HomeMy WebLinkAbout3123 CORK LN - Building Permits`r�
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�ooxEssoFem�owc:_ 3123 CORK LN �'
°""ERs"""E"'°'°"": SCOFIELD, CLIFFORD C
""��� 3123 CORK LN
COSTA MESA,CA
�cri. �uuxc �ooxess:
ARCHRECTOHEIM�NEEN:
RCH.OH ENG.'S ADDRE55:
uxT`
�� � FLOOD: X _ �46
92626
uc. xo:
UNT:
��u�T� � SENTRY_ROOFING CO (719)751-7663
CONfHACTORSYAIIING 3364_NEVADA
eooxEss, COSTA_ MESA CA uc.ra.: 678801
92626 uNt:
LICENSEO COIRHACTOHS DECLRPATION: I hereby ellirm under peneXy d pe�vry thel I em Icenaed uMer prmisiona W Chepier 9
(mmmancng wiih Seni 'lo0a W Drvisbn � d �he Buaineae enE PMesaione Code, eM my license u in full force end eHxt.
cmuc.No.: 0_6 4 9__uacuss: C-39 uc.No.: 88 E Pi. 10%9.6
Dete' ConVatlor. 'CAL
OW NEP BUILOEP DEC ATION: 1 Mraby dfirm uMer panely d perN�' �� I em ezamq tmm IM Conlretlon ' nae Lew Iw �M1e
Idlowiip �eaton (SeGpn l 1.5 Busnesa ard Proleviana Cade: Any cIY a oounlY �id� reQuiree e pe�mA �o aonsWCM. elle�. imp�ova.
Eemoleh, or roper any eWcwre, qiw �o na eauence, eho requirea �he epplicen� for euch pe�mmil lo file e aipned sietamant �hel he or eM
is IicenseE W nuent lo iha 0��'iaiana d the Comredon License Lew �Chepter e(mmmendip wilh Sed'an laoo) d Divwion � ol �he
�usirreas end PrMesabm Code� or �hat M a ehe ia exempt Iherehom eM ihe beaia lw the elbped mempion. My vbletpn M Sedion
13t.5 by any apWie�ant lar e permn wbjeeu ihe epplcenl lo e dvil pereXy ol nd more ihen Me hundred ddlen �5500�).
�] I. en owner d �he propanY a my empbyeee weM1 weg» m Ihei wb wmpammion, will Eo IM wwlc, e�M Ne al�ueture c m� inieedeE
a MereE la sale (�� )�. BusiressarM Prdessions Cade: TM Conlretlan Lioense Lewdaea rot eppyto en ow�ror d propaily
wla buida a inpmvea �Aareon. arW who doeo auch xork M1msell or hene� «Mraph he a har ovm employeea. povided thm wch
'mpwemem� ere not imenEed a o1�ereE Iw eeb. M, Iwwaver.IM Wikirq «mpo.emenl o add wilhin me yeer d mmpleiion, tM
ownmbutldar wi0 heva iha burden d proviip M or aM did m� Wik or impare fa tM WT�e M Wa).
� I. es axnar d the propeny. em e�clusrvey conlred'np wilh limnsad wnireciom lo mnstrutl IM P�M� (Seaion J01d. Busirimn aM �'�i
Profesaionn COEe: The Contreaon Lironse Lew Coes iwl epply to en awnm d propaM � buiNe ar improvea thereon aid who �
comrecte Iw eucn o�Mena wnh a mnvazmr�e) Icensad pwauan� ty11S&V�plrectma Licanae Lew�, �,
� I em exemq ander Seclion: 8. 8 P C.. br I�is ra�ep %� ,
i�f�
Oeie: o»,�er: �TO
i eo nareev �nar mv i� a.�.a a�a ���,d ma �.a���,e�a a c�eomr �.nn �d ser�v coee saa� uws, zssu, .�e
25531, eiM thet I a eny Mure Wiki�q ampem will / wil nd (arcb wre) need lo camply wYh aek aeta mdm vd iha repuiremmM1 M
epeimilfpcotqVuclionamodificmionkanlMA'e ue�y erepamanlDistna.ReakemielmruVupionepplutbmenexemqtromthsse
Drwisims.
oa�e: nvW�c
WONKEH'S COMPENSRTION DE0.ANRTION: I Mreby elfiim under peridiy d pxjury aro d the lollowirp dadvm'vre:
❑ IheweMMilmeintenecenil'raedconunitoaeX�inwreforxaken'wmperpetion,mprovidadlwbySeqion3>OOdiMLebor
Code. ia lM perlormerce d iM wwk lu whic� �hia permn ia iaued.
❑ � ne.e ena wi� melmen wonferm• mmw�wun iruureeo. a, mpuirae M smbn a]ao a ma Leb« Coae. I« �ne oerlormeMe d ine
w«k la xfiM thie pamiil o bsueE. My wakeii mmpensetbn inaurarce wner eM pdiry number ere:
c�a.:
Polcy Number:
�s sMion need no� 6e can0lerod d Me permit ia br one hundred EWlers �SI00) w IesvJ
I cenM �he� in the perlamence W tha wark ror whch thia parmN is iaeueJ. I ehell m� employ eny pemn in any menner eo es lo
become aubjed io ha Aers' compeme�ion lewe d Celilomie, thtl A I ey� bxmie wbjea to IM wMnn'
companaeiian vra bn 1 Seaion a�ao W ine lebar Code. I s�ell lo �nwX Oh - 1 ���si
Oa�e: r App'raN:
Waminp: Fsllun b hcu worken'rompxuatlon rovorapsls �n/awNl, entl ihe/l �ubJoct en �mployn fo Nm�.i o.�,ro.,.�e ,
c/vll flm� up ro on� hunArM MouunJ rbll�n (5100,000), In arK/Hon ro Ih� cw! o/ ro�veruaf/on, Mm�pe� �s proNJW br In
SwHon 3](I6 0l Ms Lebor Cotls, Infsn�f, erW ettomsy'a /so.
CONSTFIICTION LENDINO AOENCY: I hareby �rm unJer penelly ol parjury Ihet iMre ia e mne�ruaion bndiip egency br iM
�,nom,�� a ina wn m, .n��n ine v�a �a m.�ea lswo� aos�, ca, c�.
LENDEN'S N4ME:
IENDEW4 1DDPE55: �
I ceniy Iliet I heve reeE ihia epplira�ian eM ame thei the ebove intorme�un ia cortee. I pree Io epnpty wi�� ell ary eed ooumy adinarcee
eM sieta lewa raWip ta buildnp wnsUiWun eM M1ereby eWiorae repasenteiivx d Ihn Nty 10 enter upon ihe eEwe-mantioned vmpeny
forinsoection vurV�a,
AN HI L
t Neme /� y /
^��/ / Dma: _____t!J I
9 u, I er penVA P �nlmda �
(5151<6 WP) WM1de-Buildiq 8 Selery; GreeirFle: Canery-I�ppifani; pink-Revenue; GoldenioFMaevor
� _ ._v . _. _ .. _._.CITY„OF COSTA MESA r .BUILDING .PERMIT
PERM NO: B 07703
PERMIT NO: B 077039. PLAN CHECK,NO: __ N_..,__GOVT.: N SUPP: N�
CONSTRUCTION,_TYPE:, _V-N, _ , . �P,ERMIT_ TYPE:. .STR. _ ... PURPOSE:' OTA .
JOB DESCRIPTION__,,: T/OFF SHEATA 6 REROOF W/FIBERGLASS SHING SQ FT; 4,607
CLAIM VALUE: __, 4,607.00 CALC-VALUE: 4,607.00 GROUP OCC; R-3 /U-1
COMMENTS: SMOKE. DETECTORS REQUIRED PER 94UHC REROOF 193,6.^nF'�����a���
*�***�rx���*�*��**�*x�**+r+����t��*+r�r*x�*�r���r**�*�*k�*�x�+r+�**�***����¢§P� x y
_„„, Z O N I N G R E Q U I R E M E N T.S
_ SETHACKS P�I�t�UIRED .
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------,•'
FRNT: _., FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: _. FT ....IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: . PROV: PARCEL: 14163348 ZNE: REF NO:�,_
PLANNING NOTES>, . -
� i .
1E iE 1E iE 1E IE iE 1E iE iE iflE iF 1E 1f IE if IF �E iE 1! iE IE 1E IE 1E 1E iE 1E'lf if 1E 1f if if 1f 1f iElF IE it 1E IE 1E 1E1E if 1E iF 1EiE IF iE IE fE 1E fE ff 1E 1E iE iE 1E iE iE 1F 1E if 1f 1E if�lf 1E 9E 1E ik 161f� iE
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:
/"J
BUILDING APPROVBD HY : DATE: I
APPLICATION ISSUED BY: 7�{4. DATE: ^1�
LEGALIZATION:N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 72.00
STRUCTURAL SEGMENT:Y
FIRE SMIP/RES GRADING
SMIP/NON-RES
PLAN
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 72.50 0.00 0.00 72.50 72.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 72.50 OVER/SHORT: ,00
BLD72P�M�T PLUMHING ELECTRIC MECHANIC FIRE SMIP/TO�T GRADING PLAN-CHECK
iE If IE 1f 161(� 1f� K �f iE if iE if If If if 1f dE 1E 161f 1(� 161E if if If i(� i(� 1(� 1E iF 1h iE iF 1@ ik 1f iE fE IE IE IE IE IE 1FlE 1E iE iE iE iE ik IF if if if iE fE i! 1t 1E 1E iE iE iF iE iE iE iE iE iE iE iF iF iE iE iF it
I N D I V I D U A L F E E H 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 4607 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 4,607,00
END OF FEES
4' r:0:�"s?!`-0027?'�6 T�J"6 %'s,��
D;IE: Q4.'C�;F` ?IrE: 11: �3
`� �� . � �
_ _ �_9 -
CONSTRUCTION AND PLANNWG POOL d � -
APPROVALS Permit# Date Inspector AppROVALS Permit# Date inspector
t. Temporary Electriral Service or Pole 52. Pool &' Equipment Location -
,_
2. So(I Pipe-Undrgrnd. - 53. Steel Reinforcement '
: 3: Electrical Conduit�.Utiiity-Undrgrnd� � 54. Forms - . � J�
'-4-: Etectrica� Conduit=Undrgrnd. ^ ' 55. Electrical Bonding ' -
•-�,•' Steel Reintorcemenr,._ 56. Rough Plumbing & Pressure Test '
� 6. Electrical UFER�Grnd. _ 57. APPROVAL TO COVER-GUNITE,
' 7: Foot�nqs �' � . 58�� Electricai Conduit�Undrgmd. y�A
�c•8. Foundation �^ ' ,- ' 59. Gas Pipe, O Undrgmd., Test '
_;
�9. Water Pipe�Undrgrnd. _� � . "� 60. Backwash Ltnes, P-Trap, �7 Undrgmd. �
10. Structural Floor SYstem �'� - �� _ i 67. APPROVALTO DECK , ,{
11. R� pertY Sewer Line& House�Co 1 ection� � 62. Backwash & Receptor-Final '� '
72. Sewer CaP v� � r�� - 63. Heater & Vent-Final - �
•1
13. Roof Drains 64. Plumbing SYstem - Final ' �
7�4, Rough Plumbing, T.+^-• , 65, E�ectrical-Final .
15. Rough �IectricabCoYduit `r -i 66. Solar SVstem�Final ' �� . � ..
76. ftough Electric N!iring _ . - 67. Fencing & Access Approval
17. Rough Wiring Sign y 68. APPROVED FOR PLASTEfliNG ,l �
18. Rough ElectricaYT Bar Ceiling 69. POOUSPA SYSTEMS FINAI
79. Rough Heating & Air Conditionirg y � �,* � p E�PT..gEQU�REMENT �
IR_.R
- , ' ,q � ,. :,' � y x _ � � , �,.
20. Eiou9h Factory:fir.eplace - �. 5 � . APPF�OVAI�S' _ Pectnit # -
21. Duccs, in'Stru'cture"+ •� •• , ` + - �� ' " � 70. ,T�'lnder� rouod dro �
-x cH- � r• �r . B �Y
22. Ducts-, VentilaGng�y � ; rt q �=, �'�.� 71. Produpi Fiping O�6as �Oii
23. Gas Bipe�Rouqh & Tost � �!� :� =L C'+� �_ 72, Undergrou�d Ftush� � " o
24. Roof=framing"' �r "'" �"� }1 .,y �,73T Undergrnd.Stora��e,Tenk��Gas O�OiI
�J x
25. Roof,She3lhing .nw �� �:�y_��� Q(v�� � 74;�Overhead Hydrg_•_ '
r V l O :^:r . .a �-, -, n,
26_ T�Ba'r ;Ceiling (Structtiraq & Mo��c'oat , - _ .,. 75� ,Dry Cher�aicai . � ,K �-;:
27. Frameand_FlaShirtg,X -_- r c- - c• 76. Dry Standpipe �� � �_ _
- 28. Lathing &,:,Sidin9 ;- r " � `-' � `" .. ..,� 77� FIXED SYSTE,M;FINA� �.. -
J29. Insulation • ;* v S' ~ �� :. r � � 7£� FIRE PREV. FIN,�4L ' = ' �'
' 30. Drywall (�ailing s y. r �� c. ' "� � hiEALTN DEP%. REQUIRSMENT
� 31. P�aster 6rown;GoaT� ~ � ?.^ � ix :� 79.� FINAL I7VSPECTION -
r
32. Electrical Po�ver Mefer�ipal � r�' � �� SqT FOOD CERTIFiCATE I�SUED_ �
- ' -y. _ `.". -�: :•� �� �
�33. Fina�.Eleclric; � . *. ' �t Notes: ^.,T± : � ��.
- .,. � �.
-34. Final'Hea't�ing & A r Conditioning S r w ` � * '� '� �^ " - '
.- :� x�i� : t� i r r•-1: �"x f' �
35. F'nai�Gas.Pipc�:Test�x.." .. � r � r;.; �� e:c - � 4-E,.
_ - � - �
�36. Hood or GnoPv =%* - �`- ` � � � �" � - = " ^: •
' �D' ^ Gifl 4 6 LT. �`.0 c Y. JL�•
.. .r n' i• ri
- 37. F1nal�Factory Fireplace „- � � , � a ;i � �i
�
- 38. Final Plumbin9 ''% � + ; `z - r � _
,: , �
� �� .; � �� � r � . � �.
'39. Water'Sent�ce;�nat. , � . i :- � rx . c:� r. � '
_ - � w w .. n,
-40. Gas Service-Final r*. .T. ".,:':" 5 ' • j �'� C. � t�'� r
r. � y� � _. ti- � 4
=41. Solar pomestic Ficial� `-� .. f �. �' � ' -� � � -
.�� ic ��- .c.
42. Beckflow'Prevemer. r � c: +. - i -` - %F • '; �� -
- r �: � 7 •; � ,, . .
43. Backflow�hrigation �,. �Sc i 1 �`� - - - .
�:
44. landscaPe;Irri9atioh�SYstem'- � �� ' ? r% - ��'�' `� ;? T� . _ , -
� T� # r„ v, �. a� E r- C x F
45. Sound At[enuatio`n' . - .. ' � $ � ~ - * � � a` . �r ,
46. Handicap Regulations � - � _ ' � * � = •S G^
Y" '� T��fl "� X
47. FiNAt STRUCTU.fiE & 8'UIL'DING �% /O,L16 �� ,� � � "'`"' _ ,� �
t G �
48. F.iNAL PLANNING � "� . - K :� -* : �' "' •' `' -
�C� �� k . .
49. Electn"c Release to EdiSod ; 1"` J � ;' ' '
, '..%. :3 � . _
50. Gas RElease to Soutfiern California_Gas Co = "- �•�='" � '
t s ,
51. CEFT.lFICATE OF OCCUPANCY �` ^ � ^ '" -
No. Date
A MESA CO
linp Address
UCTION PERMIT
Applicant [o fill in all zpaces except tltose witltin heavy bortler lines an0 zign all aOPropriate Oeclarations.
P€RMIT NO��� �TRACTCO. LOT NO. UNIT NO.
G�-�
o� �
�p TYPEOFCONSTRUCTION NEW ADD ALTERATION REPAIR
❑ ❑ ❑
r� CONVERSION DEMOLISH C
Ow�ier'sName �-ti�+�+ 9��anK1S1 �� ahone����3p D SCftIPTIONO ORK/ OFBLDG.
Address �' �►.4�� . .i �Ap\tL4 1`PC� �%.�+h\4'(1-�1 �]TGa-`c 1 �
Arch/Eng. � License No. � " TVPE OF PERMIT GRAoiNG�q FOUNDATION � STR� VCTURAL
Add�Ess - • y��p ��p��� '❑ TENANT �-ELECTRICAL� LG4 PLUMBING � MECHANICAL
Contractor'sNam��+'�`�E��`�T_�in:K'tlY�Phone.ZLiS�� . ' �� oTHER
`7�� 7� ��PROJECT DESCRIPTION 5Q. FT. oCCUaANCv
Addresslmailing� Y�3Z{, 1—A<.ri�` La�M_ r�aQ :
- I� - COfYSTRUCTIONTVPE ��- � VALUATION$�
City License No. �( 3� � ZpryE � GRADING CU.Y�S. ACR �
LICENSED CONTRAC40R OE ARATION
I hereby affirm that I, am licensetl untler provisions of Charter 9(commencinq Remarks: %'� . �� w.� �
with sec[ion ]000) •o(: Division 3 of the Business antl Professions Cotle, antl
my license is in full �orce�antl effect. � '��
�icense¢�ass. 1'S1 r� �ic�n3e.No.�'061"i-�.�1 .. ___.______.._____ __ ~
Date � Signalure ' �
W00.KE S' OMPENSATION DECL'P.RATION �
I hereby affirm Ihat I,have a certiticate oi conzent to self-insure or a certificate
a oi Workers' Compentation Insurance, or a certifietl copy thereot (Section
� �oo. �ao. c A ' ' , � ,
iicy rvo. �/��(7�� Company���Q A\nwPt
\� Certitietl coDY is nere0y furnisnetl. _ �
Certifi tl op is tiletl'witM1 [he ciTy B ing Division.y�
\ Data ' Applicant �.�'S1�N_j�JA+.�'�'��—
' EXEMF ON FROM WORKERS' COMPENSATION DECLARAT OI N ,
(Thi55ection neetl nobbe,completetl if the permit is tar one huntlretl ($100) or
less) ,
I certify that in lhe pe�fo�mance ot tne wo�k fo� which this perm�t is issuetl, I
shall nol employ any per5on in any manner so as to become subject to the
Workers' Compensation Laws of California.
Date �� Signature ,
� NOTICE: If,atter making this tleclaration, you shoultl berome Subject to th¢
Worker5' Compensation provlsions of the Labor Cotle, you must forthwith
comply with such provisions or this permit shall be tleemeE revoketl.
- CONSTRUCTION LEfJDING AGENCV -
1 hereby affirm that;there'is a construction lentling agency tor the performance
ot the wark,for whicb-tM1is permit is issuetl (Section 309J Civ. CJ
Lentler'S Name
Lentler's Atltlress Q .
OWNER BUILDEH �ECLARATION �
I hereby afflrm thaLl am exempt irom the Contrac[or's License Law fo� the
followinq reason (Section ]031.5 Business antl Professional CoOe: Any city.or
county which �equires a permit to const�uct, alte�, improve, demolish or repai�
any struc[ure, prior to its issuance, also requires the applicant for such pe�mit
to file a si9netl statement that he/she is Ilcensetl pursuant to tne provisions ot �
the Conlractor's License Law (CnaDter 9(commencing with Section �000) of
Division 3-of.tne Business antl Professions Cotle) or that he/she is exempt �
� theref�om antl M¢ ba5is fo� tlte allegetl exemption. Any violatiOn of Section
]031.5 by any applicant tor a permi[ subjects [he applicant to a civil
malty of not more than five huntlretl tlollars ($500).
� I, as owner of the p�operty or my employees with wages as their Sole
aompensation, will tlo�the wovk, antl the structure i5 nof intentletl or o(feretl
tor sale (Section 7044, Business antl Professional Cotle: The Contractor's
LiC¢OS¢ law tl0¢5 OOt apply [O dO OWnCf Of a plop2l[y who builtl5 OI irtlprOv¢s
ihereon, antl wno dces su<n work nimself/nerseli or through his or her own
employee5, provitletl thai such improvements are not intentletl o� offe�e� fo�
sale. If, howeveq the building or improvament is soltl within one year oi com-
pletion, the owner will have the burtlen Of proving he/she ditl not builtl or Im-
prove for the purpose of sale).
❑ I, az owne� ot the property, am exclusively contractinq with IicenSetl con-
tratto�s to construct the project (Section ]044, Busin¢55 anG Professions Cotle:
The Contractor's License Law does mt apply to an owner of property who
� builtls o� improves lhereon, antl who cont�act5 Por Such 0/ojects wlth a con-
tractor(sl license-pursuant fo'the Contracior's License Law). I am aware that
proof of their Worker'S ComPensation insurance shoultl be provitletl to me.
❑ I am exempt untler Section B. & P. C. for this reason
Date Owner �
I M1ereby certify+that I have reatl this application antl state that tM1e above
information is wrrecL I agree to comply with all city antl county ortlinance;
antl Stale laws relating to builtling const�uction, antl he�eby autho/iie �ep�e-
sentatives of t ry to ente pon the above-mentionetl pr oert for
� inspection purp 1
Signature Date �
Preventer �
Irri9ation
Drinking Fountains
Floor Drains , •
Floor Sinks ,
Gas Service y9 O
Interceptors � ' � '�
Kitchen Sink � .
�avatories �h:
P-Trap • r '
Roof Drains ��, �
Reinspection Fee
Showers
Service Sink �
Sewer Cap
Sewer Connection ;
Solar Collecmrs-
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
,' Water Cbset .
^' r •�Water Heater
:'�
.Watei Service
. Auto�Wash
Laundry Trays .
$15. Issue Fea
Boiler
Duct-UnderGround
Duct - Structural
Duct - Ventilating
Exhaust System ❑ MWtiple ❑
FirepUFacLBIt.IC80# ^
Heating System & Ducting
❑0-100,000 BTU Ot00,000BTi
Drivers' License or 55 �
' Reinspection Fee � I $75
CMF 0865-46, rev. 10/84 White - Bu
Canary - qpplicant; Pink - Accounting; Goltlenrotl - Assessor
Hood or Typel ❑ .
Canopy Type I I ❑
Refrigeration Sys[em
❑0-100,000 BTU ❑100,000 BT
System Repair/Alteration
Fire Dampers ,
� Registers , .
Issue Fee
!EES
�
A.P. #
S Main Building:
TFront �Q�6�
AFear
C Right ' �
g Left � 5
Ping. Ref. #
Planning Notes:
: �1`ON�^+ i y � n�. �
�' _ AutomaticWasher� �
- � - Construction PoleSub.
� Cooking�Unit
� � Dishwasher ' '
Dryers ❑Gas �Elec
Fan
F.A.U.' '
� ,� Fixtures
_ Device Boaes
$ 3
$ 3
Switches
Garbage Oisposal
Generato� DO-5 KW
836�. .�.�G � ]� � `,% y � .
Zone '
Accessory Building: �
Z
' � �
N
I
� N
G
R
Parking fteq./Provided � � E
�J -. -C- o.. - .1 M
� � 6+`� �O�c T
S
_ELECTRICAL .,
Trensformer �:� 15-50 KW
❑ 50+KW
Meter up to 100 amps �
Meter ❑over 100 amps '
Sub Panel
Motors �0-1 HP �1 %- 8
IncSolar �9-15 HP �16-75+
Pole Light
�Range �
' Siqn -.
Standing ;
�5�15 KW � � Trash Cort
I Reinspection Fee I$15 I
�DEVELOPMENT SERVICES REQUI
Zonin9 APProved BY�
Building Approved 6y
Issue Fee
FEES
$ 3
� SUMMARV OF�PEES' �
BUILDINGPERMIT $ -sa SMIP� �$ �_3G
PLAN CHECK $ __� PERMIT .
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ %- (iO ENERGY P.C. $.
ELECTRICAL $ /g'�A GRADING $
PLANCHECK 50% $ � Z-G+O MICROFILM $
MECHANICAL $ � ' TOTAL FEE $ �� •
PLAN CHECK 25% $
CONSTRUCTION AND, PLANNING �' � POOL & SPA ��
APPROVALS Permit #�� Date � Inspector qppROVALS Permit # � � Date Inspector
7. Temporary Electrical Service or Pole 52. Pool & Equipment Location �. 1�
�
2. Soil Pipe-Undrgr�d. '� � 53. Steel Reinforcement . - ' �
3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' �. ,
4. Electrical Conduii-Undrgrnd. -55. Electrical Bonding . � - �
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
� 6. Electrical UFER Grnd.. Q"jB' 57. APPROVAL TO COVER-GUNITE,
.7. Footings 58. Electrical Conduit�Undrgrnd:-
�8..Foundation , . 59. Gas Pipe, O Undrgrnd., Test
�. �
9. Water Pipe-Untl�grnd, t� � - 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Structural Floor System;� � g% ��-' 61. APPROVAL TO DECK �
>. ,.
11." Property Sewer Line & House Connection 62. Backwash & Receptor-Final �. �
12. Sewer Cap 63. Heater & Vent-Final .� �
13. Roof Drains 64. Plumbing System - Final �� ' '-
r .
14. Rough Plumbing ����n G� 65. Electrical-Final �
15. Rough Electrical-Conduit � 66. Solar System-Final •
76. Rough Electric Wiring � �67. Fencing & Access Approval �
17. Rough Wiring Sign .. 68. APPROVED FOR PLASTERING �• -
i.
18. Rough Electrical-T Bar Ceiling �� " 69. POOUSPA SYSTEMS FIN7lL• -
19. Rough Heating & Air Conditioning � � FIRE DEPT. REQUIREMENT. j. �
20. Rough Factory Fireplace APPROVALS Permit # J �- "-
t .�.
21. Ducts, in Structure 70. Underground Hydro �
22. Ducts,Ventilating' 71. ProductPipingOGas ❑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 �� � t � '
28. Lathing & Siding 7,a/8 77. FIXED SYSTEM FINAL �.
29. Insulation .g J C 78. FIRE PREV. FINAL � .' .
.
30. Drywall Nailing ��3 ' HEALTH DEPT. REQUIREMENT ,
31. laster Brown Coat ..7,Z_�`� , 79. FINAL INSPECTION '�,t' -
. Electrical Power Meter-Final 80. FOOD CERTIFICAT�E ISSUED
33. Final Electric - Notes:s � Y� �}p M�� 4 •
34. Final Heating & Air Conditioning ' �� � g�p -
35. Final Gas Pipe-Test . ���� ,D,�
36. Hood or Canopy , �
37. Final Factory Fireplace � . '
i
38. Final Plumbing , • �
39. Water Service-Final ' � ' ' . . � ,
40. Gas Service-Final � •
' 41. Solar pomestic-Final � ' - '
42. Backflow Preventer � � � � ' �
� �
43. Backflow Irrigation � � . � ' -
44. Landscape Irrigation System � • . �
�-45. Sound Attenuation � � , �
48. Handicap Regulations ,. � � " •
- �r�
� 47. FINAL STRUCTURE & BUILDING �. � � � �, �a� ��j'��OB� g ,
�
48.•Special Requirements Completed . � .. . � ' �
49. Electric Release to Edison , , ' ,
� 50. Gas Release to Southern California Gas Co � � •
51. CERTIFICATE OF OCCUPANCY '
No. Date _ _ , ' ,
OWNER HARF30$ HA
JOB ADDRESS 312
GENERAL CONTRACTOR
AP No. LOT
INSPECTIONS
OCCUPANCY
FAME HOMES IAIC. nwTF �.�DV 3 0�°�'
Lane BUILDING PERMIT NO. li 30
ime �esidential Bldg. orp. VALUE $ 17�07 .00 �
TRACT 1�356 FIRE ZON� DESCRIPTION OF WORK Res Att. �P,
�Signature� DA1'E, GROUP I&J TYPE V 7,ONE R-1
SUBCONTftACTOR
iR�zn
� . FE �ECEiVED
� f 8330 «�;L: .; � ,;��
COSTA MESA BUILDING-SAFETY DEPARTMENT Lot 80� Traot 4356� �B�EPT.
P. O. BOX $17 COBTA MEBA. CALIFORNIA ��jy OF COS1A MESA
For Applieant to Fill In Complefely APPLICATION FOR PERMIT
TYPE OR PRINT
Buaui��
BUILDING 3�� 3 /� rK LG, �.
ADDRESS �-� .
COSTA MESA. CALIFORNIA � FOr Office Use Only
RECEIPT NO. P 1 N.
OWNER Aarbor Hall of Fame Homes Inc. ' %�_ �O
MAIL aece� o er o T} rsey vay oeie teaueo -
AOORESS P.�• BOX 2066 /e� I'/ ��'C�Q� ;j (� iq��
CITY S2IIt8 Ail$ TNOi11 9'22� ADD E'65
ARGHITECT TE�. COSTA MESA. CALIFORNIA
OR ENGINEER J3�160II No.544-00
ADDRES6 22S'��D�� SY.. �Ii18t.1T1 ZpNE TYPE 1� GROUP �
CON7RACTOR Li£etime Residential Bld Ci0 �PPROVED .
Y DATE
ADDRESS 21j1 SO• F1I'tf618 ZONING ' �
CITY SARtg tYlu ��NE NO. OF U8E OF N8W '
PLAN9 �/ BUILOING�
LIC.TNO. ZO06/6 NO. KI ]�GL" ` � DEeCRIPTi O / • y
SIZE � I NO. OF BLDGB.
OF LOT 6�� - rvOw oN LOT � A. P. NO.
USE OF 'NOIIB � Y.e.RD6 EVES
EXISTING BLDG. APPROVEO ALLOWED
C NTE6KOP18TREETM /�� REAR YARD 2/�7V, ��M¢H I.�NH BT4 .�p ��
FRONT ✓ O FT. IN.
SIDE YARD I LEFT lv1 I RIGHT `�� R. SIDE � O FT. IN.
DESCRIPTION OF WORK L. SIDE /� FT. ' IN.
NEW I X II ALTERATION I II ADDITION I REAR Z 3 7`�'� Fi. � IN.
REPAIR I IIMOVING I IIDEMOLISH I BYPROVED _. /� �y OATE J�y/�
Kr�[
gBZ1ELDING 16OH ROOMS � STORIES 1 �—�
EXTERIOR L ROOF
COVERING�Yaster COVERING +St12�CC
USE OF BIIILDING AND WORK TO BE PERFORMED
' U " / O�
I XEPEBY ACKNOWLEDGE /�T i HAVE RHAD THIB APPUGTION THE AMOUNT BNOW OER VALUATION �8 POR iHE
AN� eTAT¢ THAT THE A6 E IB CORRECT AN� AGRHE TO COM- pUpP088 OF, E9TABL19HIN0 A PERMIT FEE ONLY.
PLY WITH ALL QTY O i NCEB T¢ W8 REGULATINO
OUILDINO coNarnu H VALUATION
SIGNATURH OF PERMIT FEE $ �S �'�
PERM17TE $/�D�� PLAN CHECK $�O. SD m
AUTHORIZED AGENT � rc
TOTAL FEE � I% 4
Vnl\GR ���'����f �• �• VFIC �—�u—ii
JOB nDDRESS or Lane BUILDING PERMIT N0. 43586
AP No. 141-bSS-425 LOT �3�
INSPECTIOHS
soa
GAS
WATEP
ROUGH PLUMBING
PROP: SWR. LINE [� MOUSE CON.
SPRINK�ING SVSTEM
MISCELL�NEOUS
NOUGH NE�iING AN� AIH CONDITIONING'
TEMPORANY SERVICE OR POLE
UNOERGROUNO � POWER �
ROUGH WIRING
TRENCHES [ FORMS STEEL REINF
FLOOR SYSTEM
BOND BEAM ❑ �SiEEL REINFORCE ❑
SMEATNING
FRAME RN� FLASNING t-�
L�THING — IN � OUT ` �
PLASTER, BROWN COAT
STRUCTURAL, FINAL
HEATiNG. VENT., REfRIG. AND A.C., FINNL
PLUMBING. FINAL RNO GAS TEST (-J
ELECTRIC, FINAL
BUILOING, FIN4L
GPGf1AI � fiF0111(iFMENTS
SUBCONTRACTOR
.'� i."
43586
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COS7A MESA, CALIFORNIA 92626
For Applican[ [o FHI in Completely — Use Ink Only
BUILDING 2 �� /��
ADDRESS d
OWNEft �, O J ` p��
MAIL i.� / � �1 .�-�.
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CAN5TRUCTION
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ARCHITECT
ADDRESS
CITV
STATE
LIC: NO.
SI2E
OF lOT
USE OF
TEL
NO.
TEL.
TEL.
NO.
arv
LIC. NO.
NO. OF BLDGS.
NOW ON LOT
Separate permits are required for
electric, plumbing and heating work.
USE OF BUILDING AND_WORK TO BERERFORMED
A.P. NO./
BUILDING
ADORE55
OWNER �
FIRE
ZONE
APPROVED
�.� :R ,_F�<<,0�; � 42 �:> �1 %.5�
<<:-, �:,��:�:t
FORSTRUCTURALPERMIT
DATE RECEIVED nerc ic<i�rn
PERMIT NO.
� �
LOTOa BLOCK
DATE fX �
NE/J ( INO.OF I USE OF NEWB(J��,�
K � PLAN$ � BUILDING �+� K
YARDSAPPROVED YARDSAPPpOVED
MAIN BUILDING ACCESSORY gUILDING
VAR. #
C.U.P. #
I heraby acknowletlge that I have reatl this application antl state
that the ebove information is corract and agree to comply wlth
all lews regulating building conscruction, and I shell not employ
any pe�son In violation of ihe workmen's compensation laws of
ffie State of California. . . ���
I hereby c¢rtifY ihat I am Properly licensetl es a contractor untlar Q. FT.
the State of California Busihass antl Professions Code, Divlsion 3, THE AMOUNT SHOWN
Chapter 9, antl thet such licenses are in full force antl effect, or I THE PURPOSE OF ESTAE
am exempt from the provisions ot the State of California B�siness VALUATION ' PE
and Professions Cotle, Divisi0n 3, Chapter 9.
SiO�aiure f � _/�. -'.'� P�
� �C/ � � l/L/
�
� FT.
zFT.P,
DATE
APPROVED
$
K 3
Pelmltte $ � (� ' TAX $
��
Authorizad Agant � TOTAL PA1 D $
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