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Home My WebLink About424 COSTA MESA ST - Building Permits� (714) 754-5273 • Fax (714) 754-4856 • wv+w.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 424 COSTA MESA ST Suile: Vicinity: ROOF Parcel Number: 42631206 Zoning: Applicant: JOHNSON, SCOTT Address: 1824 E CARNEGIE AVE " Phone: (949) 250-1221 SANTA ANA, CA ' � Zip: 92705 Owner: GUDER, DAVID L TR Address 424 COSTA MESA ST . Phone: � COSTA MESA; CA- - Zip: 92627-2321 Contractor: A-1 ALL AMERICAN ROOFING CO WEST LA INC Address: 1824 E CARNEGIE AVE � Phone: (949) 250-7221 SANTA ANA, CA Zip: 92705 ' License: 671922 Arch : Address: Zip: Phone: License: Eng: � Address:� StaWs: ISSUED Applied: 08/20/2002 Issued: 08/20/2002 ��, i � : /•� Phone: License: SCOPE OF PERMIT � TEAR OFF EXISTING ROOF. INSTALL 30 YR, ELK, COMPOSITION SHINGLES. 2500-S.F. INCLUDES ATTACHED GARAGE. .. . . . .. � . .. . Plan Check: Permit: SMIP Res: SMIP Com: Other. Inspection: Total: $0.00 $97.25 $0.50 $0.00 $0.00 $0.00 597.75 , SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0.0 �- � PARKING Ezistinq: o NOTES: FEESUMMARY s Calc Valuation: Claim Valuation PLANNING & ZONING Rear 0- 0' Left 0- 0 � Right 0- 0. ' - Rear 0- 0- _ LeFl 0- 0 Right ' 0- 0 i . Required: 0 Pro osed: � 0 � � sa,000.00 $4,000.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatirally expire and become void if work is not commenced within 18p days, or if work Is suspended or abandoned for a period of 180 days. ' ' INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepeetiona and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration oi this permit. FOR INSPECTIONS CALL: (714) 7545626 aae-ae �e�ao� WORKERS' COMPENSA710N DECLARA710N: '� I here6y eKrm under penalry of perjury one ot ihe tollowing declaralions: ❑ I have and will maintain a certificate of cronsent to self-Insure for workers' compensetion, as provided for by section 3700 of the Labor Code, for the peAortnence of the �work fof whiCh �hi9 permit i5 i55ued. I:have and will maintain workers' compensatlon insurance, as required 6y sectlon 3700 of the LaDor Cotle, for ihe peAormance ot Ihe work for whirh this permit is issuetl. My wo rs'.,c/�p mper�5atlon Insurance carder and policy number are: �ner �/y`��— (1� G� lPolicy�N�mber.—� �G 9/ Z G i�2 � (TAis secfion need not be comp/eted i/ the permil is veluetl al one hundred dollers (S 100) or less.) ❑ I certiy Ihat in iha peAormance of tha work for which Ihis Oertnit is iuued, I shall not employ eny person in eny menner so as to become subject to t�e workers' compensation laws of Calilomla, end egree that II I shoultl become subject to the workere' compensetlon provlsions of Saction 3700 of the Labor Code, I shall fotlhwith comply wiih these prav� n'(°�� D %�7 ApplicenfSgneture. �.�n"�C `---- Dale � C/ ^/��/ f�— WARNINO AF ILURE TO SECURE WO KERS' COMPENSATION COVERAGE I$ UNLAWFUT AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED THOUSAND DOLLARE (5100,000), IN AODfiION TO THE COST OF COMPENSATION, DAMAGES AS PROVI�ED FOR IN SECTION 37060F THE IABOR CADE, IMEREST, AND FTTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: oi Chapter 9(commencing wl�h Sectlon 7000) ot Divislon Code, antl my Ilcense Is In full CONSTRUC710N LENDING AGENCY: ❑ I hereby ettirm tha� �here is e conSWction lending agency for the pedormance ot the work for which this permit is issued. (Sec. 3097, Civil Code). Lentler's Name: Lenders Address: Signature: OWNER-BUILDER DECLARATIONS: Date: I hereby eHirm thet untler penelty of perjury thet I em EXEMPT FflOM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business entl Professions Code: Any ciry or county which requires a pertnit to construct, elter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signetl statement that he or she is licensed pursuant to Ihe pmvisions of ihe Contractors License Lew (Chapter 9(commencing with Sectlon 7000) of Division 3 oi the Business end Professions Code) or ihat he or s�e is exempt therefrom entl the Dasis for the alleged e:emption. Any violetion of Section 7037.5 by any applicant for a permit su6jects the epplicant to a civil penalty of not more ihan tive hundred tloilars (5500).): ❑ I, as owner ot Ihe properry, or my employees with wages as lhair sole compensa�lon, WILL DO THE WORK, and ihe slructure is not intended or ofleretl for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to en owner of properry who buitds or improves ihereon, and who does such work himself or hersetl or through his or har own employees, pmvitled Ihat such improvemenis are not Intendad or ottered for sale. If, however, ihe builtling or improvement is sold within one year ot completion, the owner-buiider will have the burden of proving Ihat he or she did not build or improve tor purpose of sale.). ❑ I, as owner of ihe properry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business antl Professions Code: The contractors License Law tloes not apply to an owner of property who builds or improves thereon, and who contrads tor such project with a contractor(s) licanse pursuant to ihe Contrecbw Licensa Laws.). ❑ I em exempt under sec. Business and Professions Code tor ihis reason: Signature: Date: Owner ID vanfietl by dnver's license. ❑ Ves ❑ No DnvefS LiCense No. Expires: Verificetion of Owners�ip by (rype ot documem, I.e. - properry tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMiT CERTIFICATION: ❑ 1 hereby certify thet no excavation tive (5) or more feet in depth into whic� a person is required to descend, will be mede In connection wi�h work euihorized by this permit, and that no Duiltlinq swcWre, scaHolding, falsework, or demolition or dismentling theraot, will be more Ihen Ihiny-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tule B, Celifomia Adminisirative Code). ❑ As owner-bullder, I will not emplay enyona ta do work which would require e permit irom �he Division of Intlusirial Sefety, as noted ebove, unless such person has e permit lo tlo such work Irom ihe division. Signature: Data: Division of Intlustrial Safery Pertnit Number: CERTFICATE OF COMPLIANCE AND AUTHORRATON OF EMAV: I certify under penalry of perjury that 1 have read ihis epplication antl stata that the infortnation given is correct 1 egree to comply with ell ste�e laws end ciry ordinances relating Io huildlnq construction, entl authorize representatives of the Ciry of Coste Mesa to enter upon Ihe ebove-described properry for inspection purpases. I egree not to occupy or ellow accupancy of any building authonzed by ihis pertnit until final inspec�ion. COOE �. IXSPELTIONTYPE 1616 Fixed System Final Fira Preven�ion 1266 200 Pool Spe Finel Finel RB-Rool 201 Final Block/Retaining Well 202 Final Fectory Fire Place 203 Finel Sign 204 Final Demolitian Q� It�l.B Z6 ,9Z � CODE � INSVECiION TYPE 206 Finel Mec�anical 20B Finel Plumbing 210 Final Elecidcel 212 Finel Flre Preventian 220 Final Planninp Approval 222 Finel Site 250 FinelBuilding/Otcupancy �-��r-6/i L_aie_� aeg u�s .�GITV OF,COSTA Pioject Address � �r r� � r �77/. /.l ul:/��j►1ly /L�I� .11��%C!� ... . _ .Ti� � ADOlicant to fill In dll ipaees except those within heavY �o�Eer lines antl si9n all apvroo�iale eeclantions. ,eE(iMIT NO. �__, TRAC� fJ/J. LOT NO. UNIT NO. ................��,.�...��,.—' ro'_ _ _ .�..�� Address lmailing) City License No. LICEry D CONTRACTOR DECLARATION I hereqy a t 1 am licensetl untler provislons ot commencing with sectlon �000) o rw f the cin antl Professions Cotle, antl my licpnse is in full /orce antl ef License CI s a ti� s Oate-` $i9nature WORKERS' COMPENSATION �ECLARATION I M1ereby aifirm [hat 1 have a certiflcate of consent to self-insure or a certificate " Workers' Compensation Insurance; or �a, certifietl copy thereof (Section � 00, Lab. C.) � - -' �olicy No. ��' '^Company 8 Certifietl cooY �s hereby;tumizhetl. Certifietl copy is filetl wiEh the city Builtling Division. Date— 'APplicant EXEMpTION FROM WORKERS' COMPENSATION DECIARATION (Tnis section neetl not be campletetl i( the permlt is Tor one huntlretl (5100) or less). 1 certity that in the perlormance ol the work !or which t is permlt it issuea, I sna)1 not employ any person in any manner so as to ome subject to the WofkeYs' o sAtion,Laws of Calit i. �ate "� � Si9nature ' NOTI�E. If, fter making this tletlaration, i znoultl become subject to the Worker5' Compensdtion P�ovi5iOn5 of the Labo� Cotle, y0u must fo�thwitn comply �y{�h such provisions or this permi[ shall bC tleemetl revokeE. CONS7RUCTIDN LENDING AGENCY I hereby affl�m Ihat there is a const�uction IEptling agency fo� the pe�formance of thp work for which this permit is issuetl (Section 309� Civ. CJ lxntler•s Name LentleYs atlaress OWNER BUILDER DECLARATION - I hereby aifirm Lhat I am exempt from tne Contractor•s License Law for the followin9 reason (Section 7031,5 Business antl Protessional Cotle: Any city or county �yhiGh �equires a permit to Const�uCt, alter, imp�oVe, tlemolish o� repai� any st�ucture, p�ior to iti issua�ce, also reqW�es the applicant tor such pe�mlt to fil@ a si9netl statement that he/she is licensetl pursuant to the provisions of [he Cryntractor'S License law (ChaO�er 9(commencing with Section ]000) of Division 3 oi the Business anq Professions Cotle) or that he/sne is exempt '•erefrom and the ba5i5 tor th¢ allegetl exemption. Any violdtion ot $ection 31.5 by any appliCant tor a permit sUbjects the dpplicant to a civil nalty of not more than five huntlretl tlollars ($500). L� I, as owner of the property or my employees with wages as their sole compensation, will do the work, antl the structure is not intentletl or ofteretl tor 581e (Seclion ]044, Busin¢ss antl Prof¢ssional Cotle: The COnt�acto�'S License Law-tloes not apply to dn Owner of d prope�ty who builtls or Improves thereOn, antl wM10 tloes such work nimself/herself or tivough his or he� own empl0yees, provitletl that such im0�ovements are not intentletl or otferetl for saie.'It, nowever, tne buildin9 O� improveinent fs soltl within one year of com- o�etion, the owner will have tM1e bu/Cen ot p�Oving h¢/5nC tlitl not bulltl or irt�- pr ve for lhe purpose of sale). �, as own¢� of the p/operty, am extlusively contractibg with Iic205etl wn- ractOrs to construct the pro�ect 1Section 7044, Business antl Protessions Cotle: The Contractor'S License Law doe5 not apply to an owner of prop¢rry who builtlq or improves tnereon, antl who contracts for such oroiects wltn a r.on- t�actor(si hcense pursuant to tne Cantractor's License Lawj. I am aware thac �p{roof of their WOrket's Comp¢nSatlpn'linsu�ance shoultl be p�ovitletl to m¢. ys � am exemot untler Section 1 �"� 7 8. & P. C. for this reason Date Owner w I nereb certify tnat I nave reatl th' a plication antl state that the above inlormation is correcL I agree to co pty rth all city antl manty ortlinances antl 5(ate laws relatin9 to builtlip g nst uction, antl bereby authorize repre- Sentatives of [his citv 1n enle/ u on the above-mentionetl orooer[v. fo� Signa�ure �� Drivers' License TVPE OFCONSTRUCTION �J NEW U ADD U ALTERATION LIREPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER -�c�r. s F� DESCR� 10 �IO,F�"�'O,R,K�,/,�U,S F LDG. �A �t�� ]�°��j %.� CXi �pr7L'--4� �I�`cY'�lr�a�4� TVPEOFPERMIT GRADING LJ FOUNDATION pJT�TRVCTURRC ❑ TENANT � ELECTRICAL � PLUMBING ❑ MECHANIGAL ❑ �OTHER 1 B�'� PROJECT DESCRIPTION 5��p�p^7 oCGUPANC�v CONSTRUCTION TYPE +'- VALUATION $ �� .i �y� �� ZONE GRADINGCU.VDS. ACRES Sink Preventer Irrigation iking Pountains �r Drains �r Sinks Service Kitchen Sink lavamries P-Trap Roof Drains Reinspection Fee 1 � �Q..� LV • L ' a+,. 4'S 8q � �BING FEES Showers � � Service Sink Sew¢r Cap . � ' � Sewer Connection � � Solar Collectors - Solar Pipin9 Solar,.Tank Swimming Pool w/Spa Urinal Outlets Water Closet Water Heater Water Service Auto-Wash LaundrY Tra'ys $15 Boiler Dutt - Under Ground Duct-Sttuciural � Duct - Ventilating Exhaust System ❑ Multiple ❑ FirepVFact. BIL �CBO # Heating System & Ducting � ❑ 0-100,000 BTU � 100,000 BT Reinspectian Fee � $15 0865•46, rev. 5/88 White • Builtling; Canary - APpllcant: Pink - Accouniing: Goltlenrotl - Assezsor Isue Fee Hood or Typel ❑ Canopy Type I I ❑ Refrigeration System ❑o-io 000sTu ❑ioo,oaoeT S em Fepair/Alteration FireDampers • Registers Issue Fee !� � F A.P. q{E �-�- S Main Building: E T Front A Rear C flight K Ping. Ref. # Planning Notes: 1- , 3 �: - alo zo�a Accessory euilding: � :� �� Parking Req./Provided Automatic Washer Cooking Unit Dishwasher ., Dryers ❑Gas ��DElectric Fan F.A.U. FixtUres Device Boxes �� OUtI2L5 Switches � �� . Garbage Disposal _ . ELECTRICAL Transiormer CJ 15-50KW ❑ 50+K� Meter ❑up to 700 amps Meter ❑over100amp5 ieneraior 00.5 KW �5�75 KW � � _ . ' ^ ., f' Sub Panel Motors �0-1 HP � 1 Y, - 8 Inc. Solar �9-15 HP 076-15+ Microwave Pole Light v; Range Standing Sections Trash Compactor einspeaion Fee $15 Issue Fee SERVICES REQUIRE B'y ��1 � � SUMMARV ({�FEES fBUILDING�PERMIT $ Z�,3_.� SMIP ' •PLAN CHECK�' $ pERM1T �'.PIUMBING $ .vV �SSUANCE PtAN CHECK' 25% $ ENERGY P.C. ELECTRICAL� $ ___� GRADING PLAN.CHECK 50% $ MICROFILM ��MECHANICAL $ TOTALFEE -'. PLAN-CHECK 25% $ i N E Q M T S. OI ��D77L.-10-tn�3;G1� �;'�r-, _ DATE: ��GS!29 ii;;=" ;:rl: � , � .., �<: " r CONSTR '�' APPROV( r �L.Pempor'a �2. So.il_P.ipf � _ `. ;r S/ .. ,.. . . . � . ./ , _ . / _ � � - - . . voo� >a AND PLANNING •� � ' `� Date `�+� �Inspector � � � eimit # � APPROVALS Permit # - t:al Service or Pole � 52. Pool & Equipment Location N. d. � 1 ' v 53. Steel Reinfarcement 3��Electrical,ContluiF Utility-Undrg 4 � Electr,ic�l Condui{�-Undrgrnd.; �a- - 5. St�e.e�^�leinio��e ent � ' ��EtecFrical` F�R,;Grnd. �� : i . .-- , _ 7._Fooiinas'%�::i �t 101 Stfuctural Floor=System 11.SP�opertY Sewer'Line & House 14.� �Raugh Plumbing j ' i 15. Rough Electrical-Conduit ; 6. Rough Electric Wiring i1i7t Rough W�ring Sign 18� Rough Electrical-T Bar Ceiling � �� Rough•l9eati�g & Air Cond it�oning �20'. RoughtFsciory Fireplace "� l � 21. Ducts, in�Structure � �. . 22. Ducts, Ventilati�g �j v'� - � 1 23.�Gas Pip�Roagh 24. Roof F� ming 25. Roo�f Sh�re�athing 26. T-Bar Ceiling (Structural) &rMonocoat �. � 27.: Fra�me ntl Flashing. � � 4� 28. Laything�Bi�Siding �� _Z 29. Insulatio ��.�/ ,. 30. Drywall;Nailing A� �! (Ab 31. Plaster Brown Coat �U � 32. Electrical�Power,iMet�-Fina� C - �,.� �� 33. Final Electric � �' "-2 � 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test . 36. Hood or Canopy L � �37. Final Factory Fireplace 38. Final Plumbing � . i ;.39. WaterService-Final.�-� 40. Gas Service-Final v � 41. Solar pomestic-Final 42. Backflow Preventer� 43. Backflow Irrigation 44. LandscaPe Irrigation System 45. Sound Attenuation 46. Handicap Regulations . 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed . 49. Electric Release to Edison 50. Gas Release to Southern California Gas 51. CERTIFICATE OF OCCUPANCY No. � Date -___ � Date Ilnspector V 54. Forms � 55. Electrical Bonding . 56. Rough Plumbing & Pressure Test � � 57. APPROVAL TO COVER-GUNITE _� j: 58. Electrical Conduit-Undrgrnd. �' i �� 59. Gas Pipe, � Undrgrnd., Test �-`? 60. Backwash Lines, P-Trap, O Undrgrnd. '7.r 61. APPROVALTODECK e l 62. Backwash & Receptor-Final i � 63. Heater & Vent-Final 64. Plumbing System - Final 65. Electrical-Final � 66. Solar System-Final 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING 69. POOL/SPASYSTEMSFINAL . FIRE DEPT. REQUIREMENT APPROVALS Permit# 70. Underground Hydro 71. Product Piping O Gas ❑ Oil � � 72. Underground Flush 73. Undergrnd. Storage Tank O Gas ❑ Oil � 74. Overhead Hydro � 75. DrY Chemical 76. Dry Standpipe 7. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED ote5: 7.� K,lRS r, �-�3�,P�i� 4.� ,n w; � L y f.l / ,a 4 • � x � � jJ � jV i N itak. �S . .. _ Aoolieant to fill in all soaces exceo< lhose within neavr bortler Iines an0 siyn au avoroo��ata Oeclarations. �^ PERN�IT NQ.O �� TRACT NO. LOT NO. UNIT NO. Ci7Y oF coSTA MESA �ONST.RUCT�IOtN PERMITS} E � A.P.# Zone �Proiect Address �Z' �{��5 1"`2�� S Main Building: Accessory Building: r {�7,7 TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR E Z ApplicanCs Mailing Address 1 0(� 1'ZiG� 8 .. �/lJ. .�'.,�. Front VYZ`�V+"�J WU'^7liC'� Z��`—� � ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T N � Owner's Name �Phone�.�.Ey:zd',Z2 DESCRIPTION OF WORK/USE OF BLDG. I B Rear Address � �Ocl DG'R +h70� (J. �. 'i� C�CoC7 A � TYPEOFPERMIT GRAoiNG FOUrvDaTION S7RVCTVRAL '� C Right N Arch/Eng. License No. K C+ ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL g Left R Address �a. 1_ ❑ OTHER �' Ping. Ref. # Parking Req./Provided E �� OLLIIAQ! r IW\ Phone Q Contractor's Name�--- — pqOJECT DESCRIPTION SQ. FT. OCCUPANCV Address (mailing) Planning Notes: ry� CONSTRUCTION TVPE VALUATION § T City Licen52 No. Z GRAOING CV. VDS. ACRES L CONTRFCTOR DECLARATION �� S I hereby ai� fi��M nsetl untle� provi ertdn t Y �Commencing Remarki: '3�.0 3O1 ,$' WI[b SCC110l1 %Q��) Oi Division SIOE55 dlld PIOfC55�005 �Od2� dOd my license i5 in tull fort ect. ELECTRICAL FEES LicenSe Clds LicensG No._ 0 519nawre PLUMBING PEES Auromatic Washer Transformer ❑ 15�50 KW WORKERS' COMPENSFTION DECLARATION BarSink Showers Cons[ructiOn PoleSub. � 50+ KW 1 he�eby di/irm that I bave a<¢rtifiGat¢ of consent to sel(-in5ure or d C¢rtifiCate vorkers' Compensatlon Insurance, or a rertifietl copy thereof (Section Cooking Unit Meter ❑up to 100amps Backflow Preventer Service Sink ), Lab. C.1 Dishwasher Meter ver 100amps roticy No. Company Backflow Irrigation Sewer Cap �� BCertifietl copy I5 nereby furnished. Dryers ❑Gas ❑EICct�ic Sub Panel Cerlifietl copy is tiletl with the Uty Builtling Division. Bathtubs Sewer ConnectiOn Date Applicant Fan Motors�0-1 HP01'/x-8 EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Cla�ifie�5 SOlar C011ecto�5 (Thissection neetl not be completetl if the permit is tor one huntlretl (E100) or Dishwasher Solar Piping F�p`�U� Inc.Solar �9-15 HP �16-15+ icss). I certiiy lhat in the pe�formdn<e O� the wo�k (or which thi5 p¢rmR is issuetl, I shall not employ any perzon In any manner zo as to b co{�e subject to tha Drinking Fountains Solar Tank Fixture5 Microwdve Worke��Fort�p� 'on Law9ot Calitryq� �) 1�� A/�/� 9 P Date (!�_j Si nature Y`—C��1LV l/1/� Floor Drains Swimmin Pool w/S a Device Boxes Pole Light NOTICE: I7, after making this tleclara[lon, yo(isKoultl become su�ject to the Outl2ti F�an e Workerz' Compensation provisions of the Labor Cotle, you must forthwith FIOOr Sinks U�inal 9 comply with such provisions or Ihis permit snall be tleematl revoketl. WNSTRUCTION LENDING AGENCV GaSServiC¢ OUtlets WatEfClOset � SwitchCS Sign 1 nereby aifirm that lhere is a consV uction lentlinq agency for the performance ol thu work tor which this permit is issuea (Section 3097 Civ. CJ Interceptors Water Heater Garbage Disposal Standing Sections Lentler's Name �entlers Aatlress Kitchen Sink Water Service Generator �0.5 KW �5-15 KW Tresh Compactor OWNER BUILOER DECLARATION 1 heleby al�ilm lhat I am ¢znmpt trom th¢ Contra[tOI's Ucense Ldw toI thC L2v3tOfi¢5 AutO�WBSh followin9 reason (Sectlon 7031.5 Business antl Professional Cotle: Any city or county whiCh r¢quiles d perml[ lo wn5truct, altC/, implove, tlemolish or repall P—Tf2p LHUOdry Tl8Y5 any struclur¢, pNo� to its IssuanGe, al5o �equir¢5 the appliCdnt f0/ such pe�mlt to file a sign¢tl statement lhat he/She I5 IiCensetl pur5udn[ t0 Ihe pfovisions of ROOf DldipS the Contractor's License Law (Chap[er 9(commencing witb Section 7000) 01 Division 3 of tne Business antl Professions COGe) or that he/she is exempt Rainspection Fea $75 luue Fee $.4 �efrom antl the basis for t�e allegetl exemption. Any violation o� Section 1.5 by any applicant tor a permit subjects the applicant [o a civil alty o( not more than (ive huntlretl tlollars (E500). 3 DEVELOPMENT SERVICES REQUIREMENTS: LJ I, as owner ot tne oroperty or my employees with wages as their sola Reinspection Fee $15 Issue Fee $ Zoning Approved By Date compensation, will tlo the wo�k, antl the structu�e I5 not intentletl o� otfetCd (or sale (Se<tion 704a, Business antl Professional Cotle: The ConVacror's MECHANICAL FEES Building Approved By Date License L2w tloe5 nOt apPly to an own¢r o( a prope�ty who builtls or imprOves tM1ereon, antl who aoes SUGh wo�k himself/herself or through his o� her own HOOd OI Typ21 ❑ APPIIWtiO� ISSUBd By Ddt empl0yee5, prOvitletl thal such Impravemen[5 ale not intentletl o! offeretl for BOiIQf sale. I/, however, lhe builCing or Improvement is soltl withln one year of com- Canopy Type II ❑ SUMMARY OF FEES plelion, ihe nwner will have tho bu�tlan of provinq ne/she tlid not builtl or im- DuCt - U�dE� G�Ound r ve �or lhe purpoze of sale). BUILDING PERMIT $ SMIP $ I as owner ot the property, am exUusively contracting with licensetl <on- Duct -Structurel Refrigeration System P�,qN CHECK S PERMIT ractors to <onst�uct Ihe prOject ($ection 7044, Busine55 antl Protessionz Cotle:" Tne Contractor's License Ww tloes not applY to an owner of property who Duct- Ventilating ❑0-700,000 BTU ❑100,0008TU PLUMBING § ISSUANCE $ builtls or improves thereon. ana wno contracts for such oroiects with a mn- tracror(s Lcense pursuanc to �ne ConVactors License Law). I am aware thai Exhaust System ❑ Multiple ❑ System Repair/Alteration PLAN CHECK 25% $ ENERGV P.C. $ .Qpr o( o�their Worker's Compensatl n insurance shoultl be provitletl m me. ELECTRICAL $ � 0 GRADING $ IS.�am eaempt untler Section �� B. & P. C. (or this reason Firepl/Fact. BIL IC80 �k Fire Dampers MICROFILM $ PLAN CHECK 50% $ ❑ q p 5_ e.�/' Heating System & Ducting Registers MECHANICAL $ ❑4100,000 BTU 0100,0006 TOTAL FEE $ � 3 m I nereby certify that 1 nave reatl this app ation antl state Ihat the aDove PLAN CHECK 25% IntOrmation is mrrett. I agree lo omply with all city antl County ortlinances $ antl state laws rela[ing to bulltli consVuction, and bereby authorize repre- sentatives ot his city [o n[e p he above-mentionetl property (or insoecUon 0 0 .�Gl Signature Date Y � Reinsaection Fea $15 laue Fee $ 3 �1 COa4. 631—��D4iE3i �� ; .i�� Orivers' Llcense _ ' � � OB65�46, rev. 5/88 White - BUiltling; Candry - AppliGant; Pink - ACCOuntin9; GOltlenrOtl - Assessor �4��' �r�� i� Tjli�: _6:l}/ . .. : . . �- , . .. : - . . ,, , , CONSTRUCTION AND PLANNING POO' iPA �.. �, • 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 ' � i 3. Electrical Conduit Utility-Undrgrnd. `' 54. Forms " ' 4. �Electrical Conduit-Undrgmd. 55. Electrical Bonding •� �� r 5. Steel Reinfor�ement 56. Rough Plumbing & Pressure Test `� E.ElectricalUFER;Grnd. � 57. APPROVALTOCOVER-GUNITE � r � '•'_, 7. Footings � . �� 58. Electrical Conduit-Undrgrnd. �' � -�! • � � 8. Foundation �� i 59. Gas Pipe, O Undrgrnd., Test ; � i 9. Water Pip¢-Und�grnd. ' � • � 60. Backwash Lines, P-Trap, O Undrgrnd. - , � • 10. Structural Floor System � .=, 61. APPROVAL TO DECK ' 11. Property $ewer Line & House Connection `•' 62. Backwash & Receptor-Final i� 12. Sewer Cap ' ' � 63. Heater & Vent-Final , 73. Roof �Drains � ( 64. Plumbing System - Final . � r 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Condui�' �� 66. Solar System-Final ��6. Rough Electric Wiring � � 67. Fencing & Access Approval 17. Rough Wiring Sign ` �� 68. APPROVED FOR PLASTERING �18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ;,19. Rough Heating & Air Coniiitioning FIRE DEPT. REQUIREMENT ;�20. Rough Factory Fireplace „' APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating '�� 71. Product Piping �Gas ❑Oil 23. Gas Pipe-Fough & Test -, 72. Underground Flush 24. Roof Framing '�� 73. Undergmd.StorageTank �Gas ❑Oil 25. Foof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall NBiling HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � 79. FINAL INSPECTION 32. Electrical Power Meter-Final /o-/� ��✓`' 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final � �. 42. Backflow Preventer � � i 43. Backflow Irrigation ti_ � •44. Landscape Irripation System � � � 45. Sound Attenuation ' 46. Handicap Regulations . 47. FINALSTRUCTURE&BUILDING '�'� 48. Special Requirements Completed � f 49. Electric Release to Edison ��.� 50. Gas Release to Southern California Gas Co -� i 51. CERTIFICATE OF OCCUPANCY "+ - . '" : No. Date � �- , � -� � v COUNTY OF ORANGE @tLJILDING DEPT. 636 No. Broadway - Santa Ana� California Phone: KI 2-6211 _ :� � Application for Building Permit � AND FOR A � � Certificate of Use and Occupancy t. OW[VER'S NAME------COd1ST _ORA[A3E_AGF?_Fr$-------- Permit No.--_-_�-�-,.--1 s�- R---I--- Date.-- ...�:��d (! ----------- -------- / PHONE: $��QOJl_B`�� I-- MAILING ADDRESS.----'.BS_Tk. �%$11 S�Y'9@�i CITY.----CQBSii�_MA0{�-----..--------- - -- ----- -- --------- ------- - - --- -- -- • c�o3��o t�i, iiola'C99.n 2� 3one Name..- ---------------------------'--------------------------------. IVame------------'------------------------------------'------------- (Archiceco or En mee_) � (Con�racror) g --- ---- -------. Address __�.�'Fi _ �r''. _i7�Eh _S�reo�-- ------- ----� ------ -- Address---------------------------------------- - ---- c�t Co�$a Pfeo4 ��y -- --- - - - - ------- - - - _.- - - - v ---- -- -- - --- ------ --- ---- -- --- ---- -- ----- ------ -- - $tate $ta[e 7 L«. No. -- --- - - ----.. pt,ane ---- — --- ----- - �«. rre119�.tt0_._.. - 89'... ---- nhon�et€ao_i�__829?---- PROPOSED USE:---ROf3LQal1CB--------------------------- - -- - ------ ------ - - - --- -- -- - _.. z. . os �ocnTioN-- :5� E --�n�z� �.�s _ �'.. Co1Q�iA__2:I9A$---- ---- --- -- J 'Z-`�------- • �--------- - /�-- �'-------- '(Housp No.) (Name of Streec) (Town or School Dis�rict) 3. LEGAL DESCRIPTION: Lot .-'��E-�"-^---------------------Block -------- ------------__-------Tract _ia`�.�9r---------------------- (Meres and Bounds Desctiption—Use reserse side of form) 4. CORNER LOT ( ) INTERIOR LOT (✓) THROUGH LOT ( ) SLOPE OF LOT ( ) 5. SIZE OF BLDG.: .,3�_X._y3.. AREA:__Lz 2.,�_____________ SIZE OF LOT: _��-�1.�_�.��AREA:79�.J-.-�--..___ 0 9 6. HEIGHT OF BLDG.: ___�'�.__._..__________-CEILING HEIGHT:.____�____ NO. OF STORIES___._. g___.__.__.. i. NO. FAMILIES ___ —___�`_____________________Size of Smallest Bedroom:...__�x./O-___ Size of Kitchen: __9,),�../.y_____ 8. EXTERIOR WALL CONSTRUCTIOI�' _�_'A _$�it1000 __ INTERIOR WALL COVERING ___ �iAH'�F1T__.._____ (Framp, Smccq Ea.) � (Plasrer�Drywall, E[c.) 9. SE1'BACKS: Front Yard £rom Center Liae of-Street.._._..��---'-_----------____--_-_-_---__---------_.--___--_______-_-'--_-------.--- i i . Nearest Side Yard.____.�_____..Rear Yard-__-��____._.Distance in Feet Between Bldgs. on Same Lot ___�Q--------... ._.__ ]0. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES ANp USE OF EACH. 11. For (a) Footing: Width _._._._a______ _ p p �'� ----_- De th in Ground ------_�G�.----_----_..---Width of Wall --_--_g_p- -----.___ Acressory n Bldgs. and b Size of Studs: ._'c'._� �___.__.___S acin 1�n _______"CC Macerial oF Floor __QOa_____._ ___-, _- ' ( � ----- P 8-------------- - $imi�ar $tructures: � (c) Size of Floor Joists:.�--R-a---------'---`-Spacing --�.e��------ .---------�<CC - ------ - - ----------- S acin - - -- (d) Size of Rafcers: ._------�--- p g_--�"�u-----------------` CC 12. VALUATION CiF PROPOSED WORK: Induding all laboq plumbing, electrical wiring, heating, fire sprinklers, paint- in and sewa e dis osal .. � s g p � ---79�a ---_ ---- --- ---- - --- -'= - . ---., _�___i-i-tExEBY' CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AIVD BELIEF THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE COi�7STRUC"rION- WOR1C �WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORIVIA APPLICABLE THERETO. -------Signed:------�-- - L --�. --��x/(�Q�,it.+..._.�_��--------------- �---`�� 0 ~ Owner) Plans Filed:._--__- � �D_-___-___ - - -- By:----- � - --- -------------- - -- -'-'- ------- --- --- ---- -(Au�horiz d Ageat) FOR DEPARTMENTAL USE ONLY Bldg. Permit Plan Check Total - - Receipc No. - Paid ro - Date ,' DA SM-f 50 FEES: ,p m - $ ----- �Q---- - --- - $ - - sa� ��d---- - $----��/ -----a------ D- GROUP_------T---------- TYPE.--- ------I�.._------ --- DIST. MAP ---- -- - -------- ------- SHEET NO.._.___��_.._.____ CH C ING BY APPLICATIO HEALTH ---------- FIRE ZONING-- - . ------..._ ._. , MARSHAL_--- - -- - ------ --- PLANS AND � SPEC'S-- -- � ------------ - STATE- - COP.RECTIONS ENGINEER VERIFIED -------------------_ CAL.--____-. PERMI�ISVV� 'DHUE �OUNTY EU LD'�NG r iras��croR -- -------- -- - -------- -- ----- --- -------------- ---- --- - - - -- - ------- ----- ------------- LEPUTY � __ / U %�/ COUNTY OF ORpNGE BUILDING DEpT. 636 No. Broadway �Santa Ana� California Phone: KI 2-6211 � ;' w. �� Application for Building Permit - P"'�"`�°.- �-�-�'-�_A___ AND FOR A � Certificate of Use and Occupancy Date----------//�-----� -�_a--'-------------- 1. OWNER'S NAME.--- --�A�' ORAIT� A�--------- - - -------------- ---- ----- ---- -- - PHONE:B3@QOA--$`��-- MAILING ADDRESS.-'------ZG�._E'---�e�t+Il__�til•8BL - - - - ---- ----- - ---`--- CITY ..�i09EA- i�I891----- --- --------- Name - - Address City State Lic. No. (Archicect or Engineer) Phone Name (;g(} - rgo -1:. Hoiq�ai�r�o� Sonn------------- --- Address _��1 __ _T'e.�... 17�1__�iii.i'QQ�i ____.______""_________'___ City _.�ii7��.-1�8Q3._________._.__. $tate Lic. Nol�9�.�.��----��:-------��-- PROPOSED USE:--aARAaS --------- - ------ --- --- -- ------ - ------ ------ - ---- -...— -- --- - 2. JOB LOCATION.----�'Z`�---�-..4mJT.4---�ES/�---ST-- ----aO8L8_I:90d---------------------------- (Housc No.) �/ (Name of Strec�) (Town or $chool Discrict) 3. LEGAL DESCRIPTION: Loc --_-7.`l..-.---_------_--_--------------Block _----- _-__--.- --_Tract _ - ------ - - 1�--- - ---- - -- ---_.. (Meres and Bo�nds Description—Use reseroe side of form) 4. CORNER LOT ( ) 1NTERIOR LOT ( ) THROUGH LOT ( ) SLOPE OF LOT ( ) 5. SIZE OF BLDG.: �_.x._��___ / _AREA:._��._gQ--P�____.SIZE OF LOT:�I.Y.k.-I�S----AREA:.Z�_.�p.�.._._...__ Y 6. HEIGHT OF BLDG.: __14._ ._..______.CEILING HEIGHT:._____.__.____._ ...... ............_ NO. OF STORIES._.�,.._._____.__.__._ i. NO. FAMILI$S _ Size of Smallest Bedroom: .__________________._. Size oF Kitchen: ______ ...............____._.._ 8. EXTERIOR WALL CONSTRUCTION:Niim1i15.__.9LllO0Q___.__.IIVTERIOR WALL COVERING _______._._.____.__________________ (Frame, Soumo, Etc.) y � - (Plaa�er-Drywall, Em.) 9. SETBACKS: Front Yard from Center Li:�e of StreeL...___..__.��._y_____ _ ________..____._,.______...__. / '/ � Nearesc Side Yard._____.�_.____._Rear Yard.___.____.___...___.Distana in Feet Between Bldgs. on Same Lot ___-T� ............ ......_.... 10. A COMPLETE PLOT PLAIV IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. ll. For (a) Footing: Width_�'�»_-____-___-_- p �!�__ ...............Width of Wall_8�-_-- _.._. __. De th m Ground...l�,,, . . --._ Accessory Bldgs. and Z � y Similar (b) Size of Studs: ________. �____._Spacing________�{.e_._____."CC Material of Floor i70A8TOLd ---- - $tzu[ture5: (c) Siu of Floor oists: _..__._____.____._ J -----...----'-.Spacing rvC� r n R__�i_'.. ."""""""_ 5 dCln M""'"'""""""__'_ � CC (d) Size of Rafters: ______.�._. . p g_.___'�_ l2. VALU.ATIOIV OF PROPOSED WQRK: Induding all laboq plumbing, electrical wiring, heating, fire sprinklers, paint- in and sewa e dis osal . �� S S P �--7��--`.--------'------'---- I;. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CO� IFORM TO ALL LAWS OF THE COUIVTY OF ORANGE AND THE STATE OF CALIFORIVIA APPLICABLE THERETO. 'A_ ��j'� -- — ---- Signed:-- ---- ' - I�.t.a----'��/��%�=8- f.t�wi—� -" -- - ----- ' lo- 3 - �a w�ef) Plans Filed:.------------------------------- By:.-- -�� _'_ - - --------- ---------'-._---- ------------ . (Auchorized Ageno) FOR DEPARTMENTAL USE ONLY FE�S: �� Bldg. Per�nit - y$._ �:'° ---- ----- — Plan Check - �. �/ � 0 To[al - - - �-_-----_�,. Reccipt No. - - -_---_'�/-+'�--L Paid ro - - -_-_-_�yl� Dnte.- ---------1'�-'�1 DATE-- -�---- --- ---------- �M-1.30 GROUP--------SZ.-. _------ TYPE-------.-,.IL--.�. �r-- DIST. � MAP- --- ..�----- SHEET NO._______.�/______________ CHF,CI�ING BY APPLICATIOrk.�_`�"��-y,"��'"- HF,ALTH --------------------- <=��o,c0 FIRE ZONING .-- - --- ------ --- MARSHAL.---------- ------ -- - PLANS AND SPEC'5--- --------------....__.. STATE - --------�---------- CORRECTIONS EIVGiNEER PERMIT�IS$�E[�t��OHUL� COUrJTP_CTOR�NG r vv --------- ------ -- --- --------------------- ---- - - -- --------- ------------- DEPUTY �J � � �C vwNER BA�CTER� HAROLD DATE OCT 1 5�95A � JOB ADDRFSS 42�F COetB MESS St. BUILDING PERMIIT N0. .'L O9 � GENliHnL COYTRACI'Ofi Opnei-Bttilder VAi,UE 5 1�000.00� � � P 'o. 11�-251�-�FS LOT 1'RACT H11tE'LONE 3 DI:SCRIPTION OF WORI$tqT.Add'P lA_✓LCTIONS � Signaturc � llA'1'E � CROUP ,j TYPE V 'LONE Rl SUBCONTRACPOR � 2�osi COSTA MESA BUILDINGSAF�Y DEPARTMENT P.O. BOX g�7 COBTA M68A, CALIFORNIA For AppJicont !o Fill Ja Complelely TYPE OR PRINT wooae�ss°' OS/fi �`S� COSTA MESA. CALIFORNIA NO.OP � BETBACK LINB PROM EFY � � / I RIGHT DESCRIPTION OF WORK BUILDINO SIZE EXTERIOR COVERING UeE OF BU 1 HEHBBY �CKNOWLEDOB THAT I NAY, �NU 9TAT8 THAT TH6 ABOV6 �Y COHi PLY WITH �LL CITy OpDItiANCflB �ND �WLDINO CON9TpyC{ O /. SI6NATUREOP � PERMIttH AUTHORIZ6D AGENT �EE RECEIVED FinAN(,'�sD�EPT. CITY OF COSTA MESA APPLICATION FOR PERMR BUIIDING For Offica Use Only 116CtIIT NO. �P�v� j FIRB � 20NH TYPE GROUP BYPROVED � �. DATE I � ZONINCi ZO [ NO. OF UBH OP N �uns em� �a �ea�� O oeecairt�on AP.NO. /� R��y �� NOTE: NO EAVE OVERHANG BHALL BE LE55 THAN YARDSAPPROVED MAIN BUILDINO _._'_..,__ . .I 1 YAR�SAPPROVED ACCESSORYBUILDINO � R. SID6 PT. L. SIDE FT. FT. IREAR . v FT. I�ISTANCE BEf. BET. MAIN Q MAIN BLDGS. AGCESS. BLD69 VAR.$ DATE � C. U. P. ^ APPROVED � � wvp///.6�� A� c, onTe f O^ Q/ n t-j SO. FT. � TII¢ �MOUNT BHOWN UNDHP V�LU�TION 18 FOp TXB F PURPOSH OP 88TABLIBHINO A PEHMIT FE8 ONLY. � VALUATION �O � � o PHRMIT FEE � � m $ � �OO �. O _ 4