
� I em uemq urder Seciion: B. 8 P G.. fa Nis reason:
Da�e: Owner:
I do hereby cerliy ihm I em ewere d eM uMerstentl Ihe reQuiremenn d CalAanie NaeXh eM Selety Cade Seqpns 255p5, 25539, eM
255J0, ard ihei 1 or e�ry tuNre buildirq ocapem will / wtl r�d (vrcb ma) need io wmWy wih aeiC pete coAee eM tM repuiremams la
e permil lorwmW lian w rtadifiW ionhan IlieAr�ue6iyR%regamenl Di9M. Reaidentel oonaewian eppireliamere ssemq from �Mee
a��,.
oaia: ncvi�c
WOFNEH'S COMVENS�TION DECLAF�TION: I Mreby eifirm uMer pereAy d parjwy ore d IM idbxiiq Jetlareiuna:
� IhereeMwilmeinteneceMicatedmnsentioaeXimurelaxwkarecompemelbn,mpmiEeEfabySeaion3)OOdihelnbor
coaa m� �n> o�no�� m in, ..an� ro, w�n m�. w,ma n �a�ad.
� I heve end witl meintein woMaii mmpensetion insuranca, ea repuiretl by Seclim �)00 W Ihe lebor Code, br tha parlormence d the
work for w1iiW ihia peimn is i�uad. My wakan' mmpemelion inwrenee raeriar erd pdiry number ere:
c�a�:
Pdicy Number:
lhis eMion need not be canpletaJ / Ihe perme is Iw one hundmE Edlars (S�W) or less.)
� I cenAy �hal in Iha perlomie a W �he wwk 1« whch �hia paim� is isaued, I ehell na emd%' env pa�eon in en nenner eo es to
become abjed io iM ri compenaeiion lewe d Celilomie. arM eprae thel ii I gFouk become wb' to tM xvM1a�i
rnmpanut ' 3]OD d iM lebor COAe. 1 I la wnh c«npN xn, �how qwiaimv.
�pa�e: nppitenc
Werninp: llun ro s ro workxi compmueHon rovsrays b unlewN( entl �n 11 cWlxt an employw ro ctlminnl p�nnitls� entl
nvn xn.. uP ro a�s nunerse mouwro ewun �s�o0.000A in ede�non ro m. m,r oi mmPawnon, am.os. „ povmw ror in
5ectlon ])� ol Ms Labor Code, Innn�t, anJ ettomey's Isu.
CONSTNUCTION IENDING AGENCY: I M1ereby eHirm uMer perially M perlury thei there ia e wnatmdion brMiig epency la �M
petlormence oi tha waM br which ihb pertnil is beued (Sed'un 309], Civ. C�.
LENDEF'S NM1E:
LEN�EH'S ADDPE55:
I cerliy �M1at I have raeE Ihia applkatim end a�e�e �hel iM ebova inlormetion is coma. I pree to wmON �h ell vry vW mumy wtlinences
and siaie laws relaiing io buildmg consrudion ard MraEy emhorize ropresanr�fnea o/ l�is dly m enter upon ina ebove�memioned v�veM
�OIIf19PBC11011 PUle09B9�__ _ _ A
,��a" 9 �
oa,a ����
imer/AgenVRppliran onv nw••
(5t51ie WP) � Whne-Buildiq 8 Selery: Greer�Fle; Cenery-AppFranl: Rnk-Revanue: (ialEenro�Aaaeamr
PURPOSE: ALT
SQ FT: 6,335
M VALUE: 6,335.00 CALC—VALUE: 6,335.00 GROUP OCC: R-3 /
ENTS: SMOKE DETECTOR RE�UIRED PRIOR TO FINAL
*+t+t*�r+t�t�t�*�r�t�t�tx�x�**�t*�t+tx� x��t*x��t�t�t*�rx�x��x��tx�+t�r*�r�t�t*�*�t�r+t+�+t**��r�*�+�*�rx���r�t*�+�*�e�t�r*
Z O N I N G R E(j U I R E M E N T S
S E T H A C K S
------ — MAIN HUILDING
. FT IN REAR:
. FT IN RGHT:
CNG REQ: PROV;
-------- --------- ACCESSORY HUILDING ---------
FT IN FRNT: FT IN REAR: FT IN
FT IN LEFT: FT IN RGHT: FT IN
PAACEL; 11910306 ZNE; REF NO; ,.
PLANNING NOTES> �
i /
1E 1E 1E 1E 1E 1f 1F iE 1E 1F 1E iElE 1f 1E 1E 1F 7E 1f 1F 1f 1k iF 1E iE 1E 1k 1F 1E fF 1! 1F iE 1E 1E iE 1E iF if' iF 1t 1E 1E 1E iE 1k 1FlE 1Fft 1ElE iFiE k 1FlE 1E IE iF 14 iF 1E ii 1E 1Flf iE iE 1E'iE 1E 1E 1F fF ik 1t iE i!
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 DATE:
BUILDING APPROVED HY ;_ DATE: �=5 - 9S�
APPLICATION ISSUED BY: DATE: S=�1 '�
1f1EiE1f1f1E1EiF1k1f1f1E1f1Eif1E1E1FiE1E1ElE ifiElEifiF3F1F1E1E1E�iF3 iEiE
LEGALIZATION:N F E E S U A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC EIRE SMIP/RES GRADING
PERMIT 124.75 ,63
.% SMIP/NON—RES
PLAN •
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 125.38 0.00 '•- 0.00 125.38 125,38 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 125.38 OVER/SHORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
124.75 /.. ,63
!F iF IF 1E if iE if 1F 1f iF iF iF iF if if iE iElh iF iF i(� if jE iE IE IE 1E 1E if iE M 1i if'lE iE 1E if 1E 1E IE iF 1F 1E 1E if if iE 1E iE iE 1f if 1E 1E 1F f! iE 1E 1E iE if 1E 1E 1E iE 1f 1E 1E 1F'IE IE iF iE iE 1E iE 1E 1Elf
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 6335 REROOF BY VALUE RESIDENTIAL NOZONE L.00 6,335.00
END,OF FEES
�
1
� - . j _ . i '.'; t, '_ ; p'",_ _
� ' '1 . � ` , . � _ . J • J
�-^ CON6TRUC710N AND PLRNNING POOL PA �
APP,flOVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
� .
L Te�porary Electf�cal Service p� Poie = 52. Pool & Equipment Location �
, �
2. Soi}Pipe�Undrgrnd. o . 53. Steel Reinforcement �
''�E��tricafCondi2;z`,tJ{�Iity�Unlligrnd. 54. Forms
iJ�J �ectrical CondWa�hlr+drgrnd. 55. Electrical Bonding � �
a_� 5F Steel fleinforcer�e�t„�`�, 56. Rough Plumbing & Pressure Test
- l�� ��lV
- t�= Clectrical UFER; 57. APPROVAL TO COVER-GUNITE .
4 7?6o'atings Y"< 56. Electrica� Conduit-Undrgrnd.
i ^ 4'
� Bl�oiindation ' �� a' S9. Gas Pipe, � Undrgmd., Test - �
� 9. Waser Pipe-Undr�nd. T� 60. Backwash Lines, P�Trap, O Undrgmd.
v,
10. Str�ctural Floor�Ystem � 61. APPROVAL TO DECK �.
71. ProDerty Sewer MneC& HouseLonnection 62. Backwash & Receptor-Fina4
, : a' cci '
72. Sewer Cap ',�� 63. Heater & Vent-Final
13. Roof Drains � 64. Plumbing System � final
14. Rough Plumbin�; .y 65. Elearicai-Final '
15. flou h Eiectrica • oqduit `..
9 � 66. Solar System-Final . ,
16. Rough Electric Yv`�ring• c 67. Fencing & Access Approval . . � �
17. Rough W(ring S�Frn �� 68. APPROVED FOR PLASTERING
18. Rough Electrical--T Bar Ceiling 69. POOLJSPA SYSTEMS FINAL �
79. sPu�h He�ting�& QiqConditiqning.. ._,tr � uc ¢. � � FtRE�MFT.r$EQUIFlEMEN� i t
� ... � .. � Y ti �„� � y * � `�
20. �iougti Faatory.Fit�'ulace ^!T' �c�c * 5 . . � ; ,APPROV%x�'S` - Per,"T,mit # % T `^:
� Yr� x 'a }-. Y r :z S ' : �t
�. rr.k � .... ..: �� - � � -� -
2L �yct4; in�S�truLRur9_.� � � �� . ,-: -- ,-•,. ,' 70. FNndergioeod HFdro �+
22.�ucts;Ventilating�'t%r I x'7 ��c' �. `yi;:7�.Produ�Pipingt7�as C�OiI _ _
23. Gas � e-T u &- est " . '
P$�A 4� �� n.�, * m a m �� 72. Undergro+irid F±usfi< � �
2A. Roof �raming � � x � � r � •� �Y� ; 73� �ndergrnd. Stoia'ge7ank�C Gas ❑ Cil
r� ^'r, k h NS �}� J F•-' t:
25. BoO�heaihi� '�'� � +. v c : � s=-- r,., �,� -
9 , �, �. ^� m 5� 74`�qverhead Hydrqr ,�
� i S' O :v :.; �'-J'k L- H^i �Y. [•l
26. t•Bar.Ceiling (StrUcRurai) & Moi91�'.pat 7-'T,�-. Dry ChefSicel
m �r r., < ^ R�
27. �ram`EanFi'Flashin'y� �s.� � a� r�w r�; F�C 'k G
i F1�Y• �.•,r,; �T W ;�.•. 76. Dry Start�,pipe S� x G U
,28. Lath'mg BcSiding �J� „ 17a1F .`J #� _ , ?i 7T� PIXED BYSTEM�PINA� `'� �- �
29. Insulation. ^ " � • � . � '�` . .�m . � : �
� ; � i� � � y_ .,; 7� FIRE PREV. Fi�v�L .
30. DrywaH tvailing C.+�. �-+ . :x E^ ' '+ _ +Yi&ALTH�DEPT. REQUIREMENT
i- r :
.' 37. Plaster Bro`�vn`Cea�'r � i FF � '.�ye. � 79. FINAL I.S�SPECTIQN ��, c., .�,�j
s, 32, yectricai;p,ower Nleter�i,tial � *� �-�+� �� 80-7 FOOD CERTIFQCATF 18� SU��ED- �"
,. .. ... r r-i •-n c ,-
-33. Fina�.`Elefiric=' T�' M � .`.'�,• � ' �� N er = ^� � �
� �r C � s .-� � � = x i .� �t /q��6 � .".siiy.s� S'a2- ,
'v `' :, � ..> � � . .> � ..--- r�-.. •
; 34. FFnaC�le�rng?� Ae�jBqr.e ition�ng .r; k �� .. t� �-. F,¢ '. !,�
f-' 'F' - .'l Ci� 'k i
35. final Gas Pipe�iest � f` ' '� ` � �' ^" L � -"?
r�i: Q :x' � ••� � � t*1 r:
_ C1c y :. � _. `1 •
_j36. Hood-or CanoPY r C'. . r�- p� ,_ tT s.o �• f=:^
r � �. r�
i
J37. FinalFactory Fire'�I�e=.x ���; �; , � i* , d : T. - N
38. Fina ,lumbing, '7+ �Tl.y • o ?: � �fi ^' -S X � -
y39. Water Sarvice=Pinal " � t. x �. "' '- ''rt ° .:
� - 'x � � u. • �. R'
�'�40. Gas Service-Fi al .: ' � ; ;`�.,r " .k " � - �=. - � �;� x ='
. �
�41. Solar Oomesti�PinaF� F !T * _ � � H �'c� �� t '
� Oi z
y �
42. Backflow Pre�en2er .� f� n'�:�...� r,..• ' { �-; �-�r� * t-•
� �
43. Backflow Irri�iion ` >'✓� '' � ; ` � * �
,- r ,'-., x '�: N :t s
^J ^ O m : ,. .,. i i i � . . . � _ . � . ..', .l
44. Landscape,Irripation+System p�,^;y; �r � a; ,,.i � � E c�. 4•G 't � F
' �� - . . . . . .
�, .r
4'5. SOund At4en�ation � '-� �.. •. �: m �T; r7�s i c 'r <' • ,- i
n i
q6. HandisapF?egulations j , Y�np '��' ;; F
--�---: -
49. FINRi STRUC7URE & BUILDrING �� �O'� �(�-, ,� r" � F .
C *
48. Ft'.NA'LPI�ANNING c ,�r ���� -' � ni Y v �
A9. E�lectrvie Release to Edison � 7 �y •C ���
#: Ct r ' ♦ i
5D. d'as ft'elease to South�m Caiiforn+aGas Co �� r. . � �e _ t� �, •-
� r
51. CERYIFICATE OF OCCUPANCY
Np Date
Aoplicant to fi11 in all spaces except inose within heavy boraer Iin¢s antl sign a11 appro0riate tleclarations.
ciTY OF coSTA S CONSTRUCTION PERMIT
Project Address �� � � W �y
Applicant's Mailin Address � � S� M� N r7
Owner's NameI � �'• Q/�_�. QA�S � �/ Phon Z(�?
Addreu �--L� `-��i `--�"C Y' J �2"'
Aroh/Eng. License No.
Address
Contractor's Nam � � � ��/� � S � � �- P/hone�s
Address (mailing) �-� �g/_ 7�y� �� 7 "�'
City License No. �� 1p�C�
LICENSED CONTRACTOR DECLARATION
I Itereby affirm tha[ I am licensetl untler provislons of Charter 9(mmmencin9
with section 7000) of Division 3 of [he BuSiness antl Protessions Cotle, antl
my Iicense is In fulY rce pjtect.
License ass �� icense No.
Date _ Si9nature _
WORKE 5'CO PENSATION DEC ARATION
� hereby aifirm that I have a certificate ot consenl to self-insure or a certificate
' Woikers' Compensation Insurance, or a certlfletl copy thereof (Section
100, Lab. o� �_��
Policy No. v` Company �-
rti(i tl copy is hereby fumishetl.
Date�e 1' p fNetl with the city $yjl � 'sion. S!��.
� APPlicant ��
EXEMG ION F OM WORKERS' COMPENSFTION DECLARATION
(This seclion neetl not be completetl if tbe permit Is for one huntlretl (E300) or
Iess).
I certi(y Ihat in the periorm ce work for which this perm�t is issuetl, I
shall no[ employ any perso i anna� so as to beCome subjeGt to tM1e
Wo�kers' Compen5ation Ld o a i or a.
Date Si9nature
NOTICE: H, alter makin9 this aeclaralion, you shoultl become subject to the
Workers' Compensation provisions of the Labor Cotle, you must forthwilh
comply with such p�ovision5 or this pe�ml[ shall be deemea revoke0.
CONSTRUCTION LENDING AGENCV
1 hereby attirm'that tnere is a tqns�u lon lentling agency for the periormance
of Iho work for whicn t�\ r t is issuetl (Section 3097 Civ. CJ
L.entler'S Ndme
Lentler's Atldress
OWNER BUILDEH bECLARATION
I hereby a/flrm that I am exemot from the ContractoYs License Law (or the
tollowin9 rea5on (Section 7031.5 Business antl Protessional Gotle: Any city or
rounry wnich rGquires a permit to consl�uct, alter, im0�ova, Eemolisb o� �epdir
any st�ucture, p�lo� to ifs i55uance, also requires the applicant fo� such permit
to ti�e a signetl SWtement that he/she is licensetl pursuant to tne provisions ot
the Contractor's License Law (Chapter 9(commencinq witn Section 7000) ot
DiviSion 3 of the Business antl Professlon5 COtle) or tha[ he/she is exempt
;i';?er¢from antl [he basis tor the allegetl ex¢mption. Any violation ot $ectiOn
�;i,-j31.5 by any ap0licant tor a permit subjects the applicant lo d civil
r'"nalry of not more than /ive huntlr tl tlollar5 (E500).
���� I, a5 owne� of the pro0er rr� employees with wa9es as their Sole
compensation, will tlo ttte wo a tl /h� structure is not Intentletl or otferetl
for sale (Section 7044, Bui e ar/C'halezzional Cotle: The ConVactor's
License l.aw tlocs mt apply to an owner of a prOperry who builtls o� Imptove5
Iheteon, antl wh0 tloes such work him5elt/h¢rSClf or INough his or ner own
employecs, p�ovitleC tha[ zuch improvements are not intentletl or otferetl fo�
sale. If, nowever, the builtling or imO�OVCment i5 Soltl witM1in one year ot com-
plelion, the owner will have the burtlen of provin9 he/5he tlitl not builtl or im-
prove tor the purpo5e of sale).
❑ I, a5 Owne� O/ the p�operty, am exclusiv¢ly <ontrac[ing with licensetl con-
IldCLOf5I0 CO05[(IICL II1C prolect (SeC[ion ]044, Bu5ine55 antl Profe55ioh5 COtle:
The ContractoYs License Law aoes mt apply to an owner ot property who
bulltls or improves [M1ereon, antl who contracts for such projects with a can-
tractor(5 hcense pursuant to the Cont�actor's License �aw). I am aware that
proof o� their Worker'S Compensation insurance shoWtl be provitletl to me.
❑ I am ezempt untler Section B. & P. C. for Niz reason
Datc Owner _
1 hereby certity chat I have reatl fhis
informa[lon is correct. 1 agree to compl'
antl stale laws reta[in [o builtling cons
sentativez o( this cit o enter upon
in5p¢CUon p
Signalure
Drivers' Lic se or 55 � ��� �
M 3 0 5 c� I I I
TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHE
�D RIPTIO OF WORK/USE OF BL G. %� T��� �
v � Q�a 5o i.P�a-� D� CSi l.t� 0 2�
TVPEOFPERMI GRADING FOUNDATIO��N/' STRVCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PI.UMBING LJ MECHHNICAL
❑ OTHER
PROJECT DESCRIPTION S4.�F7. OCCUaANcv
CONSTRUCTION TVPE VALUATION $
20NE GRADING CU. VDS. ACRES
Remarks:
Preventer
Irri9ation
Bathtuhs
Dishwasher
Drinking Fountains
Floor �rains
Floor Sinks
Gas Service Outlets
Kitchen Sink
Lavatories
Roof
Reinspection Fee
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swim ' g Pool w/Spa
nal
Water Closet
Water Heater
Water Service
Auto-Wash
Laundry Troys
$15 � Issue Fee
Boiler
Duct - Under Ground
DuCt - StrUctUral
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. BIt. IC80 #
H,,.e� 9 System & Ducting
L7P700,000 BTU �100,000
Reinspection Fee � S75
CMF 0065�46, rev. 10/B4 White - Builtling; Canary - AOP���ant; Pink - Accountin9; Goltl¢nrOtl - ASSe550r
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑0-t00,000BTU ❑100,000
System Repair/Alteration
Fire Oampers
Registers
Issue Fee
A.P. iW
S Main Building:
E
T Front
6 Rear
A
C Right
�S Left
Ping. Ref. #
Planning Notes:
6345 9/29/87
Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL
Automatic Washer Transformer 0 15-50 KW
Canstruction Pole Sub. � 50 + KW
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixlures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator ❑ KW 05-15 KW
Merer LJup to 100
Meter ❑over 700;
Sub Panel
HP O1h-8
�15 HP �16�15+
Pole Liqht
Range
Sign
Standing Sections
Trash Compactor
$� Reinspection Fee . S15 Issue Fee
FEES
DEVELOPMEN7 SERVICES REQUIREMENTS:
Zoning Approved By
Bui�ding Approved By
Application luuad By
$ 3
�4aDp 7L
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G
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FEES
$ 3
SUMMARY OF FEES �
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT.
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGY P.C. 3
ELECTRICAL $ GRADING S
PLAN CHECK 50% $ MICROFILM 5
MECHANICAL $ 4'� � TOTAL FEE $�¢��
PLAN CHECK 25% $ '
CONSTRUCTION AND PLANNING POOL & SPA
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. Elec[rical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgmd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test -
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-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.
10. Structural Floor System 61. APPROVAL TO DECK
i t. 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 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT �
20. Rough Factory Fireplace APPROVALS Permit # _ ;
21. Ducts, in Structure 70. Underground Hydro '
22. Ducts, Ventilating 71 . Product Piping � Gas ❑ 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. 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 Note�.��O�4 �� �a,D J.(�,. L�F,D
34. Final Heating & Air Conditioning
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 pomestic-Final " . . � - .�
-42. Backflow Preventer � '� � . -
4 -- i
�43. Backflow Irrigation , ' -� , � -
�. . , _
44'�. Landscape Irrigation System - - , ' . - �
�:45. Sound Attenuation � ' ' �
: 46�. Handicap Regulations - . • .�- ` ' , , "
47. FINALSTRUCTURE&BUILDING • � � ' �
• . ...._ i.
48. Special Requirements Completed ., '_ • , '
49. Electric Release to Edison �'- ' ' ��
50. Gas Release to Southem California Gas Co . - -
51. CERTIFICATE OF OCCUPANCY .
No. Date �
' COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT
. P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
RECEIVED V PERMIT '
For Applicant [o Fill in Completely — Use Ink Only I'4n �lN°i �• 5 Q 28 2�� ��
ADIDRESS � �jl�w y�L/ L. A.P. NO. � � i —�
OE NqER pR p � /_ �� ADDRE55 G% /� � �^(lilt {�r
[7c- C; �C�
UNIT OR
MFILING / SPACENO.
ADDRE55 G
T .NO. � LOT / BLK.
i TEL.
CITV /9 ��f L�� NO. �
NEW ADD ALTER REPAIR M ING DEMOLISH
CONSTRVCTION � /'
LENDER L. /\
BRANCH S/ G�� Le�
OWNER Q�.C•
ADDRE55 Q� VALUE
. ARCHITECT TEL. _ USE Q. E�OOO�
OR ENGINEEF � MC�
ADDRESS //� �(//J% �J/� ZONE � TVPEV� GROUP
� APPROVED _ p�
CONTRACTOR - L� BV DATE - p
ADORE55
TE�.
CITV NO. �
F STATE CITV AP EDSETBACKS
LIC. NO. LIC. NO. FROM C/L STREET) ��S
� SIZE / NO.OFBLDCS. �
0. OF LOT 0 NOW ON LOT RONT FT.
a USE OF
� EXISTING BIDG. C •��
�
F Separate permits are required for L SIDE / FT. </
0 electric, plumbing and heating work. REAR O FT. b°'
� USE OF BUILDING AND WORK TO BE PERFORMED PLqNNING ACTION
F
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1 ' !/� C GC- �Y�/ /�� .4PPROVED (7 ).3 �
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�a I hereby ecknowledga that I hava reatl this eppllcation entl ztate �
that tha above intormation is correct ontl apree to comply wlth
a all laws reBulating building construcHon, antl I shall not amploy �
Z any person in violation of tho workmen'a compensetion lewa of m
W the Stete ot Calitornia. '
m �/:2c�SQ. FT. J OOD •— „
3 I hereby certify ihet I am properly Iicensatl es a contractor untlar ]
tho State of California Busineas and Protas�lona Code, Dlvlsion 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Choptar 9, antl that such licenses ere In ful� antl ffect, ar I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: �
am axompt from [he provialonyuf'fFj2 Ca �a B�sinass VALUATION v
entlProfesslonsCotle,Divisit�3 ( cer9. PERMITFEE E 32_� N
PLAN CHECK 5 0
Sipnature of �L` � .� ' -�
Permlttee - 5 JQ f
TAX S
or � � u
A�thoriz Agent Dat TOTALPAID E
Lor 17 TRacr 40
. " j . -�495 a
CCSaTA MESA BUILDINGSAFETY DEPARTMENT
� P. O. BO7[ 917 C08TA MEBA. CALIRORNIA
For Applieant fo Fill In Complefely
TYPE OR PRINT
1 MAIL
COSTA MESA
I�
$_��'Z BUILDING
ADDRE6b
FIRE
ZONE
APPROVED
BY
20NE
STATH TEL.
LIC. NO. NO.
e'ZE � 6,3ox9o�'�`� NO.OF B1D69.
OF LOT Now oN tAT
USE OF
EXISI'1 G BLDG NONE
BBTGACN LINf PPOM � ^
C6Ni8R OP BTR88T � REAR YARD�d
/ /. ! /
81DE YARD LEFT "� RIGHTJ " D
DESCRIPTION OF WORK
E%TBRIOR WALL ROOF
COVBRING STUCCO COVERIN �
U6H OR BUILDING AND WORK TO BE PERFORMED
SINGLE FAMILY RESIOENL
ATTACHED GARAGE i19n
�aaw�
FEE RECEIVED
.wL�1 �96s 0 �
FINANCrEneOpEPMT�.
APPLICATI� FOR'TPER1Vt1T''
BUILDING
For Office Use Only
NHC81P1' NO. _ .PENMIi NO.
JI�T� �ai�6f
COSTA MESA. CALIFORNIA
ZONING
NO. OP � I U98 OP N!W
PLANe BUILDINO ,�,
YARDS
APPROVED
cc¢wrex uxe er.�
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R. 61DE
s
L. SIDE
IREAR ��`
IAePPROVH� ��(�,
EVES O� , �C +�'
ALLOWED
r. C�L w.
7. ^ IN.
- 3
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I XBREBY ACKNOWL2D0H THAT 1 HAVE READ iH19 MPIJGT�ON 7HE AMOUNT BHOWN UNOEP VALl1ATION 19 FOR TH8
AND 6TATH THAT TXE ABOV¢ 18 GORR6CT AND /�aRHB TO COM- pURPOBE OP E9TABL19XING A P¢RNIT FEE ON�Y.
vLY WITX wLL CITY ORDINANCE6 �ND 6i TE L/.W8 RHODUITNO
eUtLDINo CONBIRurnoN. VALUATION �
SIGNATURH OP . PERMiT FEE S
PERMITTE n �J Hf
J/�///, ////,�` S // / � / �7 uU PLAN CHECK $ �/
AUTHORIZED AGEN7 Q�,.W�.�V'f/ �./ / ��,/ v ��� �5--/ �1
Tl1TAL FFF S
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