HomeMy WebLinkAbout2853 DRAKE AVE - Building PermitsPflOJECT AOOflESS: Z 8 S 3 DRARE FiV UNIT:
OWNEH'S NAME: FARR KATHLEEN C TR
FOOPESS:292'�'CASSIA Jr7
NEWPORT HEACH,CA 92660
� APCN/ENGINEEH: ( 7 1 4� 7 6 O— O 3 S J� qEG.NO.:
� nooaess: uxiT:
'1i
�' PEXMITTEE:C.R. ROOFING (714)722-1504
` noosess: 216 COLTON ST
NEWPORT BEACH CA 92663
UCENSEO LONTNACTOB OECfARl1T10N: I hereDy a��irm tha� I am Iicen5e0 un0er O�o�sions o� G�ap�er 9(commencing wi�h Sec�ian
7000) ol Division 3 0l ihe 9usiness antl Pmlesslons CoEe. antl my license is in full lo¢e antl etle t.
cirruc.:098507 STRTELIC.r)z�58'� cuss 39 - -
Daie: �/F._��3 Signa�ure:—�
WOBKEPS'COMPENSATIONOELIAflATION: Iherebyal�irml�ail�aveaceM1ilicateotconsenl sel4insureoracenificateoiWorkers'
Compensalion Insurance. oi a ceniliea copy t�ereol (Section 38W. LaO. C�.
POLICY NO.: E%P. OATE:
COMPpNY:
� Certilietl copy Is hereCy fumi5he0. � Cetlifietl [opy is filed vnth ihe ciry Builaing DiviSion.
� Dale: Fp0licanl:
EXEMPTIONFpOMWOPREFS'COMPENSATIONOECUMTION: (Thi55eclionneMnotEecampletedillAeDermrti5loronehuntlretl�E100�or1e55).
I cetlify �hal in ��e petlormance ol the work �or w�ic� I�is permit is issued. I shall no� e loy any pers n any manner so as �o become
suDlecl to t�e Workeri Compensation Laws of California.
�� �a�e: _7 �T/ ��� Sigremre:
NOTICE: II, afl¢r making lhis Eetlaration. you 5houltl Gewme suUle�� �0 ��e Wotlters' Compen5 i pmvisions of Ihe Labor
Cotle. you mu9 bhhwi�� comD�Y ��� suc� pmWsians or I�is permit shall Ge Eeemed revoke0.
CONSTflUCTION LENOING ACENCY: 1 �ere�y allirm Iha� ihere i5 a con5imction lentling agency �or Ihe pedormance al �he work br
wAich IAis Dermil is issue� (Section 3W7. Civ. C�.
LENOEH:
AO�flESS:
OWNEF BWLOEB �ECIABRTION: I here�y aHirm thal I am ¢xemp� Imm IAe Conlraciars' $ta�e License Law lor IAe following reason
(Seclion 7031.5 Business and Pmlessional Cotle: Fny ciry ol county which repuire5 a Dermii lo wns�mcl, alier, improve, demolish, ar
repair any slmclure. o�ior lo its issuance. also repuires Ihe applicant lor sucn permit �o file a signea stalemeN inat he/sne is Iicense0
pursuant to the pmvisions ol i�e Comractors' S�ate License Law (C�aO�er 9(commencinp wit� Section 7000) ol �ivision 3 of ihe Business
� antl Pmlessions Co�e) ar inat he/she is exempl Iherelrom ana tne easis for Ine allege0 eKemption. Any violalion ol Section 7031.5 by
' any ap0licant for a permil Subleci5 I�e apPlicant �o a nvil penalry ol not more I�an �ive hunared dollars (5500�.
I, as owner ol Ihe pmperty or my employees with wages as Iheir sole compensaiion, will Uo Ihe woB, antl ��e
❑ simcm�e is not imeneea or ouerea far ule 1Seciion 70aa, Busineu an0 Pmlessional Code: T�e Coniractors' State License Law
tloes nol apply Io an owner o� a DmDe�y who builtls or impmves l�ereon, and w�o Eoes such work himsel�/hersell o� IhmuA�
his ar ne� awn emDloyees. pmviQeO I�at such impwvemenis are noi intentleC or otfereG far sale. II, M1owever Ihe huiltlinp or
impmvemenl is sold wi�hin one year ol completion, I�e owner will have ��e CurCen ol pmving he/5�e aid noi Uuild or impmve
�or Ihe purpose 01 5ale�.
I, as owner ol Ihe pmperly, am exclusively conlra[ting wit� licensea coniraclars lo cons�mct Ihe pmlec� (Sec�ion 704a, BuSinesS
❑ and Professions COGe: The Coniractors' Stale L'KenS¢ law Caes not aDP�Y �o an Ovmer ol Dropeny who Uuiltls or impmves ihereon
ana who cantracis br suc� pmjec�s wit� a coniracior�s) license pursuan� to I�e Conirac�ors' S�ale License law�. I am aware
Iha� prool ol ��eir Worker'S ComDensation insmance shaulE be pwvi0¢C la me.
� I am exempt unde� Seciion: 8. 8 P. C.
lor t�is reason:
�ate', Owner.
I tlo �ere�y cenily Iha� I am aware of antl untlers�ana Ine repuiremems ol California Health anU Safely CaEe Sec�ions 25505, 25533, and
2557a antl inai I or any lulure buildinq occuDant wilVxtill nat (d¢le one) neea b comply wit� saitl state catles and Ihe requiremenis lor a
permil lor conslmciion or ma0ilicalion Imm Ihe Air Oualiiy Managemeni DisUicl. ReSiUential con5imctian aDDlicaiions are exemp� Irom
Ih¢Se ptOviSians.
Oa�e: ApPlicanl:
I here�y ceruty �hat I �ave rea0 this application antl sta�e tha� I�e aDove inbrmation is correcl. I agree �o comply wiih all city antl caunry
or4inanceSanOSlalelawsrelalinglobuilEingconsimclionandhe�eGyauilror¢erepreSenlatN �I�iscityme � uponiheabove-mentionetl
properry for mspection pmooses.
Dale'.���9_� Signature:
�rivefs License or Social Security a; �. �
t64t�a6 Whi�e—Builtling: Green—CoEe EntorcemenC Canary—Appbcanl; Pink—Revenue: Goltlenrotl—Assessor
CITY OF COS'CA MESA - BUILDING PERMIT PERM NO; B 062852
PERMIT NO; B 062852 PLAN CHECH NO; N GOVT: N SUPP; N
CONSTRUCTION TYPE; S-N PERMIT TYPE; STR PURPOSE; ALT
JOB DESCRIPTION ; T/O SHAKES,RESHEATH W/1/2"CDX,APPLY COMP SQ FT: 6,900
CLAIM VALUE; 6,900.00 CALC-VALUE; 6,900,00 GROUP OCC: R-3 /M-1
COMMENTS; SMOKE DETECTORS RE�UIRED PER 'I'HE 1991 EDITION OF THE UBC.
*��r+e**+��r**x��r�r+r�ex*�x�r*�e��x�rx� x�rx+r*�*�r**x�rx�e�r**���r**�r�r*��t�tx*��r*�r+��x�*�t*�x�*
20N ING REQUIREMENTS SMpKE������
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUZLD��Q.UIRED
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARRING RE • PROV; PARCEL: 14159104 ZNE: REF NO;
PLANNING N TES>
.� _ .
*�*�r�****�r�r�r�e*�r*�x��� �r�r��*��tx x�r�r��r��r�r�r*�r*��r�r�r**x�r��r*�r*�**�r�r*�r�t*�t*�r*!�*at�t*�*x�**�*
D E V E=L O P M E N T 5 E R V I C E S R E Q U Z R E M E�N,T S
, ,�
ZONING APPROVED BY � DATE; ; '
BUILDING APPROVED BY ; DATE;
APPLICATION ISSUED BY: �
DATE; � 3
1FifiF�ltkiEif�klkifikltkfkiFiFikiEiflfifk3F3FiFiF�ii'3� iF3F 3FiF �fiiiF �� 7FTF 3F'£3F�Fh-iffk3ftE3flkiliElfll� itif
ififiEiliEilfEiklflffF%kkiEiF7fiF1ElEififlFlkiEkifdflfikilifiEiFiklfififik�fiEiEiflf7F fFlf�kiEiEiliflEiFiflfiEk!liFiflElfiEiFiF�EifiFiEiElkiEiFlFiFiEif
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL�SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RESt GRADING
PERMIT 90,00 ,69,
SMIP/NON-RES
PLAN a
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID in DUc
TOTALS----> 90.69 0.00 0,00 90,69 90,69 ,00
REVENUBLDGVPMT�PLUMBING ELECTRIC�MECHANnI� FIRE��SMIP�/TOT/SGRADING PLAN-CHECK
90,00 ,69
i
1f 1E 1E !f 1E if iF lE iE if if ik iE iE 1f 1(� i! i! iF iFlE �lk iE ik �1E if iF 1k if !f 1F 1f if iE iF if iE if iE iE%iF )f !E il� �%iF ik if ik ik 9k IE �If iF 3(- lE ik ff !k iE fF�)h if iE iF 1E 1ElF 1!� iE 1klE 1E �1! iF 1E iE iE
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 6900 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 �� 6,900,00
y� END OF FEES ;
e � •
�
- ,...:nr .:- .
�0.. '
_ - 4
� p
�: C�142142-00142:�3 T�� T 40.6S
DATE: 07/Q1;93 TII1E: 13:3b
CONSTRt vl0��i+ND P4ANNING POO. iPA �
APPROVALS Permit # Uate Inspector AppROVALS Permit # Date Inspector
7. TemDorary Eiectrical Service or Pole 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement �
3. Electrical Conduit Wtility-Undrgrnd. 54. Forms
4. Electrical Conduit•Undrgrnd. 55. Electrical Bonding
5. Steel Reintorcement , 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, C] Undrqrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap. Cl Undrgrnd.
10. Structural Floor System 67. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap ' 63. Heater & Vent-Pinal
13. Roof Drains 64. Plumbing System - Final .
14. Rough Plum6ing 65. Electrical-Final
15. Rough Electrical-Condu�t 66. Solar SYstem-Final �
16. Rough Electric YViring 67. Fencin� & Access ApProval
77. Rough Wiring Sign 68. APPROVED FOR P�ASTERING
18. Rough Elearical-T Bar Ce���ng 69. POQL/SPA SYSTEMS PINAL '
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT i
i
20. Fough Factory Fireplace � ; APPROVALS Permit � �
21. Ducts, in Structure •- � - 70. Underground Hydro '
22. Dutts, Ventitating 71. Product Piping � Gas ❑ Oii
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Freming � 73. Undergrnd. Storaye Tank Q Gas ❑ Oil I
25. Roof Sheaihing � '/6� 3�� 74, Overhead Hydro �
i
26. T-Bar Ceiling (Strucmral} & Monocoat 75. Dry Chemical
27. Frame and F�ashing 76. Dry Standpipe
28. Lathing & Siding • � � 77, FIXED SYSTEM FINAL
29. Insulation � 78, FIRE PREV. FINAL
3Q. Drywail Nailing � �- HEALTH OEPT. REQUIREMENT
i
31. Plaster 6rown Coat I 79. FINAL INSPECTION �
32. Electrical Power MeterPinal � � 80. FOOD CERTIFICATE ISSUED
33. Final Electric � � ," Notes:
34. Final Heating & Air Conditioning �
i
35. Final Gas Pipe�Test , � �
36. Hood or Canopy % :
37. Final Factory Fireplace � � �
38. Final Plumbing � �" j'
39. Water Service-Final J '
40. Gas Service-Final " � I
41. SolarpomesticFinal ' �
42. Backfiow Preventer � � I
43. Backflow Irrigation
44. tandscape Irriqation Systgm
45. Sound Attenuation �
46. Handicap Regulations�:,,: ... -}-- /
47. FINAL STRUCTURE& 9C1�LDING 7$� � i S y�� Dk� �JL_
48. FINAL PLANNING ,�' � ; � �
i,
49. Electric Release to Edison y � ' '
50. Gas Release to Southern Caiifornia Gas Co .
51. CERTIFICATE OF OCCUPANCY
No. Date
� AOP���ant lo fill in all spaces within heavy bortler linei antl si9n all approD/�ate tleclarations.
CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO.' BLOG. NO. -' -
CQNSTRUCTION PERMIT �� � .ZZ� ` . ` ' "
Project Adehess 2 R .. �"' ^ TVpE OF CONST�RUCTION • � . _ .�_ . . _ . , - ,
�wner � - PhOne ' ❑ NEW ❑ AOD ❑_ALTERATION - � � S3I G � �7I3D�BL7 8�00 � T�.'
� Addrea' -- 2, S R/1 C S " - ❑ REPAIR ❑ CONVERSION; �DEMOLISH . - '- - . _ -"
Arch/Eng. License No. - ❑ OTHER _ 'A P� _ ZONING REGULATIONS_
DESCRIPTION'OF WOftK•
Addf255' ' - - - - ' ' ' ' " - . - - - ' ZONE � - PLNG. REF. �.-. . � '
� Contrecmr ' ' � �;,� ��/L, Phone �' TVPE OF P,ERMIT , � � ' o - TpBU IL pING - .
Addf¢55 . SETBACKC T._ PFOPERTYLINE' �
�S pTT�=� , GN QRI✓Fy. 7.JF �O�GRADING „ O FOVNDATION -O STRUCTURAL SI�E'VAq� i_} . i. -
UCENSED�CONTRACTOR-OECCARATION EF � ^��
' �O TEIVAIVT- O EIECTRICAC-OPWMBING ❑MECNANICA 5IpE VAR
I hereby affirm lh;.t 1 am IlcenseC untl¢r prOvisiOns of Charter 9,�com- �- r . RIGHT
Qmentlng with sectlon -7000) -of -Dlvlsion 3 01 the- Bu5ine55-dntl •� OTHER � .REAR�YARD T � � ' ' �
Professlonz Cotle, antl my license iz in fu❑ force antl effect.- ( O P/L) _
_ PROJECT.DESCRIPT.ION � _ �
LlcenSeClasS ce eNo, � '! � -� � �PKG SPACEREq. � �� P,fiOQIDED, �n -
. _ SQ.�FT., ,� .t � . , �
Date �� Signature ' � �. - :� - -' , -' �STREETWIDTH � � � PARKF,EE-S 'i �
WORKERS' COMPENSATION DE AR TION -� : OCCUPANGV_CONSTRUCTION TVPE �
1 bereby a/firT Ihat 1 hav¢ a certit ale Ot COnsent t0 selLlniure or a VALUATION� ZONE ZONING APPROVED'BV - - DATE " .-`' �
[¢rtiflUt!-Of Wo�ker2' Compensation �InSurance, o� a cerUfietl-coOY - - -- - . - - - - -- � - _ _ -. - _
thereot (SocHs 3800, L-ab� Q•Company RbY.4L� _ � GRADING�CU. �'D5. ACRES SPECIAL CONDITIONS: '
--y rypfi �%,C7 SP -- • �. r
�p5"�ertilied copy ii hareby turNshetl. . _ _ _ _ _ _ REMARKSP ' _ � ._ .... _ . _ _ ._ _ _ �
�;.tiertifietl topy is filetl with the city Builtling Oivl5lon. . - ,, , ' , � , , , r
�EXEMPTION�FROM WORKERS' COMPENSATION OECLARATION' "" �" ' "" " ' ' ' -
�This sectlon neetl not be campletetl i( the_perml[.is for one huntlretl _ _ _ _ _ _ �� __ _ __ __ , _ . _ _ __ , _ _ _ _ _ _ �� � �'� � _�-� �� _
(5300� or less). � ''' permit is � 1
_ .: .
I C¢rtity that in the perfOrmanc¢ of Ih¢ work for which this _ ,. . --.
Issuetl, I shall not employ any person in any manner so as to become PWMBING - . PLAN CHECK'� --- �"-- - EL'ECTRICAC � PLAN'CHECK: -'-
subject [o [he WorkCrs' Compen5ation Laws o( Calltornia. . _ . _ ` ' � _,
Date Si9nature � BATHTVBS � SFIOWERS � - � - ' -' � - " ' -'" - � -, ' -
NOTICE: If after making this tleclaratlon, you shoultl become:subject� -TOILETS. • • URINAL'S' "' ' �" ' -GENERATOR- - 0-1 KW_ �-10 KW - -�- -
to [he Worker5' Compensation provisions of the labor Cotle; you must � -� TRANSFORMER - .�. ��
forthwith comply wlth zuch provisions or tniz permit shall be tleemetl LAVATORIES DOUB�E LAVS"" � APPLIANCE - 30-50 KW_50'+-KW - -- --
revoketl. ' ' " _.� _ ' ' ' " _ . . _ " . -
CONSTRUCTIONLENDINGAGENCV � KIT.SINKS -'DISHWASHERS 'MOTORS'�' - p:�'ryp_1d0'HP� ' -' -" ,
I hereby aHirm that Ihere is a constructlon I¢ntling aq¢ncy for tM1e Oer- SERV ICE SINKS � ."SUMPS" " "" - �UNC..SOLARj.. _-30-50 HP_--50 + HP ---�' --�- � �
formance of [he work for which this permi[ is Issuetl (Sectlon 309] - -
Civ:'C.). ' ' '- - - � -' ' � . -. - " � ; ` FLOORSINKS� FLOORDRAINS �- --' FIXTURES"—OUTCETS-""5WITCHES�-" - "- '
Lentler's Name �" - ' I
Leritler•zAtltlress DRINKING��FOUNTAINS' .-�- ' '-- '- 'GASTVBESIGIVS - ' ' - _ -��
OWNER BVILDER'OECLARHTION'- � �� '� "" �' �' jIVTERCEPTORS CIARIFIERS - � -',POL'E CIGHTS � ' ' "' - - ' ' '�-- '- -' - -�
I hereby aflirm that I am exemp[ from the Contractor'S License Law for � -
i�e-tollowing rea5on (Section �031-.5-Business�-antl� Profe55ions Cotle:- - SWIMMING'POOL " P.TRAP ' ' '- - ' ��' - ' " - -
Any tlty or county wnich repuires a permit to construc[, alter, 'POLES �METERED �- SU9 .. � .'{1
ImprOv¢, tlCmollSn or r¢palr anystructure,'prlort0lt515zuance, also re� -yyATER $ERVICE HLTERAT.ION"--'� ` -'PANELS —"'- MAIN' S08' " � '"' 1
quir¢s the ap4���n1 tor sucn permit fo til¢ a si9netl statement that h¢ -'
IS' Iicensetl'pu/suant to tM1e-prOvipiOns of'the Contractor'S LICGnse'Law- � -'-' . ' 'SE VICE' - - - ' '- "- AMP- � - 1
1Chapter 9(commencing with Section 7000) of Division 3 of the GASSERVICE OUTlETS � „�: . ' � i
9uslne55 antl' Professions�Cotle)'or that-he'iz exempt [hereirom and the y,�qTER HEATERS BTU OUTPUT' ` -- -- ' " ' -
, -. .. ... . . . :. �
Y�-�s lo� the alleged exemption. Any vlola[ion ot $ection ]03L5 by' � •� - "�� � '
applitant' for a �permi[ subjects �tne� applicant to a� clvil penalty- - SEWER CONNECTIONS ' � '- ' - " -' � ' " "- - - -' - - - •- - ' ' -�
at more tM1an live-huntlretl tlollars (y500).
L, I, as owner oY the property, or my employees with'wages as thei'r SOLAR TANK ' COLLECTOFES -' �" �-- ' '-' ' '- �-"' - '- ,� 1
Sol¢.CompCnsa[ion, will tlo the work, antl the struclure is nOLintentletl ' v' �� �' f
or offeretl Por sale. (Seclion 7044, Business antl Pro(ezsions Cotle: The � SO�AR PIPING SVS. {! �� � ISSVEFEE ' ' '_ ' ' Q �
Contractor'S Lit¢nsC Law tloez.not apply to an own¢r of a property __ _ - . - -. t... -- --- qppLICATION APPROV ED BY -- ---- DATE - �
wbo builtls or imOwves [hereon, antl who tloes 5uch work himself or ISSUE FEE -
lhrou9h hls.own ¢mploye¢5, prOviOetl ibat Such iTPrOvements are not ' � �
intenaetl or otteretl ror sale. If, nowever, the bulltling or improvement MECHANICAL PLAN CHECK �� SUMMARV OF, FEES .�.
is soltl within OnCy¢ar ot_completion, [h¢ owner wlll have Ilie burtlen -
of provinq he tlitl no[ builtl or improve tor tho pu�pose o( sale). ' BUIL-DING ----- --
HEATING SVSTEM 0-300,000 BTU ! PERMIT § � SMIP $' �
❑ I,'a5 owner ol-[he-property,-am-exclusivBly-mntractiry. with qNDDUCTING it - -
li<ensetl contractors to wns[ruct tne project (SecUon 7044, Business' 300,000'} BTU ^ 'PLAN CHECK y PERMIT. '- - �
5ntl -Professions-Cotle: The Contractor'z License Law tloesmot apply to - - -• - - -ISSUANCE - $ - -�
Bn owner of property wbo builtls or improves thereon, antl wbo con- REFRIGERATION 0-100,000 BTU 'PLUMBING� y !
tracts• from sucn projects-with a �contractor(s) Iicosnetl-pursuan4�ro � SVSTEM- - � -� - � - -- � - - - - - � . GRA��ING '..S �'
tne Contractor's License Law). ' 100,000 + BTV� � PLAN CHECK y� - � � .���
❑ I am exempl untler Section'-- B. & P. C. for this gOILERS BTQ ELECTRICA� E(f_�_, .' s r� '
rea5on - -- 'PLAN'CHECK $ - _MICROFILfv1_§�� �
Oate� Owner SVSTEMREVAIR,ALTERATION , � �
'MECHANICAL $ JOTALFEE'$ �' �
I hereby certitythat I have reatl this application antl sta[e [hat the above EXHAUST SVSTEM MVLTIPLE � . ' ' LE55 A�-' ' i
informatlon is mriecL I aqree to comply-with BII city zritl'county � 'iPLANCHECK E ' 'VANCEPG $_'" -- -
ortlinances antl slate laws reiating to mns[ruction, antl hereby authorize �� ' , � _ � , ,„- „
repre5entalives of thi5 ciTy'to enter upOn th¢ abOv�e �m��en�[,i�o�ne�tl � � ' � �� '
property for ' spectlon es. . _�4��' - _ . . � FINAL FEE 5...6._-- '
Signatur¢ D �! , -
Driverz' Licc or 5$ � �SSUE FEE . . .
CMF 0865-46 White-Builtlin9: ��ary-Applicant: Pink-Accoun[ing: Goltlenrotl-Assezsor �
CONSTRUCTION AND PLANNING POOL & SPA �
APPROVALS Permit# ��y°�'v Date Inspector p�ppROVALS Permit# Date Inspector�
1 r Temporary Electrical Service or Pole 43. Pool & Equipment Location
Soi ipe-Undrgrn 44. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrn 45. Forms
4. Electrical Conduit-Undrgrn 46. Electrical Bonding
. tee ein orce . 47. Rough Plumbin & Pressure Test �'
6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE � � - �
7. Footings 49. Electrical Conduit-Undr rn �
._8. Foundation . • 50. Gas Pipe, � Undr rn; Test �
.9. Water Pipe-Undrgrn � 51. Backwash Lines P-Tra '❑ ndr rn ' � -
10. .§tructural Floor System ' 52. APPROVAL TO DECK -'� '"
11. __,Property Sewer Line,& House Connection � 53. Backwash & Rece torFinal � �
12. Street Sewer Connection � "� - 54. Heater & Vent-Final �
' 13. Rough Plumbing � ' � " -
14. Rough Electric-Conduit -- •�56- Electrical-Final �
. 15. Rough Electric-Wiring � - � 57. Solar System-Final � � �
16. Rough Heating & Air Conditioning � - • encing & Access Approval
-17. Ducts; in Structure. � APPROVED FOR PLASTERING
18. Ducts, Ventilating - - ' . . _
19. Gas Pipe-Rough & Test � - 60. POOL/SPA SYSTEMS FINAL
201 ��Roof Framing - ' ' � '
21. Roof Sheathin
22. Frame and Flashin NOTES:
23. Insulation � - - - �
24. Lathing & Siding -/ �
25. Drywall Nailing
26. Plaster Brown Coat � � - � � -
27. Electrical Power Meter-Final ' � � �
28. �Final Electric . �� �
29: Final Heating & Air Conditioning - ��
30. Final Gas.Pipe-Test � �
31. Final Plumbing
32. -Water Service-Final �
33. � Gas Service-Final �
34. Solar pomesticFinal � ' -
35. Landsca e S rinklin S stem � �
' 36. Sound Attenuation � - � ' •
; 37. Handicap Regulations � -
38. FINAL STRUCTURE & BUILDING '
39. Special Requirements Completed � ' •
40. Electric Release to Edison - -
41. Gas Release to Southern California Gas Co.
42. CERTIFICATEOFOCCUPANCY ��. .
No. Date
ADD���ant to fill in all s0aces witnln heavy boraer Iines antl sign all apvropriate tleclarations.
CITY OF COSTA MESA- Pea IT O � � TFACT NO. LOT NO. BLDG. NO. " " r'JB%C� 5/ I 4/B2 :7�00 TLI
' CONSTRUCTION PERMIT � � � �
Project Address e`i� / TYPE OF CONSTRUCTION „ , � : . '. � �� . ' � ' '�� � � �
� , Owner " � , Phone � ❑ NEW ❑ ADD ❑ ALTERATION , , _ � '.-_ � . ' -,
Addf255 ,�jQ[f� - -O REPAIR-� CONVERSION ❑DEMOLISH
(}� Arch/Eng. - - �- � - License No. � ❑ o7HER ' - ZONING REGULATIONS
A.R �
W DESCRIPTIONOFWORK ' -
, �Addfess -' ' " ' " .. , . - . ' , ZONE � ' . PING. REF. p� � �
� Contractor - - Phone_ � -� TYPEOFPERMIT. e N ��pPE�RTVNLiNE
SETBACK C L ST.
� Address � . � . - � :O GRADING -❑ FOUNDATION ❑ STRVCTURAL "' SIOFE,rYARD - -
9 LICENSE CONTRACTOR OECLARATION � ❑ TENANT ❑ ECECTRICAL' O7LUMBING ❑MECHANICA �E
1 M1ereby affirm that I am Ilcense0 untle� provisions of Charte� 9(COm-' • � . , �. SIpE YARD'
\ mencing with "section �000) of DlviSion 3 of 'the Business antl -0 OTHER - �- RIGHT
Profes5ions Cotle, antl m II nse is in full fort � a g ' - REAR YARO (TO P/L)
'J� - .- �PROJECTDESCRIPTION � _.__ _
Litense I License . PKG.SPACEREQ. PROVIDED' .
�Date - • ` Si9nature ".' � - : FT. �' ' : . . . _ . . . - .
WORK 5' OMVENSATION DECLARATION-- - - � -� -- �CCVPANEV_CONSTRUCTION TVPE STREET WIDTH PARK FEE $ _
I hereby aHirm that I have a tertifica[e of mnsent to self-in5ure or a -,VAIUATION ZpryE ' �ZONING APPROVED BV . DATE _ .
'certificat¢ Of Workers' Comp¢n5ation InSU ce, ora c�rtlfietl-copy - - � - ~
thereOt (Secti n 39p 0� Lab. C.)./� � � / ' SPECIAL CONDITIONS: ,
9q/-�[/��,,Qy� GRADING'�CU. VOS. ACRES
' ";'�,;:Y No.--i�'�'-`-""�✓an _' _' ' _ . " ' � ' � - . . . '.
. c"`;y���fied copy is her¢by furnishetl.-- �- - - -- -- - -REMA K5: ' �
�
u'Certlfled copy is filetl with the city Builtling Division. r. , � ,,�i �
'EXEMPTION FROM WORKER$' COMPENSATION DECLARATION � - " ' - ' ' ' �
(Thls section neetl not be Cortfpletetl if the permit.is.to� one huntl�etl _ . ,. . _ - ,. �-"_ _ � '� ,'�� ' : _. ' ".
(§L�Q) OI IC55). : . . . '` . . . '
'I Certlfy that m the performance of he w�k tor which this permit is _ ._ _
issuetl, 1 shall ot employ any pe�s n i y man r 50 a5 to b¢ PLUMBIiVC�i '.-� ' :. PLAN�CHEGK ELECTRICAL � PLAN CHECK
subject�to ; or ers' Compensat ,pf i. '
�Date__,.�';I'�'S19natur BATHTVBS SHOWERS " _ ' ' " ' ' " _
NOTICE: I after makinq this tleclara[ion, you shou tl bemme subject TOICETS �� . a URINALS - ' � GENERATOR - 01 KW_1-10 KW � �
to the Workers' Compensation provisions of the labor Cotle, you muzt TRANSFORMER �
forthwitn comply with such provislons or this permit shall be tleemed �.VATORIES DOUBLE LAVS ,APPLIANCE -30-50 KW_50'+ KW ' _
revOketl. _ .. _ _ _ _ . ._ _ . _ . . _ _ _ _
CONSTRUCTION LENDING HGENCV KIT. SINK$ DISHWASHERS - �� MOTORS �'- 0-1 HP_1-10 HP �
_ '
I �ereby affirm that there I5 a constvuCtion lentling agency to� the per- SERVICE SINKS �� �SVMPS -� � -' �(INQ SOIAR) -•30-50 HP_50+ HP � -
formanCe of the work for which this permit is i55uetl (Settion 309�
Civ. C.). ' - - ' " "' - " ' . " FLOOR SINKS FLOOR DRAINS � FIXTURES� ' OUTLETS� SWITCHES'� ' '- '
Lentler's Name -
. i.
� � DRINKINGFOUNTAINS � �� " �� �� ��"GASTUBE'SIGNS' ' �-' ^"- � '�
LentleYs Atltlress
OWNER BUILDER DECLARATION - - - - � � � INTERCEPTORS CLARIFIERS � �POLE LIGHTS' - -- - — ' '
I hereby affirm that I am exempt from tbe Contractor's License Law for !�
the t611owinq reason-(Section ]031.5 Business antl Professions'Cotle: --SWIMMING POOL - PTRAP -' ' ' ' ' '- ' � - -
Any_ city or county which requires a permit to consVucQ alter. �POLES METERED �SUB
improve, tlemolish-or repav any structure, pnor [o its issuance, also re- - yyqTER SERV ICE ALTEftATION � � PANELS -� MAIN ' ' SUB .
quires tne apFlicant for suth perrnit [o file a si9netl s[atemenl that he -�-
is licensetl pursuant to the provisions'of the ConVactor'S Lltense Law' GASSERVICE OUTLETS 'SERVICE "�- "' --' '' AMP -' '
(Chapter 9(commencing with Section 7000) of Division 3 of fhe
BuSiness and Prafessions' Cotle) or-that he is exempt tberefrom antl tbe ' WATER HEATERS BTU OUTPUS<_ - -` ' "--" � ' '
� 's Por the allegetl exemption. Any violation of Section 7031.5 by _ ��< �
applicant for'a permit subjects the applicanYto a civil'penalty' 'SEWER CONNECTIONS � �
�o[ more than five huntlr¢d tlollars ($500).
�IJ I, as owner of the property, or my employees with wages as their SOLAR TANK �� COLLECTORS'� �' - '� - -' �'- ' - � �� .
sole Compensation, will tlo,the work,.antl the strutture i5 not intentletl
�1 or offeretl ror sale. (Section 7044, Business antl Rofessions Cotle: The SOLAR PIPING SVS. � �SSUE-FEE ''
V Conbactor's Licenze- Law� tloe5 no[ apply to an owne[ of a property. ---- - - APPLICATION AGPROV ED BY""-' " � DATE"-, �-
who builtls or improves thereon, antl who tloes 5uch work himselt or ISSUE FEE
ihrough��his�own.empioyees, Orovitletl lhatsucn improvements are,not �' -' �
� in[entl¢tl or offeretl for sale. If, however, the builtling or Improvement MECHANICAL PLAN CHECK _ ,
1, iz soltl wltnln.one year ot Wmpletlan, the owner will have.the burtlen_ SUMMARY OFFEES ,�} '�
� ot proving he Aitl no[ builtl o� mp�ove fo� tne putpose of sale). �BUII'DING" _ _ , ; _
HEATING SVSTEM Od00,000 BTU PERMIT $ *^�+"` - -SMIP{' � � y' - �
� I, as'ownerof-the property, am exclusivery-contracting-with� qNDDUCTING � �
liGensed conlractors to construct the project (Section ]044, Business 100,000+BTU PLANGHECK E .PERMIT� �'
�antl Professians Cotle: Tne'Contractor'S License�Law tloernot apply�to- - -- -- - ISSUANCE E - ,_ '� �
an owner of property who builtls o� Imp�oves thereon, antl who con- REFRIGERATION 0-300,000 BTU PLUMBING $ ;�
tracts from'sucM1'projects with-a contractor(s) licesnetl-pursuant to- SYSTEM ' -- -• -- ---- -GRADING-
the Contra[[or'S License-law). � 100,000 + BTU � PLAN CHECK $ � ��� ' , � j y .,$ ��' :L ,
❑�I am eKempt untler Section � y�B�& V. C. for this � BOILERS BTU `Y $
iELECTRICAL $ �F
t� reason '- - - ' - - PLAN"CHECK 8 :' _ �MICROFILNIE
\ � , _ SVSTEM REPAIR,ALTERATION .
Dale-� Owner $ � ".' . TOTAL FEE.$
MECHANICAL
� I hereby C itythat I hav reatl [his,application an0 state thd[ Ih¢ abave EXHAUST SYSTEM MULTIPLE '�• CE55 AD- ��'
O informati n is rorrec a9/ee to comply with al cily antl county PLANCHECK' $ VANCEPC S_ � �
1 o�ainanG antl 5[ate reiatin9 t str ction, a �eby autho iie
� repre5enta � is 5ity t t � po � h abo e ment' netl
property for in ttion�purp .� �f _ . /, . _ FINALFEE 8�
Signatur «� 6 ,
Oriver �Li e or 55 � ISSUE FEE ' ' � - . . - _
CMF 0865-46 WM1ite-euiltling; Canary-Applicant; Pink-Accounting; Goltlenrotl-Assessor
CONSTRUCTION AND PLANNING , � POOL & SPA' �-'�-
APPROVALS permit # M-�S� Date Inspector qppROVALS Permit # � � Date Inspector
i. Temporery Electrical Service or Pole 43. Pool & Equipment Location � �
2. Soil ipe-Undrgrn ' 44. Steel Reinforcement --
_ 3. Electrical Conduit Utility-Undrgrn. _ 45. Forms - _ i -
4. Electrical Conduit-Undrgrn 46. Electrical Bonding '- � � � � '
. tee ein orce 47. Rough Plumbin & Pressure Test �
6. Electricat UFER Gm � � 46. APPROVAL TO COVER-GUNtTE -- �
7. Footings 49. � Electrical Conduit-Undr m -- - • �
8. Foundation �� � 50. Gas Pipe, ❑ Undr rn,.Test � �
9. _ Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ ndr rn � -- -- --
10. Structural Floor System " ' 52. APPROVALTO DECK " ' ' "" "� -"-"' ' " '--
' 11 . Property Sewer l�ine & House Connection ' � � 53. Backwash & Rece torFinal •� • ' � �
� 12. Street Sewer:Connection � '' 54. Heater & Vent-Final � � ��
� ---- - - . . . ,.
, 13. Rough Plumbing . . . . . . . ._ �. �. . _ - '- . ._._ • � �. ._ _
14. Rough Electric-Conduit , - - •�56: - �Electrical-Final
15. Rough Electric-Wiring ' - - - - - 57: -Solar System-F.inal - -
16. Rough Heaiing & Air Conditioning �� �� i � encing & Access Approval
..17. Ducts, in Structure -� 9• APPROVED FOR P.LASTERING � '
18. Ducts, Ventilati�g . • _ - , _
19: Gas Pipe-Rough &Test � ' 60. POOUSPA SYSTEMS FINAL , ' � � � `
20. Roof Framing ' ' � � �
21. Roof Sheathin f _ � �� � y�_ �.
- 22. Frame and Flashin ��
NOTES: �r...p �a�'�.
23. Insulation
24. Lathing & Siding ' � �
- 25. Drywall Nailing � � '
26. Plastec Brown Coat. � ' � �
27. Electrical Power Meter-Final ' � �� ' � ' '
28: Final Electric � � � "
29. Final Heating & Air Conditioning .� �y'-b - '
30. Final�Gas Pipe-Test � �
31. . Final,Plumbing ' �
32.-� Water Service-Final ' ` "
� 33. Gas Service-Final � - �
34. Solar pomestic-Final � � '
• 35. Landsca e S rinklin S stem � ' ' � ' ' ' -
36. Sound Attenuation • � � " � � �
37. Handicap Regulations - � � ' •
. 38. FINAL STRUCTURE & BUILDING � ' � - � � � -
39. Special Requirements Completed ' '
' 40. Electric Release to Edison � � "-' '�
, 47. Gas Release to Southern California Gas Co. � �
42. CERTIFICATE OF OCCUPANCY . . �
No. Date
�7f�
. _ � .
• .�
a
z
�—_ ��-�. ��--. --�� �� � �
�.�"\.,��i. j �'i'\ j "�r '/ '--• , j/":� f ..j"-\"�:i�""�:l
"�� BN FORM 716
, BIA FORM 1486
INSULATION CERTIFICAT�ON
This is to certify that, in conformance with the current energy regulations (California Adminis-
trative (ode, Title 25, State of Calif ' proved plans, insulation has been installed in
the building located at: � 33 �`{ ,
; ,..COata-l�aa — • . i O1811ge , , , li . , !
, ���, ._ .. _ _ CwnH
2859
Street No, (If Aveil�bte)
Drakct Strcet
Strset
Lot Num6er
DESCRIPTION OF INSTALLATION
ROOFS •
Type of Materia� Manufacturer
Tnct No.
Thickness R Value**.
EXTERIOR WALLS ����s �gitainteed 3
Type af Materia!% Manufacturer Thickness �+�� R Value** 11
. . �t (Or Tods Namy • - ,. . . .• . ' .
CEILINGS •
earrs: ` pibe=glase CertainLeed , b" 19
Type of Material Manufacturer Thicknes� R Value'*—
(Or Tnd� Nama) ' - ' ""
Sq. Ft. Covered
BLOWN:
Type of
Manufacturer Thickness NooBags_
(Or TnM N�ms) .
Wt./Bag Sq. Ft. CovereA R Value**— �
FLOORS , •
Type ot Material Manufacturer Thickness R Value*'—
, (Or Tnd� N�m�) -k '
SLAB ON GRADE "'
� Type of Matelial _ ' Manufacturer t'Thickness� � R Val�e•*_
�, v ;� � . : -y.. •. ; (Or TnA� N�m�) .f. " • , ' ., r- .
Width of Insulation Inches '
a4➢.
�" �•w
POUNDATION WALLS (ff r0qulred) � r
Type of Material Manufacturer Thickness R Value*'_
(Or TnM N�me) "
�.
REMARKS (if desired) " -
General Contractor (Builder) &� B� License Number
Inanlatfoa C�
JAE" II ams u Gmenl Conh
Preaident
License Number 267769
_ Date� �'�"'� %"
(•Cali(ornia Adminhtmtln Cads, En�ryy Imulatlon SmndaMx, d�dor�aY'— -IXCERR hom S�a. I9B75 of the HwIM and SaAM �da of ths StaN
"Cemouonu. uoon mm0��i�� of M� imbllallon of Inavlafion, a mrd ef Cdlfomtm '
aM��y�n0 thaf th� Inwlo�ton ha� be�n Imfalbd In conformanc� wilh M�
rpvinm�nh ef thn� rpvlolions �holl be �omo���ad und eae�ufed by "No nnlficata ef oavpanry or �imilar carllFl�vlion thaf o newly con�
tM imulotlen aDD����er ond by ffie bvlldw. ThI� !r.cvlation romolianca rtrvcled horol, mad, aoa«mam hou�a, M1ems or oPom rofldentlal
mrE aholl M oeslM a1 a mnaoicvoe� Ixotlen wlMln th� dwdllnp.") A.allinp ii habbabb �hvll ba IuuW by au<h a bvildinp d�pm}mmt
enla�s Iha strv<Nn of I�ert mti�fiu th� minim�m �nopY insvlation
�••R Valu� 6 Ih� m�asm� of th� n�i�bno of a maM1rbl or bvildlnp slandard� ertablished o����a�l to MI� aM1opbr."
componmt ro Ih� pavepe ef hwt. The n�i�mnc� ralv� �R� ot mms-yo� �
inmlatlm� �hall not Intled� anY rale� fx nflMir� bdnp.l
Form 116 —m BUILDING NEWS, INC., 3055 Overland Ave., Los Angeles, Calif. 90034--1213) 870-9871
Form 1486—m BUILDING INDUSTRY ASSOCIATION OF CALIFORNIA, INC., 1571 Bererly Blvd., Los Angeles, Calif. 90026--(213) 6255771
Applitanl
yCl-TV OF COSTA MESA ri
CONSTRUCTION PERMIT I
in a11 spaces wllhin neavy bortler Ilnes ane sign all approDriata Geelarations.
� ryn_�O� TRACT NO. LOT NO. BLOG. NO.
3
Address 3 ,(J • ,5J
ArchlEng. License No. 7
Address
Contractor � Phone
Address /` p E
LICENSED CONTRACTOR DECLARATION
I hereby afBrm that I am Ilcansatl untler pwvi51on5 ot Charter 9(com- �i
mencing wltb sactlon ]000) of Divislon 3 of ine RuSinuss antl
Profession5 COtle, anE my IICOnse is In IWI fotte antl ¢tteGt.
� License tlass LJce e No3�y�7
Date �—�&2 Si9nature .
WORKERS' COMPENSATION OECLARATION �
I h¢r¢by aftirm tha[ I have d C¢rtificate ot con5enf f0 SGIf-iniure or a
- certificate of Workers' Compensalion Insurance, or a certifietl coPY II
tnereof (Se tlon 3800, b. .). .
"oIICY No �o—ti�ComPanY • �A'J�tR�fi
Certltietl copy is h¢rlGy furnishetl.
. Certltietl coDY �s filea with the'dty Builtling Divislon.
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section neetl nOt DG cOmplete0 If the permit is tOr One huntlretl
(5300) ar lezs�.
1 C¢rtity Ihat In the pertormance of the work for whi<h this permit Is
issuetl, I snail not emPloy any person in any manner so as to oecome
subject to lhe Workers Compensation s ot CaJlfomia.
Dale G-y�g� SI9naWre f�'�
NOTICE: I( after making lhii tleclaratlon, you snoWE become sub7ect
to the WOfkels' CompGnSdtiOn pfOvislons of tlle Ldbo! Cotle, you mu5l
forthwith COTpIy wilh Sucb p�ovl5lons Or [his pe�mit ihall be deemetl
r¢vOketl.
CONSTRUCTION LENDING AGENCV
I bereby alilrm tnat there ii a constructlon leneing agency for the perv
tOrmance of tho work for whlGh this Oermil IS iSSuetl (SetllOn 3097
Civ. C.1. ' -
Lentler's Namo
Lentlar's Atltlress
OWNER BUILDER OECLA0.ATION
I he�eby a/flrm lhal I aT exempl irom the Contractor's License Law lor
[he �ollowing roa5on (Seclion ]031.5 8usiness antl PrOf¢szlons Cotlo:
Any tlly or County whith reqWr¢5 a p¢rmit to construtl, dlt¢r,
improv¢, tlemollsh or r¢palr any StruCture, O�ior to its 65uance, also re-
qWres tho apFllcant lo� Such permil t0 ti10 a siqnetl slatement that hC
is Ilcensetl pursuanl to the DrovislOns of the Conlractor'S LiG<ns¢ Law
(Chapter 9(commen<in9 witb Sectlon 7000) of Dlvision 3 of tM1a
BuSinesS antl Prde55iOns Cotle) ot lhat �a ISlxBrt�P[ therlirom anE lho
basis for the allegetl oxempNon. Any violatlon of Section ]031.5 by
v appll�aN lor a pGrmit subject5 tne applicant [O a clvil penalty
not more than livo nuntlretl tlollarz (§500).
� I, a5 OwnCr of tha property, Or my emplOyeeS with wdg¢5 d5 fllei!
sole tompenwHon, will tlo tha work, antl the structure is not Intentletl
or ofiered lor sale. (Saction 7044, Business antl Rofe551ons Cotle: Tho
Contractor'S Llcense Law tloei not apply to an owner ol a property
wh0 bulltl5 Of Improve5 ther00n, antl who tlOes sUGh work bimsel! or
thrOu9h Itis own employees, provitletl lhat such Improvemtnt5 a�e nOt
int¢ntlCtl or offe�otl ior sulc. II, however, the builtling or improvemenl
is sold withln onc year of completlon, the owner will have tha burtlen
of prOving hc tli0 nOt builtl or Improve lor the purpo5e of Shce).
❑ 1, as ownar ol. the proporty, am azclusivaly conVacting with
licensetl conVaciors la construct the project (Section ]044, Bu5lness
antl� Rofe55ions �CAtle: Tha ConlraCtor's Lic¢n5¢ l2w tloes not apply to
an owner o/ propc�ty who builtls or ImprOves thereon, antl who con-
traGts from sucM1 prO�otts with a conlractor(s) licesnetl pursuant to.
the ConVattor's Llcenso Law�.
0 I am exempt untl¢� SeGtlOn B. & P. C. lor this
reason
Date Owner
I h¢reby certify thal I havC reatl tnis application antl ztate lhat the above
infoimation Is'mrrect. 1 agree to com0ly witb all tlty antl counlY
o�tlinances antl ztala laws relating to cOnStruction, dntl hereby aulh0/lie
repre5entatives of tnis Gty to enter upon the above mentlonetl
properry for ir�ctlon qqrpo;ez. � '/�, Z
Siqna(ure K-�=i� �rr� Datela�
Drivers' License or 55 � ��"%� -
TVPE OF CONSTRUCTION
❑�/p1 EW ❑ ADD ❑ ALTERATION
UREPAIR ❑CONVERSION ❑DEMOl15H
❑ OTHER
DESCfuPTION OF WOqK �
TYPE OFNERMIT � �� '
❑ GRADING ❑ FOUNDATION LYSTRUCTURAL
❑ TENANT QELEC^RICAL OPLUMBING ❑MECHAI
�OTHERl� �^..Al.^w'�:�....�� -�e ,
PROJECT DESC/ fi�T10N
SQ. FT. S�
OCCUPANCY�-SF �C��OANS�TRUCTION TVPE �tt�
V ALUATI ON �f�JFJ�� ZONE
GRADING CU. VDS. ACRES
REMARKS:
PLUMBING . ' PLANCHECK
TOILETS
LAVATORIES
KIT.SINKS '
SERVICE SINKS .
FLOOR SINKS
DRINKING FOUNTAINS
INTERCEPTORS '
6792 6/0�4/82
A.P. i I�iI�
20NE
SETBACK GL 5�
SIDE YARD
LE�5
R�IGHT
REARYHRO(T
PKG. SPACE RE
STREET WIOTH
qPPROVED BY
CONDITIONS:
PLNG.REF.�
PROVIDED
7ARK FEE
ELECTRICAL PLAN CHECK'
URINALS 7RANSFORMER 0-3 KW_ 1-10 KW _
DOUBLE LAVS APPLIANCE 10-50 KW_50 + KW _
DISHWASHERS MOTOR$ 0-1 HP_1-30 HP _
SUMPS (�NC. SOLAR) 10-50 HP 50 + HP _
FLOOR DRAINS ' FIXTURES " OVTLETS SWITCHES
CLARIFIERS
PTRAP
A�TERATION
GASSERVICE � OUTLETS
WATER HEATERS BTV OUTPUT
SEWER CONNECTION$
THNK ' COLLECTOR$
ISSUE FEE
MECHANICAL r�Arv CHECK
HEATING SVSTEM 0-100,000 BTU_
AND DUCTING 300,000 + BTU _
REFRIGERATION 0-300,000 BTU_
SVSTEM 700,000 f BTU^_
BOILERS BTU
SVSTEM REPAIR,AL'
EXHAUSTSYSTEM
ISSUE FEE
` CMF 0865-46 White-Bulltling; Unary-Appliwnt; Pink-Accountin9: Goldenrotl-Assessor
ON
_TIPLE
GAS TVBE SiGNS
POLE LIGHTS
PFNELS MAIN ' SUB
SERVICE- AMP
' I�.00 TL
ISSUE FEE �
HPPLICHTION AGPROVED BY DATE
SUMMARV OF FEES
BUILOING /� �
PERMIT 5 LiG__ ' SMIP E
PLAN CHECK b PERMIT '
ISSUANCE E -
PLUMBING 5
GRADING $
PLAN CHECK E
ELECTRICAL S - E
PLAN CHECK g MICROFILM $ ' �
MECHANICAL S' - TOTAL FEE b
PLAN CHECK E LESS AD-
VANCEPC E_
��
FINAL FEE S
�
CONSTRUCTION AND PLANNING POOL & SPA, '' . �
APPROVALS Permit# ='380-3 Date Inspector qppROVALS Permit# " Date Inspector
1. Temporary Electrical Service or Poie - 43. Pool & Equipment Location �
2. Soil ipe-Undrgrn 44. Steel Reinforcement �
� 3. Electrical Conduit Utility-Undrgrn 45. Forms
4. Electrical Conduit-Undrgrn . 46. Electrical Bonding �
. tee ein orce 47. Rough Plumbin & Pressure Test
6. Electrical UFER Grn 46. APPROVALTO COVER-GUNITE
7. Footings 49. Electrical Conduit-Undr rn -
8. Foundation 50. Gas Pi e, ❑ Undr rn, Test ,
9. Water Pipe-Undrgm 51. Backwash Lines P-Tra � ndr rn
70. Structural Floor System 52. APPROVALTO DECK �
11. Property Sewer Line & House Connection 53. Backwash & Rece tor-Final
12. Street Sewer Connection ' 54. Heater & Vent-Final
13. Rough Plumbing
14. Rough ElectrioConduit ''� 56. � Electrical-Pinal
15. Rough Electric-Wiring 57. Solar SYstem-Final
16. Rough Heating & Air Conditioning - � encing & Access Approval
17. Ducts in Structure APPROVED FOR PLASTERING
18. Duc[s, Ventilating
19. Gas Pipe-Rough & Test 60. POOL/SPA SYSTEhAS FINAL
20. Roof Framing
27. Roof Sheathin
22. Frame and Flashing NOTES:
23. Insulation -
24. Lathing & Siding
25. Drywall Nailing
26. Plaster Brown Coat
27. Electrical Power Meter-Final
28. Final Electric
29. Final Heating & Air Conditioning
30. Final Gas Pipe-Test
31. Final Plumbing
32. Water Service-Final
33. Gas Service-Finat
34. $olar pomestic-Finai �
35. Landsra e S rinklin S stem •
36. Sound A[tenuation
37. Handicap Regulations
38. FINAL STRUCTURE & BUILDING -2-$a
39. Special Requirements Completed
40. Electric Release to Edison
41. Gas Release to Southern California Gas Co.
42. CERTIFICATE OF OCCUPANCY
No. Date
�\
�
1 Applicant to (ill in all
E, C�OF COSTA� MESA �PE.,,R_�MIT N(
• CONSTRUCTION PERMIT_I / '
Addrea
License
Address
Contractor
Address
w(lnln neavy bortlar Iines antl sign all aoP�ooriato oeclarations.
3� I�/�� LO�% . BLDG. NO.
c.�
TVPE OF CONSTRUCTION
❑ ❑ ADD ❑ ALTERATION
REPAIR ❑ CONVE0.510N ❑DEMOLISH
❑ OTHER
DESCRIPTION OF WORK
'I hereby afilrm Ihat I am IICGnzltl untlGr provl51o05 of Chdrte� 9(COm-
mencin9 with 5ection �000) of Olvlsion 3 of tne Buslness antl
Protasslons Cotle, my Iicense Is In full force gntl lacl.
ucense Class - �� � - � ��.� ��-3ES 07
Date ��'�'�'�Z' S19nature x ��
WORKERS' COMPENSATION DECLARATION '-
I hereby affirm that I have a certHiwte oi consenl to self-insure or a
certificate of Worker5'�Compensatlon Insurante, or a certifle0 coPy
thereof (Section 3800, lab. C.�.
Slicy No.- ComDany "
i Certifietl copy is hereby furnishetl.
.� Certlfietl copy is filetl with the city Builtling Division.
EXEMPTION FROM WORI(ERS'COMPENSATION DECLARATION
(T�is sectian neetl not De completea if the permit Is tor one nuntlretl
(5100) or Iess).
1 certify that in the performante ot the work for w�ich this perm(t is
Issuetl, I shall not amploy any person in any manner so as.to become
zubject to t e W kerz'.Compen5ation LyWcyt Ulljqnia„ �
, �ate Z $I9ndWre `�i/wn� �-�!�
I NOTIC : 1 tter Taking this tleclaratlon, you Shoultl be[ome Sub7ect
Ito the Wo�ke�s' Compen5atlon provl5iOn5 of the Ldbor Cotla, y0u muit
torthwith comply with such provislons or this permit shall be tleemetl
/2vOkCtl.- _ �� . _ _
CONSTRUCTION LENDING AGENCV
I nereby a(lirm that t�ore Is a construction lentling agency tor the per-
formantt ol [he work tor whith this permlt Ii i5suetl (Section 309]
�Civ. C.L — ' '
Lentler's Name
Lentler's AOtlress
OWNER BUILOER OECL'HRATION -
I heroby affirm t�at I am exempt tmm the Contrattor'S License law lor
Ihe follawing reason (SecHon-]031.5 Busineu antl Professlons Cotle:
Any clty or county whlch reqWres a p¢rmit to construct, alter,
ImplovB, tlC�110115M1 OI f¢palf any Slfucture, priof to It5155udnt¢, ali0 re-
quir¢z thC ap�li�anl lo� zuth permit to filt d SignGtl S[atGmOnt that he
Is Iicensetl pursuant lo lhe provl5ions a1 the Contractor's License Law
(Chapter 9(commencin9 with Secilon 7000) ol Dlvision 3 of the
Bu51ne5Sldntl Prof6non5 Cotle) o� lhat �e'IS examp[ [harelrom antl lhe
'�asis tor lhe allegetl exempllOn. Any v101aliOn O/ SeCliOn 7031.5 by
ry appliWnt lor a pt/mit subjects tlte'applicant to a clvil penalty
not more than 11ve huntlretl tlollars (5500�.
�]� I, as owner ot the proparty, or my omployeCs'with wages as t�eir
sole compensatlon, will tlo Ine work, antl the sVucture 15 not Intentletl
O! Off¢t¢tl !Or 5ale. (SeCtlOn 7044, Bu51n¢55 dntl R01¢SSIOnS COtle: Th<
Contractorfs Licenso Law tloes not appty to an owner oi a properry,
�wM10 builtls o� Improve5 iheraon, antl wno tloei sucn work himsel� or
Ihrouqh IIIS own empl0yCe5, prOvitlCtl tllat Such ImprovemQnti ale nOt
Intentletl o� offeretl lor SaIC. It, however, lha builtling or improvemant
I5 Soltl within One y¢a�.Ot COmplellon, [h¢ OwnCr wlll have Iho bu�tlon
of provinq he tlitl not bulltl Or Impwve lor lhe purpose ot sale).
❑ I, as ownm ot ine O�opertY. am exclusively contracting with
licensed rontractors to construct tM1e projoct (Sectlon ]044, Business
antl Grofesslons Cotle: The Contractor's Licenso Law tloes no[ apply�to
an owner of properly who builtl5 or improves thereon, antl wh0 com
traGts iram such pro�ects wi[h a COnVactor(s) Ilcesnetl punuant to
tne Contractor's licansc Law).
❑ I t tl $e tl B S P C 1 lhl5
TYPE OF VERMIT � ' ���
❑ GRADING ❑ FOUNDATION �$TRVCTURAL
❑ TENANT ❑ ELECTRICAL OPLVMBING ❑MECHN
❑ OTHER-
PROJECT DES/ C�RIPTION . . .
SQ. FT. �!Q�� � /',�����
� OCCVPANCY��CONSTRUCTION TVPE 1�69
VALUATION��,pv ZONE
GRADING CU. V�S. ACRES
REMARKS:'
PLUMBING
BATMTVBS
TOILET$
LA V ATO (31 ES
KIT. SINKS -
SERVICE SINKS „
FLOOR SINKS �
DRINKING FOUNL
INTERCE TOR ,
wATER
GAS SE
33
- PLAN CHECK -' '
SHOwERS
.� URINALS -" '7
DOUBLE LAVS
DISHW SHERS
SUMPS
FLO R NS
i '
ARIF E S
P TRAP
ACTEf3ATION " '
OUTLETS
SOLAR TANK COLLECTORS'�
SOLAR PIPING SVS. �
�SSUE FEE � -�
MECHANICAL PLAN CHECK
HEATING SVSTEM 0-300,000 BTU_
ANDDUCTING � �OO,OOO+BTV_
REFRIGERHTION 0-300,000 BTU_
SYSTEM 100,000 + BTU ���'
amexemp un er c on . .. or BOILERS BTV
reason- � -- —
Datc pw�er SVSTEMREPAIR,ALTERATION
I he�eby ceriity thal I �ave �eatl lhi5 apP����ion antl 5[ate that the aDov¢ EXHAUST SVSTEM MULTIPLE
information is correcL I a9ree to comply witn all city antl county
ortlinances antl ila[¢ laws relating to cOnStruCtiOn, dntl h¢r¢by autnO�iie
representatives of this city t enter uPon the above menlionotl
property for Insp�I- pur 5.
Siqnature T� � � Da[e S'���� '
Driver5' Lirense or 55 � ISSUE FEE
��
`.\ CMF 0865-46 White-Builtling; Canary-Appliwnq Pink-AccounUn9: Goltl¢nrotl-Assessor
6179 5/21/8�
20NE
REAR VARD �TO P/L)
PKG. SPACE REQ.
STREET WIDTH
?ONING APPqOVED BV
REGULATIONS
�
PLNTGp. RUEF�. p� '
PROPE�RTVNLINE
PROVIDED
PqRK FEE S
OHTE
EIECTRICAC - �- PLAN CHECK
TRANSFORMER 0-3 KW_ 3-30 KW _
`APPLIANCE 10-50'KW_SO+KW _
MOTOR$ '" 0-1 HP_1-10 HP _
(INC. SOLAR) - 10-50 HP 50 * HP _
FIXTURES OUTLETS "$VJITCHES'
GNS TUBE SIGNS
POLELIGHTS -- ' ,
PANELS MAIN
SERVICE "' - - -
ISSUE FEE
'APPLICATIOMAPPROVED'BV - '
SUB
AMP
10.00 TU
SUMMARV OF FEES .
BUILDING
PERMIT 5 '�Q� . SMIP 5
PLAN CHECK S 7ERM1T '
- -- ISSVANCE E -
PLUMBING E �
GRADING. S
PLAN CHECK S ,
ELECTRICAL �S $
PLAN CHECK E � ' - � MICROFILM $ '
' MECHANICAL $ TOTAL FEE $
PLAN CHECK § ' LE55 AD- � �,
VANCEPC $_
� i'
FINALFEE E_�L�
� _ �
CONSTRUCTION AND PLANNING � � POOL & SPA ' . �-
APPROVALS Permit # T� 3�37 Date �nspector qppROVALS Permit # � Date � Ins�ector
, -
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location
2. Soil ipe. Undrgrn - 44. Steel Reinforcement � - - -
3. Electrical Conduit Utility-Undrgrn 45. Forms
4. Electrical Conduit-Undrgrn • 46. Electriwl Bonding '� �
. tee em orce 47. Rough Plumbin & Pressure Test - �
6. Electrical UFER Grn 48. APPROVALTO COVEq-GUNITE � - �
7. ootings � 49. Electrical Conduit-Undr rn �
. 8. Foundation 50.. Gas Pipe, ❑ Undr rn, Test ' �
9. Water Pipe•Undrgrn � 51. Backwash Lines P-Tra ❑ ndr rti ' �
10. Structural, Floor SYstem 52. APPROVAL TO DECK � " ' -
11. Property Sewer Line & House Connection _' 53. Backwash & Rece tor-Final "
12. Street Sewer Connection � 54. Heater & Vent-Final
13. Rough Plumbing -
. 14. Rough ElectricConduit - • - �56:• Electrical-Final
15. Rou h ElectricWiring � - � -� - 57. SolarvSystem-Final '
� 16. Rough Heating & Air Conditioning -- � - • encing & Access Approval
17. Ducts in Structure � ' APPROVED FOR PLASTERING ' ��
18. Ducts, Ventilating . . • _. � . . ,_ �
19. Gas Pipe-Rough & Test ' � 60. POOI/SPA SYSTEMS FINAL � �
• 20. Roof Framing ' � � '
21. Roof Sheathin � ' � '
22. Frame and Flashin NOTES: �
23. Insulation - � � �
24. Lathin & Siding. - - -
25. Drywall Nailing ' �
26. Plaster Brown Coat � ' -
27. Elect�ical Power Meter-Final ' �
28. Final Electric �
29. Final�Heating & Air Conditioning
30. Final Gas Pipe-Test - � � �
31. .Final.Plumbing ' �
32. Water Service-Final
. 33. Gas Service-Final -
34. Solar pomesticFinal � ' - ' '
35. Landsca e S rinklin S stem
36. Sound Attenuation
37. Handicap Regulations ' � � � � �
38. FINAL STRUCTURE & BUILDING � � -�- � �
39. Special Requirements Compteted
� 40. Electric Release to Edison '
41. Gas Release to Southern California Gas Co. -
42. CERTIFICATE OF OCCUPANCY _
No. Date
� AVOlieanl lo flll In all s
��CfTM,IF COSTA MESA �PE�^ iT NO_.
COiVSTRUCTION PERMIT I .G'S -.�
Address
Address
wlt�l� heavy bo�0a� lines an0 slgn all a0D/eP��ate tlaclarallon
TRACT ryO. LOT NO. BLDG.NO.
i/ i I., ni 1 : i i
TVPE OF CONSTRUCTION
Phone ❑,�, �NEW ❑ ADD� ❑ ALTERATION -
LCREPAIR ❑CONVERSION ❑DEMOLISH
liCense No. G � ❑ OTHER
LiESCRIPTION OF WORK
_ ...__' __....... ,�/
, Addre55 - tL / ❑ GRADING ❑ FOVNDATION 1�J STRUCTURAL
LICENSED-CONTRACTOR DECLARATION. . ^ �� ❑ TENAN'C ❑ ELECTRICAL ❑PLUMBING ❑MECHN
�I hereby affirm thW 1 am IiGans¢tl untl¢r p�ovlSions ot Chdrte� 9(Com-
'Tendng wilh s¢CtlOn 7000) of OlvlilOn 3 of .lhe Businoca- antl ❑'OTHER
Profossions Cotle, ;ana my Ilcense is In tuu iorc� �Sy��ct. pROJECT DESCRIPTION
�'LlcenSa Clasz � ' Licansa o. '
oate �i'/4-fiL St9nature - ' .�S�.FT. �Nav' �
WORKERS' COMPENSATION OECLARATION . _OCCVPANGV.a��F CONSTRUCTION TYPE �L
I hereby atfirm that I have a certlflwte of <onsent to selt-Insure or a � OG
'.certifiwte of Workers' Compensation Insuranca, or a certllietl wpy . VALUNTION ZONE
thereof (Section 3800, tab. C.). GRADING CU. VDS. ACRES
"IcyNo. 'Company - � - � - - -
=ertifietl copy is.nereby turnishetl.. __ . pEMARKS: - � �� Q �
� CertifieG copy is tiletl with the city Builtlin9 Divis{on.
�EXEMPTION FROM WOftKERS' COMPENSATION DECLARATION ' � - �
(This section neetl_not,De completetl i(ihe permit iz for one hunaretl �
(E100) or less). - ' ' '
I certify that in lhe pertormance of the work for which this parm�t Is
,Issuetl, � snall not employ any pe�son in any mdnne� So as to becoine PLUMBING'. ',f,PLAN CHECK -
subject to the Workers' Compen5ation �`�,v`rs o�f Cali/o � ��Lf
'Date �-�q'&2- Sl9nature � �+i•� ��+'� BATHTUBS SHOWERS- -
NOTICE: If after makinq thls tleclaration, you z�oultl betome�subject TOILETS - URINALS" ' - '
ro the Workers' Corrmpensalion provisions of tne Labor CoOe, you muzt �
�fOrthwith COTpIy with such proWSlOns Or this p¢rTit Shdll b¢ tleemetl �.VATORIES DOVBCE LAV$ '
�evoketl., . • �
CONSTRUGTION LENDING AGENCV � KIT.SINK$' " DISHWHSHERS
�I hereby aflirm that�[h¢re is a.<onstruttlon lentlin9 a9ency for tbe per- SERVICE SINKS SUMPS " ' '
iormanc0-ol_the work for �whic� this permit,ij IzsuoO�(Settion 309� ^- �� + -
�LsnEer,s Name �' - � � � ' _ .�+^ �FLOOR SINKS --- " FLOOR DR'AINS. �
I.CnQ¢r^5'Atltlresc^ ^c^ ^^^_•^. � DRINKING�FOUN'TAINS -
Ibe'followln9 rGdion
Any�..tlty br count
ImprCve, tlemolisn or
quves the,aq:��cant '�
IS I1CC05¢tl pOlSOdOf 1
(Cnapter 9 (comme
Business antl Prdezsi
tcgts for.the allegetl
\��' aPPliGint Aor a
F�=�ol mOIG �han �i'
�i_] I, as ownm o6 tn
�sole compensatlon�W
br oHeretl for salc. (
to'construct, al(er, SWIMMING POOL
:o It5lfsuan<e, also re= y./;qTER SERVICE
atl statpment tnat ho -
lraclor's Licenie Ww GAS$ERVICE'
ol Dlvlsion 3 0/ the
tpt therefrom antl lhe y�qTER HEAT- R:
>i $ectlon 7031.5 by -
mt to a civil penalty' 'SEWER�CONNEC'1
s with wages a5 lheir. SOLAR TANl( `-,
uctuPc7e'notintentleap -
�rofe55ioni�Cotle: The SOLAR PIPING 5\
CIARIFIERS - �
PTRAP" .
-ALTERATION
OUTLETS -
BTU OVTPUT -'
J$ '" �'
�COL'-CECTORS
wno ounos or improves mereon,- ana wno aoes sucn worK mmseu or ISSUE FEE - -
through his own omploy¢es, Drovltletl that suCh imp�ovam¢nl5 a�a��nOt
intentlea or olteretl lor.sale. It, nowevar, tha ouiltling or improvem¢nt MECHANICAL PLAN CHECK
is Soltl'wilhiKonc ear Ot Com �I¢tio� thC Owne�_will. have IhC burtlOn.
oi' proving. h¢ tliE�nOt buildPor improve IOr the pur0o5e Of salej. HEATING $VSTEM. 0-100,000 BTU
'0 �I, �as owner oh'the -propurty, �am'-ezclusi`vary 'contnctlng. ivR�' - qND�DUCTING + ' � - � �
licensetl contractors to construct tne project (SecUon ]044, Business , 100,000 + BTU
antl Proflssions� Cotle: Tne Conbacior'S LICen50 Ldw tlOez nORdpply t0-
an owner ol property who builtlz or improves tncreon, antl who <on- REFRIGERATION 0-100,000 BTV
tracls /rOm su<h projeCls with a conUactor(s) II<aSnatl pu�zuant lo� SVSTEM -
the Contractor'S License Law). 100,000+BTV ' (
❑ I am ezempt unCer Section '8. 6 P. C. for tnls' gO1LER5 BTV
reason- - �- .
Date Owner SVSTEM REPAIR,ALTERATION
I he�eby certify [hat I hav¢ r¢atl thiz application antl siate tha[ [he abOve EXHAVST $VSTEM MULTIPLE
ififoimation is correct. I agree to compiy with-ail tity ana county
ortlinances antl s[ate laws relating to cOnstruttion, dntl h¢r¢by autho�iie
rcpie5enlativ9a�yf'this city�j0 ¢n[¢r upon the a�ove mp,�ltiOnetl
519nature ��d¢,C�' v��� Date `//U/ X
�Drivers' License or 55 � .� � '' i55UE FEE
CMF 0865-46 White-Builtling; Gnary-Applicant: Pink-Accountin9: Goltlenrotl-Assessor
4918 4/21/82
ZONING REGULATION
A.P. �F Ir-JI -�{ I - CtN
ZONE �'}'� PLNG. REF. �
REAR VARD (TO P/L)-
PKG. SPACE REO. Qf
STREET WIDTH�
LONING APPROVED BV
:PECIAL CONOITIONS:
1
73.92 TL�
PROVIDED
PARK FEE 5
� DATE gZ
�
ELECTRICAL a�arv CHECK --
SID. F�—
GENERATOR 0-1 KW_ 1-10 KW '
TRANSFORMER -�
APPLIANCE 30-50 KW_50 i KW �-
MOTOR$ 0-1 H�_1-30 HP
(INGSOLAR) `'10-50 NP_50�� HP• ' .
FIXTURES - �'OUTCETS _ SWITCHES ' '
GAS TUBE SIGNS. - � - �
POLE LIGHTS ' -
n�� ��v -
' �PANECS MAIN ' SUB '
' - �SERVICE • � - AMP �
1
" ISSUE FEE ' - ' ' ' I I �
APPLICATION APPROVED BY - OATE
$UMM MARV OF FEES -
BVILDING /�,//
PERMIT S ��� �T�^'_�� �, SMIP . S .• SO '
PLAN CHECK E 'y'�, �p�� � PERMIT
; .ISSUANCE S�
PLVMBING
S
-57�
GRA�ING E' �`
PLAN CHECK 5 , �
ELECTRICAL 5 E ..
PLANCHECK -S _MICROFILM E_�
MECHANICAL § TOTAt_ FEE S �
PLAN CHECK E - LE55'AD- '
VANCEPC S_
J FINALFEE SZ3•9�.
n
BN FORM 116
BIA FORM 1486
INSULATION CERT1FItATiON
This is to certify that, in conformance with the current energy regulations (California Adminis-
trative Code, Title 25, State of (alifornia*) and approved plans, insulation has been installed in
the building located at:
2853 Drake St.
Stree� No, pf Aveilahte) Strset
Lol Number
co���i
DESCRIPTION OF INSTALLATION
ROOFS
TYpe of Material Manufacturer
Tnct No.
Thickness R Value**.
EXTERIOR WALLS
TYpe of Material Manufacturer Thickness R Value**—
(Or Tnde Name)
CEI�INGS
BATTS:
Type ot Material Manufacturer Thickness R Value*'—
(Ot Tnda Name)
Sq. Ft. Covered
BLOWN:
Type of Material Fiberglass Manufacturer Certainteed _ Thickness 6��� No. Bagszb
(Or Tnde N�me)
Wt./Bag Z6 • 5 Sq. Ft. Covered-50 R Value** 19
FLOORS
Type of Material Manufacturer Thickness R Value**_
(Or lnda Name)
SLAB ON GRADE
Type of Material Manufacturer Thickness R Value**�
(Or Tnds N�me)
Width of Insulation Inches
FOUNDATION WALLS (if required)
Type of Material Manufacturer Thickness R Value**�
(Or Tnde Neme)
REMARKS (if
General Contractor (Builder) Fisher Insulation License Number z67769
Date
Su4.Contractor (I auf pplicator) Fisher Insulation License Number z67769
r(Imul�llyn. Maaonry, (Sbte "SAME" If ame u Csnenl Contne[ar)
— 7itle���a� �� Date �� 2
I•Collfornio Admini�tmuve Code, e Insulation Sbndard�, dadans: E%CERPT hem Sa<. 79873 of the Hsalth and Safery Coda of fhe Sfale
"Cemo��an<e. Upan cemplaiion of Ihe in�fallalion of In��lation, a card of Callfornlo�
c�rlify��c �M1e� �he inmlation ho� bean insfallad In conformmm wiPo fhs
rpeiM1menh ef Pona rpvloflem �hall bs com0l�rod and aaecvted by "No certifimle o( occvpancy or simllar ttrtlfimlion fhaf a nswly �em
�h� lmulatlan opplimror and by fha ballEx. Thi� im�lotion mmplionm tlr�cbd helel, motal, aoa��mant houaa, homs or oPoer n�idenNal
wrd iholl be owfad al a wmo�Noes lomtion wiMin �h� dwd�ina.") dwallinv i� hoblroble shall be i�iusd by s�ch a bvildinp depvrtm�nt
unlms the �Irvqam at lea�t mtidin Ihe minimum meryy inmlalion
(^R �alue i� tM mwsare of Iha �miimnm of a mahrWl or beildinq imMards natablished D��suaM to tAlr cAo01m."
mmoo�enl te Ihe oasnpe ef heoL The rmi�tvnca rol�a (B) of mass�ry0e
insulatiens �hall not indude any valve fx n0ecfive lacinp.)
Form 116 —o BUILDING NEWS. INC., 3055 Overland Ave., Los A�eles, Calif. 90034---1213)870-9871
Form 1486—o BUILDING INDUSTRY ASSOCIATION OF CALIFORNIA, INC., 1571 Beverly Blvd., Los Angeles, Calif. 90026--(213) 6255771
�
�
�
' ���5�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 CABTA MEBA. CALIFORNIA
For Applicant fo Fill ln Complefely
TYPE OR PRINT
ADDRE'SS 2853 Drake Avenue
COSTA MESA. CALIFORNIA
OWNER Mesa Del Mar Development Co.
ADDRE553SOO E. C.OSSC H1gt1W8y
cin Corona del Mar NobR 34220
ORCENGtNEEi�A2CC0 COL. -TN`�AR 34220
arr Corona del Mar, Calif.
ucTrEio. 98808 SB-1 Na: OR 34220
oF �or 6000 SF I�o. o. e�
NOW ON
���� �� None
96iBACK LIN6 FROM
csN'ren oP srxEer � REAR VARD
I $� I $,
SIOE YARD LEFT RIGHT
DESCRIPTION OF WORK
mww I}t II a� rvasr�nu I II anmr�nu
O. OF
�-6��X6%�-lO OOMS
attached garage
1 HEREBY ACKNOWLEDGE THAT 1 HAV6 RP.�D 'fi118 APPLIWTION
PLY WITHeALLA ITY ORDINANC¢9 AND BTATE LAW6RRlGUI.ATIN6
BUILDIN6 CONBTRUGTION. - . . -
81GNATURE OF Mg�P, DEL MAR DEVBLOPMENT CO
IA THORIZED
FE,E RECEIVED
� JUL 121So1
FINANCE DEPT.
CIiY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
HECEIPT NO. ���(� _]
����
weceiveo er I owre necerveo I owre �eaueo
GOSTA MESA. CALIFORNIA
FIRE
ZONING
ZONE n✓ I I PLAN9 � I BIy11lDiN6
/�
,
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ccermx uxe er.�
77 /
7.�//"G �
Living Area - 1306 SF
Garage Area - 414 SF
Cov Porch - 210 SF
TXE AMOUNT BXOWN UNOlR VALt1AT10N 18 POR TH6
PURP08E OP EBTpBU8HIN6 I� PERMIT pCE ONLY.
VALUATION '/
PERMIT FEE $��Y �
$ Z�F�O9H.00 pLAN CHECK $� / �
/ / Od
� qpplicam to fi11 in all spaces within heary bo�tle� lines an0 sign all app�oD��ate Ceclarations. �JBB3 �j/ � 4/fi2 ( 1�7��0 T�
'f � OF�COSTA MESA ' PERMIT NO.' / TRACTNO�. LOT NO. BLDG. NO. .
i �CONSTRUCTION PERMIT J� 3SeS_(p ' �' .
rm�ec� �+aaress � ' TYPE OF CONSTRUCTION
Owner � Phone ❑ NEW ❑ AOD -❑ ALTERATION
AddrEa' �_ �EPAIR ❑CONVERSION ❑DEMOLISH
`Arch/Eng. - - ' LicenSe No. � ❑ OTHER �
� Addr¢55 _ . DESCRIPTION OF WORK
� � Contracror _ � Phone - ,TYPE OF PERMIT - • � ' '
� • Addfe55 y� - l. , - ❑ GRADING ❑ FOUNDATION �STRUC
� LICENSE CONTRACTOR OECLARATION !' ' � O TENANT ❑ ELECTRICAL �PLUMBING �'
I hereby affirm th:,t I am Iicensetl untler provisions of Charter 9(com-
(� menUn9 with 5ection 7000) of ' DIv1510� �3 0� tha-Busin¢ss antl -� OTHER �-
Aofessions Coae, antl my Iicense is �� �u❑ for<e antl effecL � pROJECTDESCRIPTION
Litense C�lass � "� � � � - - Licens o.�G'�S`�O`7' � - - -
Dale �''I'.:-SYl. Si9nature nyrv.; � �^/L�' � SQ. FT. �1 iiG
v WORKERS' COMPENSATION DECLARATION .. OCCVPAfVCV��CONSTRUCTION TVPE �
I hereby atfirm that I have a tertifica[e 0� consen[ to self-Insure or a VALUATION �• •oC ZONE
\ �¢rtiticate ot-Workers' Compensation InSurance, or a certiflatl <opy -
,� thereof (Sectlon 3800, Lab. C.). GRADING CU.�VOS. ACRES'_
'cy No.� Company' '
• .ertifieU topy Is hereby fumishetl. . . . _ . REMARKS:
� � Certifietl topy Is 111etl with the city Builtlinq Divlslon. , -
J EXEMPTION'FROM WORKERS' COMP6NSATION DECLARATION �
�(This 5ettion. neetl.not be completetl if the, permit Is for one hunqre0 _.. _ - �
SS300) or 1¢551.
.C¢rti(y, thdt in Ih¢ p¢rtOrmanCe of the Work tor which thls permit is
issuetl, I shall not employ any person in any manner so as to�be<ome PLUMBING' PLAN CHECK
sub�ect to the Workors' Compensation w5 of Califo •
�Date � Slgnature �� °-� �'���'�✓� BATHTCIBS SHOWE0.5 -� �'
NOTIC : If aRer making this tleclaration, You shoultl become 5ubject � TOILETS�. ,VRINALS ''''
to the Workers' Compenzatlon provisions Of tne Labor Cotle, you must
forthwi[h compy with such provisions or this permit shall be tleemetl �VATORIES� DOUBLE LAVS
revaketl.
CONSTRUCTION LENDING AGENCV KIT:SINKS ,i DISHWASHERS�/ -
I hereby atfirm that there is a constructloq lentling agency for the per- SERV ICE SINKS ' •SUMPS ' "'
(ormance of the work for whith this permit is issuetl (Sectlon 309]
Civ. CJ. ' ' - '- ' FLOOR SINKS � FLOOR DRAINS
Lentler's Name
Lender's Atltlress DRINKING FOUNTAINS ' - -
OWNEq BUILDER DECLARATION -' -' jryTERCEPTORS CLARIFIERS
I M1e�eby allirm that I dm eaemp[ from thE Contraclor'S Llcense L.aw far
the'followlno reason f5ec[ian 7031.5 Business antl Professions Cotle: SWIMMING POO --
qwres me ap4��uin� io
Is'licensetl pursuant to
(Chapter 9 (commen�
BO510255 dllfl'PfO/Q5510i
's for tne allegetl e
appllWnt to� a p
A[ mOrE thdn live
�J I. ds owner of tha
or
h �equires a Pe�mit to ConSiruct, alter,
�dOY SGIICLUfE. Pl�OI IO IIS ISSIIdOCC. dI50 fC-
� Oermit to (i18 a signetl statem¢nt tha[ h¢
�rovisions oPtne ConVactor's Llcense l.aw
vith Settion 7000) of Division 3 of the
]e) or that he is exempt thereirom antl tlte
lion. Any violation of Sec[ion 7033.5 by
subjects Ihe applicant to a clvll penalty
rea tlollars (5500�.
•rty, or�my errMPloyees with wages as their
he work, an0 the sGucture Is not Intendetl
7044, Buziness antl Prote55ion5 Cotle: The
oes not, appry to an owner o/ a property_
reon, antl wh0 tloez Such work nims¢It or
orovitletl that such,improvem¢nts are nol
Intentletl o! of�evetl �or sale. If, M1owever, [ne ouuaing or impfovement
Is 5oltl within one year of completion, the o`/�ner will have [he burtlen
of provinq he tlltl nol builtl or improvC for th¢ purpose of sale).
❑ I, as owner ol the property,' am e%�IuSively contracting luitn
licensetl contractorz to construct the project (Sectlon ]044, Business
antl Professions Cotle: The Contractor's License Law tloes not apply to
dn owner Of prOperty wno builtls or improves thereon, antl who Con-
tracts Irom such Projecls with -a-con[rattor(5) �11<e5n@tl pursudnt do
the Convactor's Ucense Law�.
❑ I am exempt untler Section "_— B. 8 P. C. for this
reason
Date Owne�
I her¢by Certify thal I have �eatl Ihis appliw[ion antl Stale that [he above
information is correcL I a9ree to �comply with all city antl county
L P TRAP �/
WATER $ERVICE ALTERATION '"
GASSERVICE - - OUTLETS �
WATER HEATERS ' BTV OUTPUT ' '
SEWERCONNECTIONS ' +_ ,�i
SOLARTANK ' - COILECTORS,�
SOLAR PIPING SVS. � � - �
ISSUE FEE ��� � - � �
MECHANICA� PLAN CHECK
HE TI 0-300,000 HTV
AN �j 300,000 * BTU
REFRIGERATION 0-300,000 BTU
SVSTEM� -- - ' j00,000 I BTU
BOILERS BTV
SVSTEM REPAIR, ALTERATION -
EXHAUSTSYSTEM MULTIPLE
prtlinances a state laws relatlny[6'Ly nSiNction, antl he�eDy autho�ize
represenl ve 1 lhi5�6ity�CO e-C¢r upon th¢ above m¢ntlonetl
property I r Ins ettlon purpo
$i9natur¢ �� ate �%� � �
Drivers' License or 55 � ' ' �
' ' ISSUE FEE
CMF 0865-46 While-Builtling; Canary-APP�icanl; Pink-Accouniin9: Goltlenrotl-Assessor
i
A.P.9f . _ .-
ZONE '". PING. REF: �
--TFQTC6Tl�T(; . . . rn o� ��� .��tir_ .
_ �F ...__ � � . .
ECHANICA 51p E Y • - - - �
RIGMT
REAR VARO (TO P/L) — - - -
" PKG.SPACE RE�. � PROVIDE�, '�
� � STREET WIOTH� " PARK FEE S
ZONINGAPPROVEDBV ' .- OHTE
SPECIALCONDITIONS: � ' -
9
N•
ELECTRICAL - PLAN CHECK
GENERATOR 0-1 KW_1-10 KW '
TRANSFORMER , '
APPLIANCE' 10-SOKW_SO+KW .
- .MOTORS ' p4 HP=170 HP
.�. ._ _ !(INC.SOLAR) 30-50HP_-50+HP -
- FIXTURES' OUTLETS ' SWITCHES" ' - '
GASTUBESIGNS � � � - �
. .POLE LIGHTS - � - �
A.__ ' .._. - �_ . _.
�PqNELS' MAIN SUB '
' ' SERVICE - - AMP -
!_ _
0
' ISSCIE FEE - - - - -
-APPLICATION APPROV ED BV DATE
SUMMARV OF PEES, � � �
,BUILDING � -� ' - '
PERMIT $ - -SMIP S
.PLANCHECK E PERMIT .� i
� ISSUANCE 8
PLUMBING $�� - . ,
PLANCHECK § �GRADING E
ELECTRICAL—$ - - s
`PLANCHECK-$ - MICROF�LM,'S � �
MECHANICAL S — . TOTAL FEE S �
PLANtHECK 5� _ _ LESSAD� .
'VANCEPC 5_
. _ FINALFEE E�
CONSTpUCTION AND PLANNIN
t
APPROVALS Permit #
1. Temporary Electrical Service or Pole
2. Soi ipe-Undrgrn
3. Etec[rical Conduit.Utility-Undrgrn
4. Electrical Conduit-Undrgrn
. tee ein orce
6. Electrical UFER Grn
7. Footings
8. Foundation -
9. Water Pipe-Undrgrn
10. Structural Floor System
11. Property Sewer Line & House Connectio�
12. Street Sewer Connection .
13. Rough Plumbing
14. Rough Electric-Conduit
15. Rough Electric-Wiring
16. Rough Heating &�Air Conditioning-
17. Ducts, in Structure
18. Ducts, Ventilating
19. Gas Pipe�Rough & Test
20. Roof Framing -
21. Roof Sheathing �
22. Frame and Flashing
23. Insulation
24. Lathing & Siding
25. Drywall Nailing
26. Plaster Brown Coat
27. Electrical Power Meter-Final
28. Final Electric - -
29. Final Heating & Air Conditioning
30: Final Gas Pipe-Test
31. Final Plumbinq
37, Handicap Regulations
38, FINALSTRUCTURE&BUI�DING '
39, Special Requirements Completed
40, Electric Release to Edison
41, Gas Releaseto Southern California Gas Co.
42, CERTIFICATE OF OCCUPANCY
�No. Date
Date Irispector qppROVALS
' 43. Pool &
44• Steel R
45. Forms
46. Electri
47. Rouah
POOL & SPA . � �
Permit #_
Equipment Location
A ��
�Date Inspector �
emforcement � - - - - • �
cal Bonding � - . - -- ' ' ' - �
Plumbin & Pressure Test- -• -
�VALTOCOVER-GUNITE-�• - �• - -
al Conduit-Undr rn
�e, ❑ Undr rn, Test " • ' �
ish Lines P-Tra '0� ndr"rn ' '
�\/A1 T/lll['/�V ' ^ • '�� -
. - renany a rccess r�ppruvai
. APPROVEDFORPLASTERING
60. POOL/SPA SYSTEMS FINAL J
NOTES: J- I t�,y,'R�'=e � 1 I3.- �Gl.biN p�'
� �� - ��� �..�
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