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Home My WebLink About3201 DAKOTA AVE - Building Permits(714) 754-5273 • Fan (714) 754-4856 • www,ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 3201 DAKOTA AV Suite No Vicinity: KITCHEN Parcel Nunmber: 13908418 Applicant: MICHAEL HU Address: 8501 MARTINIQUE DR HUNTINGTON BEACH, CA Owner: COVEY, JUDITH G � Address 3201 DAKOTA AVE COSTA MESA, CA Contrector. ROVICS CONS7RUCTION INC Addr�ss: ISSUE FEE Backflow irrigali0n Backflow Preve�ter Bathtub Clanfier System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 ouHels) Gas (Over 4 ouqets) Gas Repipe Gas Service 8501 MARTINIQUE DR HUNTINGTON BEACH, CA Phone: 714375-0722 Zip: 92646 Phone: Zip: 92626-2259 Phone: 7143750722 Zip: 92646 License: 800996 Status: ISSUED Applied: 04/13/2005 Issued: 04/13/2005 ISSUED BY: �� SCOPE OF PERMIT REMODEL EXISTING KITCHEN. WORK TO INCLUDE: DRYWALL, ELECTRICAL AND PLUMBING WORK. REF.: B05-00592 PLUMBING TO INCLUDE: RELOCATE KITCHEN SINK AND 1 WATER REPIPE. AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 50.00 $0.00 $0.00 50.00 $0.00 $0.00 50.00 $0.00 �TY FEE SUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo 50.00 Sewer Connecl $0.00 Sewer Pnvate Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kitchen $9.80 Sink, service/mop $0.00 Spa (private) 50.00 Spa (public) $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr BkFlow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Claset (Toileq Water Hea[er / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK AMT $0.00 $0.00 50.00 $0.00 S0.00 $0.00 $0.00 $0.00 $0.00 $D.00 $0.00 $0.00 $9.80 $0.00 $0.00 $0.00 $0.00 $0.00 an 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 NOTICE: 7he work aufhonzad by this permit shall comply wifh all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 7, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not wmmenced within 180 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes�and all required Inspeetlona end final approvel must be obtained. FaiWre to obtain inspections and final approval will resWt in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 � (�J 2dC8d8 (8�00) WORKERS'COMPENSAnON DECLARATON: I hereby eflirtn untler penelry of perjury one ot lhe following declarations: ❑ I heve e�d will mainrein a cenificate ot consenl to selidnsure far workers' crompensetlon, e9 prwitled for by sectian 3700 of the Lebor Cotle, tor ihe perto:mance ot the work fof w�ich this pertnit is issuetl. {�, 1 have and will mainteln 4mAcees' compensation Insu�ance, as requi�ed by section 37W ot the labor Code, tor the peAortnance ot ttro work for wnlch this pe�mit ia lssu¢tl. My workers' compensetion Insurence cerder end poliry number ere: ^ �'J �n Cerrier �7/1""/� fNNP PolicyNumber: 1'T�y 7�,'�Odr (Tbls secflon n�not 6e camplefed il the permit is velued ef one hundred dollers �$ IOOJ or Iess.J ❑ I cartify Ihet in Ihe performance of �he work for which Ihis pe�nll is issued, I shell not employ eny person in any manner so as to bacome 9ub�ect to the worknro' compansation laws ol Califomia, and egree Ihe_^If I should 6acome sub�ect to Ihe workers' compensation pmvisions ot Section 3700 of the Lebor Code, I shall forihwith comply with these provisions ' I �7 �` Applicant SigOeture: �� /�� Date: � I � y� 0/ WARNING: FAILURE TO SECURE WOfiKERS' PENSATI EMGE IS FUL ANO SHALL SUBJEGT RN EMPLOVER TO CFIMINAL ENALTI 5 RND CML FlNES UP TOONE HUNDRED TINN15AN0 DO��l.fiE (St0p,000), IN ADDITION TO THE COST OF COMPENSRTION, �AMAGES AS PROVIDED FOF IN SECTION �p60F THE LABOR CODE, IMEREST, AND ATTORNE�^5 FEES. LICENSED CONTRACTORS DECLARA710N: I hereby attirtn that I am IicenseA u�er provisio lorce end eHect. Lia a QD �� Contracror's Signature: �1r CONSTRUCY�ON LENDWG AGENCY: of Chaplar 9(commancing with Sactlon 7000) ot Dlvision 3 af the Business antl Plofessions Code, and my license is in full Classb �� .,f� Dnte: N//3/o� ❑ I hereby attirtn that ther¢ is a construction lending agency lor tha pedormance of Ihe work tor whic� this permit (s issued. (Sec. 3097, Civil Cotle). Lentler's Name: Lender's Address Signamre: OWNER•BUILDER DECLARATONS: Dare: I hereby eflirm thet under penalry of perjury thei l em EXEMPT FFOM THE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, eusiness and Professlons Cotle: Any ciry or counry w�ich require5 8 pertnit to construcl, elter, Impmve, tlemolish, or repalr eny stmcWre, pnor fo its issuance, also raquires Ihe applicant for suct� pertnit to tile e signed stetement that ha or she is Ilcensetl Oursuent to the provisions ol ihe Contrectors Llcense Lew (Chapter 9(commencing with Sectlon 7000j af Division 3 of t�e Business end Profession5 Code) or that �e or 5he Is exempl tharelrom and tha he5is lor the ellepe0 ezemption. Any violetion o1 Section 7031.5 by any apP�� or a permit sublacts Ihe epPlicani to e civil penelry ol not mora than live huntl�ed dollars ($500).): ❑ I, as owner of Ihe property, or my employees with wages as their sole compensetlon, WILL DO THE WORK, antl ihe stmcture is not inten0etl or oMeretl for sale (Sec. 70a4, BUsiness antl Professions Gotla: The Contrectors Licensa Law does not epply to en ownor ol properiy who builtls or improves thereon, antl who dces such work �imself Or �erself or through his or her own employees, proVitled that suc� improvemenis ere not inlendetl or oHeretl for 5ale. If, howaveL the building or improvemenl is sold witM1in one year of completion, the owner-Duiider will heve ihe 6urdan of proving thet he or she did not build or improve for puryose o� sale.). ❑ I, es owner of the properry, em E%CWSIVELV CONTRACTING WITH LICENSE� CONTRACTORS to construct the project (SecJDaa, Business antl Professions Coae: TAe crontrecrors License Lew does not epply to en owner of property who builtls or Improves ihereon, and w�o contracts for such project with a mniractor(s) licanse pursuent to the Contradors License Lews.). ❑ I em exempi untler sec. Business and Prolessions Code lor ihis reason: Signature: Oate: Owner ID vBnlied by tlnveis licensa. ❑ Yes ❑ No Dnver's License No. Exprtes: Venficetion ol Ownership by (rype ot tlocument, i.e. - properry ta: bill or tleea): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby �ertify that no excavetion five (5) or more leet in tleplh into which a person is required to descenq will be matle in connaction wiih work authonzed by t�is permit, entl that no building strucWre, scattolding, lelsawork, or demolition or tlismantling thereol, will 6e more ihan thirry�six (36) feet high (Chap. 32, Grp 2, Art 2, Sec. 341, TIIB 8, Calilomia Adminis�rati�e Code). ❑ As owner�builtler, I will no� employ enyone to tlo work which woultl require a permit irom ihe Division ot Industriel Safety, es noted above, unless such person hes a permit to tlo such work from the division. Signature: Date: Divi5i0n ol IndVsirial Salery Permit Number: CERfiFlCA7E OF COMPLIANCE AND AUTHORI2ATON OF ENTRY: I cenify untler penelty ol perjury ihat I heve reatl lhis aDPlicetion antl s�ata ihat the infortnation qiven is correcL I agreB to comply with all stete lews end ciry ardinences �elaling lo building conslmclion, entl eulhonze represenlatives of t�e Clty ot Costa Mesa to emer upon tha above-descnbed propeny lor inspection purposes. I agrae nol lo occupy or allow acupency ol eny builtling au�horized hy Ihis permil until finel inspection. -�gaaWre OI Le�ga��) / � ) ate / \ —� C�f � � 6 � AnNUr Authonzetl Applicent � T Date CO�E I, �uc�crTONTYiE QeIE INTITIALS o__ 1616 Fized System Final Fire Prevention 7266 200 201 242 203 204 Pool $pe Final Final Re-Rool Final9�ocWRetaining Well Final fectory Fire Place Finel S�gn Finel Pemolition L4f�E[ INSPECTIONTYPE 206 Finel Mechanical 20B Finel Plumhing 210 Finel Eleclricel 272 Final Fiw Prevention 220 Final Planning Approval 222 Final Sita 250 Final Building�Occupancy QAIE irmru�s �� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Viciniry: Parcel Nunmber: Applicant: Address: 3201 DAKOTA AV KITCHEN 13908418 MICHAEL HU 8501 MARTINIQUE DR HUNTINGTON BFACH, CA owner: COVEY, JUDI7H G Address 3201 DAKOTA AVE COSTA MESA, CA Convactor: ROVICS CONSTRUCTION INC Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fizts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 7000a Service over t000a Motors to 1hp Motors to 10hp Motors to 50hp Motors [0 100hp Motors over 100hp Communication drops Sub panel l0 200a 8501 MARTINIQUE DR HUNTINGTON BEACH, CA Phone: 7143750722 Zip 92646 Phane: 2ip: 9262E2259 Phone: 714375-0722 Zip: 92646 License: 800996 Status: ISSUED Applied: 04/13I2005 Issued: 04/13/2005 ISSUED BY: C-�%�� SCOPE OF PERMIT REMODEL EXISTING KITCHEN. WORK TO INCLUDE: DRYWALL, ELECTRICAL AND PLUMBING WORK. REF.: BOS-00592 ELECTRICAL TO INCLUDE: 11 LIGHT FIXTURES, 12 OUTLETS AND 2 SWITCHES. $23.50 50.00 $0.00 $0.00 $0.00 $0.00 $12.10 $13.20 52.20 $0.00 50.00 $0.00 $0.00 50.00 50.00 50.00 50.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 11 12 2 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway/100ft Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw � .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Voll Wiring Syslem / Ckt Misc. Conduit Misa Conduclor Circus ( gen or nde) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand , Other Electrical Fee Investigation Fee Plan Check Fee Quantity 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 $0.00 So.00 NOTICE: The work authorized by this p0rmit shall comply with all applicable handicap access requirements under California statutes and ralated regulations. (Ord. No. 92-28, § 7, 12-21-92) EXPIRATION: This permit shall automaticylly expire and become void if work is not commenced within 1 BO days, or ii work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under Ihis pe�mif to be conside�ed Iegal, such work must comply with all applicable codes, and ell requlretl Inspections and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiretion of this permit.// FOR INSPECTIONS CALL: (714) 754-5626 246618(8N0) WORKERS'COMPENSAnONDECLARAnON: I hereby eHirtr� under peneliy of perjury one of the tollowing tleclaration5: ❑ I heve e�d vnll mainiein e certilicate of cronsant to self�lnsure for workers' compensetlon, es provided for by section 3700 of the Labor Code, for Ihe peAortnance oi the wOrk for which �his pertni� i5 issued. � 1 have aM wiU maintai� wo�lcars' wmpensatlon insurance, as requlrad by section 37W ot the labor Cafe, trn the peAortnance of the work tor which this permft is issuetl. My worKers' compe�n7setion Insurence cerder entl policy number e�e: 7 r, Cerner. �1 i � N Ni� Policy Number: �� J��1 (This secNon� be crompleted i! the permif is velued et one hundred dallers ($ f 00) or lass.) ❑ I certify thet in the pertortnance of ihe work for which this permit is Issued, 1 shell not employ eny person in eny manner so as to become subject to the worknrs' compensation laws at Celifamia, end egreeAhet II I shoul0 become subjec� b ihe workers' compensetion provlsion9 of Section 3700 of Ine Lebor Cotle, I shell forthwit� cnmply v+�ih Ihese provisio � �'7 % ApPlicsnt SignaNre: � �_ Dere: �� I 1/ J� WARNING: FAIWRE TO SECURE WORI(ERS' OOMPEN54ilON UNLAWFUL qND SWll.L SUBIECT AN EMPLOYER 70 CRIMI AL PEN LTIES AND pVIL FlNES UP TOONE HIINDqED TIIIX15/.ND DOLL4FE (SI00,000), IN ADDITION TO THE 00.4t OF COMPENSATION, DAMADES AS PROVIDED FOq IN SECTIpJ �O6 OF THE LABpR CODE, IMERESi, qND ATTORNEYS FEES. LICENSED CONTRACTORS �ECIARATION: I hereby a8irtn Nat I am licensed under pmvisions ol Chapter 9(commencing wlth Saclion 7000) ot Division 3 0l ihe Busines/� end Professions Code, and my license is in full lorce end ettect. Lic. k ��`� �v Cless a 1> Contrac�or's Signature: `�T T,._ Dnte: y If� CONSTAUCTION LENDING AGENCV: ❑ I hereby aMirm that there is a con5iruclion lentling agency b� Ihe Oedormance ol the work br which this permit is issuatl. (Sec. 3097, Civil Cotle�. Lender'S Name: Signeiure: � OWNER-BUILDER DECLARATIONS: Landar's Address: Date: 1 hereby attirtn thei untler penelry ol perjury ihat I em E%EMPT FHOM TME CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, 8usiness antl Professions Gotle: Any city or counry whic� requireS e permil to construct, alter, improva, domolish, or repair any stmctuw, prior to its issuaoce, also requiBs the applicant tor such partnit to file e signed statement thet he or she I5 Ilcensetl pursuant to tha pmvlslons ol the Contrectors License Law (Chepter B(commencing with Section 7000) of Divislon 3 of the Busine55 end Professions Code) or that ha Or she is exempt thefelrom end Ihe besls br Ihe alleged axemption. Any violatlon ot Section 7031.5 by any applicant for a pertnit sublects the epP�icant to a civil penelty ol not more then five hundred tlollars ($S00).): ❑ I, es owner ot Me pmperty, or my employees wlth weges as ihelr sole compensetlon, WILL 00 THE WORK, and the slmcture is not inientletl or ottereC fOr Sale (Sec. 7046, BUsiness entl Professions Code: The Contractors License Lew tloes nol apply lo en owner of property who builds or improves Nereon, and who tloes such work himselt Or herseli or through his o� har own employees, pro�ded ihat such Improvements are not intended or oHered for sale. If, howeve�, ihe building or improvement is sold witbin ona year of complation. Ihe owner-builder will ha�e the burtlen ol Dmving ihat he or she tlitl nol build or improve tor purpose of sale.�. ❑ I, es owner ol iha properry, am E%CLUSIVELV GONTRACTING WITH LICENSED CONTRACTORS to cOnstruct t�e project (Sac. 70da, Business antl Professions Code: The coniractors License Law tloes noi eDPN �o en owner ol pmpetly who Uullds or Improves thereon, and who contracts lor such prol�t w�ih a contractor(s) license pursuent to the Contracbrs licease lews.). ❑ I am exempt under sec Business end Prolessions Coda for this reason: SignBiure: Date: Owner ID venlieC by OmerS licen5e. ❑ Yes ❑ No Drivers License No. Varifiwtion of Owners�ip by (type ol aocument, I.e. � propeny taz bill or deed): Expires: DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereDy �eNiy that no axcavation five (5) or more feet in depth into which e person is required to tlescend, will ba made in connection wit� work authorizetl hy this permit, antl that no building sirucWre, scaHolOing, talsework, or demolition or dismantling thereof, will be more then Ihirty-sia (36) fee� high. (C�ap. 32, Grp 2, Art 2, Sec. 3at, Titl9 e. Calilomia Atlminis�re6�e Code). ❑ As owne�-builder, I will not employ enyone to tlo work whiCh woultl require e permit imm Ihe Division of Indusirial Salery, as note0 above, unleu such person has a pertnit to do such work trom the tlivision. Signature: Date: Division of Intlustnal Safery Permit Number: CER7IFlCATE OF COMPLIANCE AND AUTHORIZA710N OF EN7RV: I conify unUor penel�y of Oerjury ihat I have read ihis epplication and state thai �he inlormation given is correct. I agre6 to comply wilh ell stete laws enA city ordinances relating lo bullding construction, and emhoAze representatives of t�e City ol Casta Mesa to enrer upon the above-descnbed property tor inspection purposes. I eqree not to occupy or ellow occupency ot eny 6uilding eWhorized Dy Ihis permit until final inspection. COOE I. INSiEC 07I NTYPE 1616 Fixed Sys�em Final Fire Prevention 1266 Pool $pe Final 200 Finel Re-Raof 201 Fina16�ock�Retaining Well 202 Final factory Fire Plew 203 Finel &ign 204 Final Demoli�ion ow�a�,s, PAIE ��,a v oate 7yjlilALS S.QpC( ItlSPELTIONTYPE 20fi Finel Mechxnical 20B Finel Plumbing 210 Final Elecirical 212 Flnel Fire Prevenlion 220 Final Planning Appmval 222 Finel Siie 250 Finel Building/Occupency PAIE IIffQ�AL@ �� (714) 754-5273 • Fa�c (714) 754-4856 • www,ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job nddress: 3201 DAKOTq AV Suite: Vicinity: KITCHEN Primary Occ: R3 Owellings/ COng Res <10 Type of Construction: V-N Parcel Number: 13908418 Zoning: Applicant: MICHAEL HU Address: 8501 MARTINI�UE DR HUNTINGTON BEACH, CA Owner: COVEY, JUDI7H G Address 3201 DAKOTAAVE COSTA MESA, Cq Comracror: ROVICS CONSTRUCTION INC Address: 8501 MARTINIQUE DR Arch : Address: HUNTINGTON B�ACH, CA Zip: 92646 Phone: Phone: 714-375-0722 Zip: 92646 Phone: Zip: 92626-2259 Phone: 714-375-0722 License: 800996 Eng: Address: ISSUED BY: Status: ISSUED Applied: 04/13/2005 Issued: 04/13/2005 Phone: Zip: License: License: SCOPE OF PERMIT REMODEL EXISTING KITCHEN. WORK TO INCLUDE: DRYWALL, ELECTRICAL AND PLUMBING WORK. Plan Check: $0.00 Permit: $23.50 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $24.00 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existin : 0 NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING 8 ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0- 0 ssoo.00 $500.00 NOTICE: The work authorized by this parmit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-27-92) EXPIRATION: This permit shall automatically ezpire and become void it work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order tor the work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this per� FOR INSPECTIONS CALL: (714) 7545626 zaas-aeldoo) � WORKERS'COMPENSAnON DECLARAnON: I here6y effirm under penalry of perjury one ol the following dedaretions: ❑ I heve end wlll meintein e certTcete ot consent to self-Insure tor workers' compensetion, es pmvidetl br by sedion 3700 of Ihe LaDor Cotle, for ihe peAo�nance of the work tor which ihis pertnit is issued. � I heve end will meintein workers' compensetion insurence, es requlred by sectlon 3700 0l the Lebor Gode, for the pertormance of Iho work for which this pertnit i9 issuea. My workers' compenselion Insurence carrier end pollcy number ere: ��q Carrier. ��7� FUND PolicyNumber:_'�� I-7�� (This section neatl not be completed il fhe pe�d is valued af one hundred dollars ($100J or less.) ❑ I certify ihe� in the perfortnancre of t6e work br which this pertnit is 159ued, I 5hell nol employ eny person in eny manner so a5 fo Decome subject to the workar9' rnmpensa0on laws ot Celilomia, enA egree Ihel II I should bacome su6�ecl to �he workers' crompensetion provisions of Section 3700 0} Ihe Labor Code, 1 sheil forthwith cnmply wiih these pro^visions. 7 ApPlicent Signew i/ \ Deta: v'' � 7 f V� WARNING: FAIWFE TO SECURE WORKERS' CO ENSATION WVEMOE IS UNLAWFUL AND SMALL SUBJECT rW EMPLOYER 10 CRIMINQ PENALTIES NJD pVIL FlNES UP TOONE HUNDRED TIiOUSAND OOLLARE (5100,0OO�.IN ADDITIIXJ TO THE COST OF COMPENSAtION, OAMAGES / S PROVIOED WR IN SECTIpJ �O60F TNE LABOR OpDE, IMEFESi, AND ATiORNEYS FEES. LICENSEO CONTNACTORS DECLARAiION: I hereby attirtn tha� I am licensed under pro 'Sions ot Cheptar 9(commencing wi�h Sec�lon 7000) ot Division 3 ot �he Busine5 antl Prolession5 Code, and my license is in full force en0 eftect. Lic. • tQ�lii �I q� Class y � Contraaor's Signature: Dnte: CONSTRUCTION LENDING AGENCV: ❑ I hereby aH�� that there is a construction lending egency lor the pedormance of Ihe work for which this permit is issuetl. (Sec. 3097, Civil Cotle). Lender's Name: Lentlar's Addrass: Signature: Dete: OWNER-BUILDER DECLARA710NS: I �ere�y ettirtn that under penalry oi perjury thet I am EXEMPT FROM 7HE CONTRAC70RS LICENSE LAW for ihe follaving reason (Sec. 7031.5, Business antl Professlons Cotle: Any ciry of crounry which requires e pert�it to consiruct, elter, improve, demdish, or repair eny siructure, Orior to its issuance, elso requires ihe applicant for such permit m file e signetl slatement that ha or sha is licensetl Oursuent ta Ihe provisions ol Ihe Conlrectors Ucense Law (Cheptar 9(commencing with Sectian 7000) of Didsion 3 of Ihe Business and Pra�essions Code) or ihat �e or she Is e�empl t�erelrom and Ihe �esis lor the elleged oxemption. Any violation of Sectlon 7031.5 by any applicant �or a permit sublacts the epplicent to a civil penalty al not more Ihen /lve hundretl tlollers ($500).): ❑ I, as owner of ihe proparry, or my employees wl�h wages es Iheir sole compensailon, WILL DO 7NE WORK, end ihe siructure is not intentletl or otteretl for sale (Sec. 7044, Business and Professions Cotle: Tha Conirectors License Law does not epply to en ownor ot properry who builtls or improves thereon, and w�o does such work himseli or perseH or through �is or her own employees, providetl Ihet such Improvemenis ere not Intentletl or offered lor sale. If, however, the huiltling or improvement is Sold within one year ot completion, ihe owner-builder will heve iha burden of proving Ihet �e or she ditl not 6uild or improvo for purpose ot sale.). ❑ I, es owner oi tha proparty, am E%CLUSIVELY CONTRACTINC WITH LICENSED CONTRACTORS ro constmct the project (SecJ04a. 6usiness and Protessions Cotle: The roniractors License Lew does not epply to an owner of pm0erty who builtls or Improves thereon, antl who contracts lor such prol�i with a wntractor(s) license pursuent to t�e Contractors License Lews.). ❑ I em exempt under sec. Business end Professions Cotle lor this reason: Signeture: Date: Owner ID veriFied 6y drivers liCense. ❑ Yes ❑ No Drivefs License No. ExDiras: _ Veritication oi Ownership by (rype of dxumenl, i.e. - pmperty tax bill or tleetl): DIVISION OF INPUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certiy Ihat no eacavation tive (5) or mora feet in dept� into which a person is required to descend, will be made in connection with work authonzed by �his permiL and Ihet no building simcture, scaMoltling, felsework, or demoli�ion or dismentling ihereol, will be more than thirty-six (36) feet higR (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle B. Calitornia Administrative Cotle). ❑ As ownerbuilder, I wiil not employ enyone m do work which would require a pertnit from ihe Division of IndusMal Sefery, as noted above, uniess such person has a permit to do such work from (he division, Signa�ure: Date: Division of Indust�al Safery Pertnit Number. CERTIFlCATE OF COMPLIANCE AND AUfHOA1ZA110N OF ENTAY: 1 ca0ity untler penalty ot parjury Ihat 1 have read �hls applicalion entl slale Ihat the intortnacion qiven Is wrrect. I egree t0 �mply wlth all slate laws 8n0 ciiy ortlinances relating to bullAing constmctlon, and aNhonze representatives ot I�e Ciry of Casta Mesa to entar upon the above-tlescribetl p�openy lor inspection purposes. I egree not to accupy or allow occupency of eny huilding euthonzed by lMs Dermit until finel inspection. cooe �. UISPECII4� PAIE 1tlIIIJALS 5616 Fixetl Syslem Finaf Pire PrevoMion 1266 200 201 202 203 20a Pool SpP Final Finel Re-RoO� Final BIa�WRetaining Wall Final FaC�ory Fire Place Finel Sign �1�j3/�� —r Date COpE1 INSPECTIONTYPF 206 Finel Mechanical 20B Finel Plum6ing 210 Final Eledrical 212 Final Fire Prevention 220 Finel Planning Approval 222 250 Finel Site Final Builtling/Occupency pl.\IiII111141F1 � � � � PN0.IECT p00flE5S: 3 Z O i DAKOTA AV � OWNEH'SNRME: MILLER, MYRON aooxess: GRAVES KATHLEEN S 3201 D�IKOTA AVE • COSTA MESA,CA 92626 APCH/ENGINEEN: ROOflESS: flEG.NO.: UNIT: UNIT: PEHMITTEE: �ITNEY ROOFING ( 714 ) 548-0769 aooxess: p0 15396 NEWPORT BEACH CA 92659 LILENSEU LONTNpGTOfl OECLAHATION: I hereby atlirm thal I am licensetl unU ot Chapter 9(commencinA wi�A Section 7000� of Division 3 0l I�e Business antl Pmiessions Code. and my lice � n tull I antl e��ec cirruc.: �p� RTEUC.:406OZZ � E : 07/94 oate: �!� ` Signalure: — WONNEflS' LOMPENSATIO OECIAPAt10N: I �ereby atiirm that I �ave C¢rli�itaie o� tanse insure Or a Certilitaie ol WOrkers' �Compensation Insurance, or a cenified copy ihereof (Section 9800. LaD. C1. roucvxo.: Zg5-99UNIT328 EX� 1/0 95 comraxv: STATE FUND ❑ Cendied cooY is here�y tu rshea. � Ceniiiea coDY �s file0 witn cit ision. Daie: � Npplicani: E%fMPT10N FflOM WOfl6EN5 COMPENSPTION DECLAPRTION: (i�is sec�i n neeU no� be comple�eE il tAe perml is �or one OunareA �5100� or less�. 1 c¢rtity I�ai in �he Dedormance ot �he work tor w�ich tnis permil is issued. I S�all noi ¢mploy any person in any mannef 5o as �0 b¢tome suolecl la Ine warkers' fAmDensatian Laws of Califomia. Oa1e: SignaNre: NOTICE: I�, al�er making �his tleClara�ion, you Sh0u10 becOme Su01e�� o Ihe WOrkers' ComDensatinn D�ovisions ol Ine Labor Code. you musl lotlhwith comDly with such pmvisions or this Dermit s�all be deemetl revoketl. CONSTflUCTION LENOINc RGENLV: I here6y alfirm that inere is a consimction lentling agency for �ne pedormance a1 ine work tor w�i�h Ihis permit is issuetl (Seclion 3097, Civ. C). LENOEN: ADOPESS: OWNEB BWLOEX OECLAPRTION: I hereby allirm IOa� I am exem0� ��om Ihe Coniractors' State License Law for lhe followinp �eason I�uian 7037.5 Bu4neu an0 Pwlessional Code: Any city al wunty wnicn rtQuires a permil m wnstmd, alter, impmve, OemMish, or repair any simtlure. prior lo its issuance. also requires Ihe applicanl far sucn permil ro lile a signea statement ihat ne/she is Iicense0 pursuant lo Ine D�ovisions ol the ConiractoR' Slate license Law (Chapter 9(commencing w�t� Section 7000) ol Division 3 of lhe BusineR an0 Ptolessions fAEe) or l�al �e/She is exempi therelrom anG t�e Oasis lar t�e allepe0 exemD��an. My violatial of S¢tlion 7031.5 Ey any aOPlitani br a permil Subletls �he applicant Ia a tivil penalfy 01 nol more I�an five hUndr¢0 dollars (5500�. 1. as ovmer ai t�e pmpeny or my employees wii� waAes as t�eir sole campensation, vnll Uo t�e work, anA �he ❑ Slmcture is no� intended o� olleretl br sale �Seclion 704d, Busmess and ProleSSional Cotle: The Contractors' $Iale License Law Ooes no1 apO�Y la an owner of a D�opetlY w�0 6uilds arimprov¢5 Itiereon, antl who does suc� work himself/hersell or l�roupA �is Or �er own employees, pmviQed Iha� SUch imD�ovemenis are nai in�enUetl or oflered lor Sale. I�, howev¢i �he builEinB or im0�ovemeni is so10 wi��in one year al comple�ion. �he owner will have Ihe burtlen of Dmving he/she did not build or impmve lor tAe Durpose ol Salel. I, as owner ot ihe pmpetly, am exclusively comracling wiih licensed contracbrs �o cons�mm �he Drolecl (Sec�ian 70a4. Business ❑ an0 Pwlessions Cotle: Tne Coniracrors' State License Law does not aOPty to an ovmer oi pmpetly who bwlas or impmves Nereon ana who coniracls far such pmlecis with a contracmqs) license pursuant lo Ihe Contracmrs' Siale License Law),I am aware ��at prool ol iheir Worker's Compensation insurance snoultl �e pmvi0e0 lo me. .. � I am exemp� unaer Section: 8. 8 P. C. for Ihis reason: oate: Owner._ Ito �eteGy cenitylnat lam aware of ana unaerstan0l�e repuiremenis ol Calilorr 25574 and ihal I o� any IWure buitaing occupan� wilVwill nol (circle one) need to c Oermii lot con9mc�ion ot mo0ilitation Imm Ihe Nr Oualiry Managem¢N Oisirici. Ihete pmvisons. �, Seciions 25505,25533,antl s antl Ihe reQuirements for a ppliWtions are exempt Irom Da�e: AOPlicanL I hereUy tenity Ihal I have read thi5 aD0lita�ion an0 Sia�e Ihai l e above in� lion i5 corr¢tl I agfee �o t pty with all tily an0 tounly ordinancesanUsia�elawsrelatin Io�uiltlingcanSimclionantlhereEyau rerepre tatives thisciry nteruponi�eabove�mention¢C propetly lor 5pet00 pur o` 5. Date: _�/� SignaWre�. Dri�er's ucense or Soda Secuniy x: �6aP46 Wmle-0utlding; Grean—COGe Enlorcemem: Canary—Ap0licam: Plnk—Revenue; GOldenro0—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: B 068282_ PLAN CHECK NO; CONSTRUCTION TYPE: V—N PERMIT TYPE: STR JOB DESCRIPTION ; T/O 6 REROOF W/COMP SHINGLES lil PERM NO; 8 06828 GOVT: N SUPP: N PURPOSE: ALT SQ FT: 5,159 CLAIM VALUE; 5,159.00 CALC—VALUE: 5,159,00 GROUP OCC; R-3 /M-1 COMMENTS: SMOKE DETECTORS RE�UIRED PER 91 UBC REROOF 30005��f l.+R ��rx�r**�rx�rx*�rx�rx*�r��r�t*x+r�r�r*x* ***+t*+r�r**�r��t�r**�t��r*x�r*��*x�*�r+rx Z O N I N G R E Q U I R E M E N T S �� _/. ��Ery S E T B A C K S �y� �� ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGAT: FT IN LEFT; FT IN RGHT: FT IN PARKING REQ• PAOV; PARCEL: 43919233 ZNE: REF NO; • PLANNING NdTES> � it M!F iF if it iF 1F 1k 1! 1f ff iF 1F 1E 1k k M 1F fk M iE ff IE iE M 1flt 1F iM ft k!t!t 1E 1! 1f !f If k!F M fk k fE fklf !f M ftlf M!f k!F M it iE 1t 1f if 1k 1f !f 1E iF iE it fk M 1! it iE 1f 1k ik it iE 1k 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 H E N.�T S ZONING APPROVED BY DATE: � BUILDING APPROVED BY : DATE: DATE: � � 1F1F1E1F1EMif 1E1F1F1t1FiEiFiFM/f 7FMM1E7EiF1f iFlkfEitiEMiFiFMif1l1litfFMlFM1f ltitiFlf MlhiFifllMMMiF1t1f 1EMiFiFiFlEiEitikiFlElFM1f 1E1FM/fiEM1E1f LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 81,00 52 PLAN SMIP/NON—RES ISSU£ FEE HUILDING—DIV—> pERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 81.52 0.00 0,00 81.52 81.52 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 81.52 OVER/SHORT: .00 BLDG PMT pLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CiIECK 81,00 ,52 it �E k ft it iE it it fk it it iF 7! 7k it iF if it it i! ff if 1f if 1f if iE iF iFlF ik k i!!!!f k 4 k 1f k 1!!f iF if 1F i! i! if if iflk it 1k iF 1f it it 1E 1E k!E IFlf 1k iE it 1F iE 1F ft fE i! iE 1t M!f it 1E i! 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 5159 REROOF.HY VALUE RESIDENTIAL NOZONE 1.00 5,159.00 END OF FEES Q1 001650E4-0026SOE5 Ts] T DATE: O8/D2/94 TIf1E: 1,`�:27 V E1.S2 �, � - CONSTRUCTION AND PLANNING P�JL & SPA APPROVALS Permit # Date f�spector qppROVAIS Permit # �ate Inspector 7, Temporary Electrical Sen�*:� or Pole 52. Pool & Equipment Location v: u.:v 2. Soil Ptpe-Undrgrnd. - a� 53. Steei fiein4orcement ��3'�j�ct'`ticat Cond�t l`i�,'�lity-l}ndrgrnd"'� 54. Forms ... 7:' •�:-�. �,��Iec,Zrical Cond'._��;bl�'ldrgrnd. S� 55. Electrica� Bondin9 C5: S[%�Reinforcerl4 � �e; 56. Rough Plumbing & P�essure Test G C ��tec��ricalUFEf$Gr,��.°.d. n' x 57. AVPROVA�TOCOVER�GUNITE . R: � �7?�� Dngt :,� ^ " 58. Electrical Gondust�Undrymd. �� $.�Cjindation �� C° 59. Gas Pipe, O Undrgmd., Ten � 9. lNater Pipe-Undrgrnd. � � 60. Backwash Lines, P�Trap, G Undrgrnd. �} 10. 5tructural Floor Syuem ;_, 67. APPRpVAL TO DECK I t. Prop,erty Sewer ling� Ho��e Conn�ction 62. Backwash & Receptor�Pinai � -� �2. 5ewe.t �aP '� � • 63. Heater & Vent-Final 'L• ]� G 73. Roof Drains 64. Plumbing $Ystem - Final 14. flough Plumbiri� �' . 7' 65. Electrical�Fina� 15. pough ElecvicSLConduit e 66. Solar SVstem-Pinal 16. Rough Electrick.'iring 67. Fencing & Access Approval 17. Fough Wiring V n a � 68. APPflOVED FOR PLASTERING 78. Rough ElectricaFT Bar Ceiting 69. POOL/SPA $YSTEA7S FINAL c 19. Rough Heating & Air Condi2ioning FIRE DEPT. REQUIREMENT ' .-�"'Y-C":' . , . `7 ri+ T �.: Cf'_. ^ « (-. V 20.;Rough .ar:tor� Figa!ace � crpt y-7 s :� � �^y� �� :4PPR0}1AWu_�CFersuit # .. 7 �'- �.r � � -� n r � , ,Z� � V -� � '� r � �^t� � � � �r4 7;� "7 ';yr. . �i �� ., ;�' ' 1'l 21.�u , ir} tru tu';4�:.� i.. .. .1S cJ -�?� :•�. `70. lladeryreynd�lY;�"o ' �r-F --i^-�'q:�i--C • 22. Duca.Vv:litilatin¢-'.y: i:S A� S��.x;-ri. Product�P' irigL+-'G,_`3,�s ❑Oii 23.`C�,as4i e�ou &'T`st � ' R 'a �'�x ` -i � ��' 7' '� r-+p � % I .45 ^:l C � �* t� Hz. UndergrolrHU:Flu5��1 , r � � �- ...� . .�. _ . � -^-�-^'./ 24.��o4$Fr�ating• g'.K �-�F y'> > � X�3. 'ndergmtL?Stordkts��k OO Gds '�Oi!' 25. Foo'�t;Sh�thin9 '�'� � 5;3=� 1.��' ��(; i4.� rhead F� dro-':'� { f't K a 1 J ��+F' Y r1 i 26. ^,-��-6aryCeiling (Str�qurall & jgor�ocoat x� :n O iTl� * 75. �ry Chemical �-7 '�i � i � r� c. 27. �Orar�,e ar�d Fip�hir�r d x p;_,y � 76. `6ry Standroe Oz " 5 Ti - I _� �- �x� r.e r R{ � J :."<8. L.atl�r�'ng�qSidingi.:<:�: -�i4�.�, c; :r� ••xs 77.�=1XEDSY�S'GEM1 . AL� �' r . -. � '_ x � � �� 29. Insulatiorf ' `�.� � <^� �� .. ,,�, � K �; 78.�IRE PREV. FIRtiA�F; � ; � r t��O.Drywall(+{,ailina,7 ..^r� � +�� ": *i- H?A�TN:9EPT.AF?EQIihREtv1[NT '.� � :37. Plaster B��wn..Coa._`��: � i„�.,, r � i: ;?9. �INAL IN��,'{'.�E;CTI(S�;aJ k ` � p m ;,, .., . � �r ;�-�T'�i -' :•i Fi2. �lecvical Po�vpr hh�ter�-�nal i a• c� c30. t500D CERTIFIC"XvTiE ISSUED � -� :._.�,y . ... . _, -.. .33. Ein�Ele�cric,� �;�. � �,-_ � " x �Jot,�.'�1� � �r � �r J N:n .y �-?,m, �4. �F,ina�He ing� Ay� Gondiziorii�S rj � � = S ii�. x � �� _ �-1 F� ✓ 1'� 35. �PinatGas PiP�iest *� c� - ` ` �� ,� r•��7 - r ^ � 1: ... :^ Y r, I _ U V•-+ r� F f�' -+ k � � _ �6.'Noo��or�anoPY r �, � � R'ti �r Ct � e . E .�:� � s C,C^ - =� '7 'S7.'�ina7hFac��ry Fire�l#ce'',� �� ;: m � �;� n v� v . .. -r... � .. ..' - ��- ----I t T, •• �v . :'3$. Fina7�lu;�7bin9 r 'i t �.n •i � � :� �: S M rt� G ^.�_ 39. Wate't:Service-Finaftx T � w e � i .f �: � s-? � Q O i � T� . .T• � � ._ . . �- ., �. Gaz Service-Fitiai `, x ;,.� � .,,;,. S .- ;r, � < : �J-, -,:.; r .f ti1. 9olar pomestiD-FinaK 5 C'� .. x�� I . `= � '-• " � � t� N" � [x` y :r ' 'J �d'1. �ackflow Prevente�;.' � �j � � j % �' �j-. • .� p H ,: � 43. Backflow Irrif,�tiorV+� � x-�S '� �� , �^`"'� . '-' "' :r r . c o; n �7. 4andscape IrI`.qatigf'� stema. j�, � � �.: :. � p� � c v -� .:.:J .� .. � r � �T. $ound AitenC'iati0"t+> -i'•�`'� �" � < F i-� [-�a 1 .�+ r, C"-� ;a� : �7r •- . x [�7 ��; 'tM .- c� a' d. r. \l S :�: [ 1 r. .��[ • / .� .' �'�y 3$, F;�andicap'�iegyjati0•._ ? � -��-1 O � #-. x �� 'S J-� .e 47. F1NAiSTRItCTt1f? "h1,ICDING �-,/' '"� ��-^= � . , _> ' �•� �'D� � � -, 48. �iNFFLPLANI�IN�...�` i r�F ;''� . T 7 t'v" 't' ,.. _ , &9. �iectric Release to�dKo �[,,,T, 2' I � � � � � ' • "' iy .-7 x �O. Cs�as�ele�etn'JSout#�n`.raliforpjaS,asCo n � �� F �', ., . �� r j �• � �• � 51. CER�IFICATE OF;ISCCUPAN z * y n !ao a: -+ -.. No. `��Date AOP��ant to till in all spaees ezcept those witnin heavy bortler Iines antl sign all apvropriate aeelaratlons. CITY OF COSTA MESA . . ,� CONSTRUCTION PERMIT y Project Addre55. -'1=O ��%1'i'K/i �} � TVPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION lJ REPAI R' ApplicanYiMailingAdd�¢ss ' � � ❑ CONVERSION ❑ DEMOLISH ❑ OTHER OWnefs Name M I�-LE� �,fc Phoner`/s9a�/ DESCRIPTION OF WORK Addreu '�"�I ��i�7/4 � COS7ii �11�-5� TVPEOFPERMIT GaaoING ❑ FOUNDATIorv ❑ STRUCTURAL Arch/Eng. License No. � � ❑ TENANT ❑ ELECTRICAI. ❑ PLUMBING ❑ MECHANICAL Addreis - -❑ �OTHER . . , ' . Contractor's Name_} RCI �'IG ��JST tXILLFRS .phone �N-3 -3 PROJECT DESCRIPTION Scl. FT. � OCCUaarvCY— Addresslmailing) �` W' UM� . S T� /P � .CONSTRUCTIONTVPE � VALUATION$ ' ' rL7 "�$ i ' � ZONE GRADING CU. VDS. ACRES_ City LicPnse No. � a , . LICENSED CONTRACTOR DECLARATION � . ' pemarks: . ' hereby.atfirm that I am Iicensetl untler provi5ions of�Charter 9(commencing ' ,vith SectiOn 7000) of DiviSion 3 of the Busine55 antl Protessions Cotl¢, dntl � ' � ' � ' � my Iicense is in fun f rce a,q eftect. � a�� 98 , . PLUMBING �. License G� ss �3 LIp"ense No. � .., oate �� // � 5'g t : d /p�-- , � � . W00.KER5' C MPENSATION DE LARATION � Bar$ink $hOW¢r5 I hereby,aftirm tnat I have a certificate of consent to self-inzure or a certiticate gackflow Preventer � Service Sink � oY Workers' Compensation Insurance,i or �a ttrtifie0-copy thereot (Se<tion�- � - - - - 3800, Lab. C•),�DLQ� // ' � Backflow Irrigation Sewer Cap , Policy No, d S/ ' Gompany � eCeltifietl coOY i5 herEby fumishetl. 1 , Bath[ub5 i S2w2� COnnEcti00 �_ Ce�Hfl o y�T � wrth the city B(j Itliny.�yi5' Date ' APPlicant IL' (�,'G �� - Clarifiers Solar Collectors � , EXEMPT ON F OM WORKERS' COMPENSATION DECLARATION '' Dishwdsher �' ' � '- -SolaY Piping `' ' � (This section neetl not be completetl i( the permit is for one huntlretl (5100) or � 1 �lecertify that'in the performznce of the work for'which this perm�t is'issueil I � Drinking Fo4ntains ' Solar Tank �� shall not employ any person in any manner so�as to become subject to�t�e . � - � � . �. Workers' Compensation, Laws ot ealifomia. . I , Floor Drains; . Swimming Pool w/Spa' ��, Date ' • � Signature NOTICE: If, after making this tleclaration, you shoWC become subject to the ' Floo� Sinks Urinal Workers' Compensdtion provisians of the "Labor COtl¢, y0u'must'forthwith - - comply �with such provisions or-this permit shall be tleemetl revoketl. GasService Outlets . WaterCl05¢t ,� CONSTRUCTION' LENOWG AGENCV � ' ' ' ' . I hereby affirm that there iz a construction lentlin9 agency (or the performance . Intereeptors � ! Wate� Hea[er � oi the work tor which this permit is � issuetl' (Se<tion 3097 Civ. C.) � ' _' Lender's Name Kitchen Sink �� Water Service � Lentler's Atltlress . Lavatories � ' � �WNER BUILDER DECLARATION - ' ' hereby affirm that I am exempt trom the C6ntractor•s License Law for the P-Tra - Ifollowing reason (Sectlon 7031.5 Husiness antl Professional Cotle:�Any city or � P _ - county whicn requires a permit to construct, alter, Improve, Aemolish or repair .any st�uc[Ne, prior to its issuance, alm requires the appllcant for Such permif , �ROOf D�dinS � antl a, pe untlrei the provisions ot � ection �000) of ie/she is exempt � Iation of Section icant to a civil • LJ I;' as� owner of the� property;or. rriy.employees with wa9es as their sole compensatlon, wlll tlo the work, antl the�structure is not Intentletl or otfere0 for sale (Settion 7044, Business antl Protessional Cotle: Tne Contractor'S License LdW tloes not apply to an�owne� o( a prop¢r[y, who,builtls o� lmproves the�eon, and who.tloes SucM1 wo�k himselt/herself o��through his o� he� own employees, prOvitletl that such-improvements are not Intentletl or otteretl tor sale. 1f, however, the builtling or improvement is'soltl within one year ot mm- pletion, the owner wlll �ave the burden of proving he/s�e tlltl not buila or im- �rove for the purpose of sale). I, as owner of the property, am exclusivery mntractin9 with licensetl con- trattors to construct the project (Section ]044, Business antl Professions Cotle: The Contracror's License -Law tloes not apply to an owner ot property who builtls or impwves Ihereon, antl who contracts for such project5 with a mm tractor(s) license pursuant to the Contractor'S License Law). . ❑.I am exemp[ untler Section B. & P. C. tor this reason Date Owner Signatu�e _ Drivers'�Lice CM F� 0865-46 that I have reatl this application antl state that the above recL I agree to comply Wlt� all City-antl cOUnty ortlinance5 ' atlng to bulltlin9 �onstruction,antl hereby authorize repre- '� ci � to nter� upon the above-mehtionetl 0�� :�. . � Date 55 if � �� /� � % � 7/83 `' M/hite'-'Builtling; Canary - Applitanq Pink = Accountin , '� ;sz5 Boiler • ' . � ' Duct- Undei Ground ' Duct-S[ructural ' Duct - Ventilating � Exhaust System ❑ Multiple Firepl/Fact.8lt. ICBO # Heating System & Duciing � ai oo,000 eTu O � oo,aoo IReinspeaion Fee ,,I $25 Goltlenrotl^ Assessor - - -- Iwue Fee_ Hood or Type I �' Canopy Type I I ❑ , Refrigeration System Oaioo.000eru ❑ioo,000 System Repair/Alteration t Issue Fee I 9 i FEES A.P. # S Main Building: ' - E T Front B Fear • A C Right g Left Ping. Ref. # ' Parking Req./Provided UseofBuilding: � Plannin9'Notes: � • Automatic Washer . Construction Pole Sub. Cooking Unit �" ' `' ' � Dishwasher - � ' Dryers ❑Gas '�Electric � Fan' � ' � F.A.U. . � • `y� Fixtures ' Device Boxes � ' , Outlets , � " . $ 3 � FEES � $ 3 Garbage Disposal r. Generator �0-5.KW ❑ r 3507 2/01-/84 Park.Fees $� ELECTRICAL , 'Trensformer ❑ 15-50 KW . ❑50+KW , Meter ❑up to 100 amps ' � Meter ❑overi00amps. ' Sub Panel Motors�0.1 HP�1%-8 Inc.Solar �9-15 HP Ot6-15+ � Microwave Pole Light � ' Range , ' Standing Sections , KW � Trash Compactor : Rainspectian Fee.�, . $25 Issue Fee � PUBLICSERVICESREQUIREMENTS: 2oning APProved BY.: APPliwtion APProved BY � . � AppliotionlssuedBy a' � ��y U� , 5.OQ TL FEES m $ 3 Z O N I N G R E , I R E N E N T � � . SUMMARV OF FEES . BUILDINGPEftMIT $ SMIP � $ � PLAN CHECK ' $ � �� _.r, PERMIT ' �� PLUMBING �; � �- � °" ISSUANCE $ ' PLAN CHECK- � $- ENEFGY�P.C. $ � � ELECTRICAL� �. $ - GRADING $ ' � PLANCHECK $ ' MICROFILM ; $ � MECHANICAL � $ � TOTAL F�EE $ ,,�� PLAN CHECK -$ ' � � i ' CONSTRUCTION AND PLANNING POOL & SPA APPROVALS� Permit# Date Inspector qppROVALS Permit# Date Inspector .1.� Temporary Electrical Service or Pole . 52. Pool & Equipment Location 2.� Soil Pipe-Undrgrnd. � • . � 53. Steel Reinforcement 3. Electrical Conduit Utility�Undrgrnd. . 54. Forms �� 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ' � 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test .' 6. Electrical UFER Grnd. ' 57. APPROVAL TO COVER-GUNITE �� 7. Footings , 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 7 i. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap . 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 75. Rough Electrical-Conduit � 66. Solar System-Final ' 16. Rough Electric WiFing . . 67. Fencing & Access Approval 17. Rough Wiring Sign . 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � � APPROVALS Permit# � 21. Ducts,in Structure � 70. Underground Hydro � - 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test � 72.�Underground Flush 24. Roof Framing � 73. Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric � , Notes: kp o�-tE bia'nQ Z-3-8`I � 34. Final Heating & Air Conditioning • 35. Final Gas Pipe-Test - � � 36. Hood or Canopy , . � 37. Final Factory Fireplace � 38. Final Pl�umbing '�-� e��/ ' �i '� �A 39. WaterService-Final . � �� 40. Gas Service-Final � /% �.o 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 • - ' � ,1 50. Gas Release to Southem Califomia Gas Co , ' �, 51. CERTIFICATEOFOCCUPANCY '� No. Date � m LL O O 6 m N F � ,� 0 2= F � & � 6 m 0 � � 0 0 m � � j� ere subject to veriRrntfou oa'ob site nnd adjustment to Rt Job con�iNons. �2oi �K�T�- Castomer wants io move sink to corner �robiem? running dishwasher thru cab? be releaaed or copied uutess appUcehle fee M1as 6een paid or Job arder pIuced. 3l13/US � CITY OF COSTA MESA BUILDING DIVISION ROOF COVERING CERTIFICATION Property Address %�� / Nry h ° Owner 6 Contractor � Permit No. ��8 Z � Z State Contractor License Nufiber / dGtl Z?� Classification e—� / I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the above address in conformance with Chapter 32, and Section 1704 of the latest adopted edition of the Uniform Building Code, as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the manufacturer. ❑ rther certity that I am the owner of the property. (Owner-Builder permittee only). I further certify that I am: OL_ wner of sole proprietorship company ❑ Full partner of the company ❑ Limited partner of the company ❑ Officer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shall be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. Received by Building Division By: �- l l4U Initial Date 0990�08 W�ita�8uiltling Oiv; Cenary�CpnVaelpr, Plnk-0wner Pn�o PPR 13-7G�;�5C00 �30 �-��*�•ZS.CO CITY OF COSTA MESA PLANNING DEPARTMENT A. P. No. 139-084-18 Bldg. Permit No. , PARK AND RECREATIONAL FEES - Apartment Developments �� Q Q"�'�j �� SO Fee Payment Receipt Project Address 3201 Dakota Avenue. Costa I•tesa Owner's Name 14urray D. Brown Bachelor or 1- Bedroom Units 1 @$25.00 =$Z5.00 2 - Bedroom Units @ $40.00 = 3 - Bedroom Units @ $55.00 = 4 - Bedroom Units @ $70.00 = 5- or more Units @$75.00 = C95_n(] Total Fee Total number of Dwelling Units � Planning Department Approval Date Park Area No � By WLD:rIb Applicant's Signature i APR 13-7C��SeOO 730`��=��25.00 CITY OF COSTA MESA PLANNING DEPARTMENT A. P. No. 13'-0��4-18 Bldg. Permit No. � PARK AND RECREATIONAL FEES - Apartment Developments ' Fee Payment Receipt Project Address 3?O1 tc'�ot<� � vrnu^. Costa C�cs„ Owner's Name �'�rroy ^. Crorcn Bachelor or 1- Bedroom Units 1 @$25.00 =�'��,uti 2 - Bedroom Units @ $40.00 = 3 - Bedroom Units 4 - Bedroom Units 5 - or more Units Total number of Dwelling Units 1 Planning Department Approval Date By Nli`:rl!� Applicant's Signature @ $55.00 = $70.00 = $75.00 = ;2:.:J Total Fee Park Area No. 1 UWNtK ....,....� ..�,..�.,. ,,. • JOBADDRESS 201 DakoCa Ave. AP No. LOT 60 7F INSPECTIONS 5� SOIL GAS WATER ROIIGH PLUMBING PROP. $WR. LINE � HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONOITIONING UNOERGROUND Lf POwER U ROUGH WIRING TRENCHES FORMS � STEE FLOOR SVSTEM BOND BEAM � STEEL REINFOF SMEATHING FRAME ANO FLA^SMING LATHING - IN ' I OUT � PLASTER, BROWN COAi STqUCTURAL, FINAL HEATING, VENT., REFRIG. ANO A.0 PLUMBING, FINAL AN� GAS TEST � ELECTRIC. FINAL DATE �-r-�" BUILDING PERMIT VALUE SUSCONTRACTOR � ' - - - '� 1616 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 for Applicant to Fill in Completely BUILDING � �/'; i�� /� �JG AO�FESS oKl T Z . a U F Z Z Q O v~i am J � J N Q W 0] J •m J Q U � Za w� aw wz J � m Z J � W w 0 = Z F. w� �O H z Q U J a a Q � H � z 0 � U � � �"' � z OWNE MAIL ADDR CITV BPANCH ADORE55 CONTRACTOI ADDRESS — CITV STATE LIC. NO. SI2E r OF LOT J USE OF EXISTING BLD( S12E OF NO. OF 7G. ROOMS STOI �R WALL ROOF NG COVERING BUILOING AND WORK TO BE PERFORMED U 0 r�PR 13-7f �.;sp00 729` �-`:: �5?.5C ON FOR BUILDING PER�/-J6 RECEI � A.P. NO. �J eUILDING ADDRESS 3�0 T.�E.�.CClU/7.it TRACT �� l. TEL. NO �- CtTY LIC. NO. INO.O LBFr DC . NOW ON LOT OWNER 0 VALUE DATE � / N NO.OF USE OF NE �I PV1N$'�� BUILDING �r YAROSAPPROVED VARDSAPPROV MAIN BUI�DING ACCESSORV BUII V AR. �W C.U.P. q{s APPROVED BET. I BET. MAIN & I hereby ackno�.'�etlge that I have reatl this applicafion antl state xhac the above ��formetion is mrzeci antl agree to comply wiih all laws regulati�9 builtling construction, and I shall not employ any person in v�olation of tha workman's compensetion laws of 2he State of Caffornie. . � I hereby cerUfy ffiat I am properly Iicensetl as a contractor untler �SQ. FT. the State of Calitornio Business antl Protessio�s Cotle, Dlvisicn 3, TNE AMOUNT SHOWN UNOER VA Chapter 9, an0 that such licanses are in full iorce antl aftect, or I THE PURPp$E OF ESTABLISHING A P em ezempt trom Ma provisians of the State of Celltornia Businass VALUATION antl Profossions Cotle, Divisian 3, Ch , ter 9 Od PERMIT FEE t Signature of Permittee / � 5 f�� PLAN CHECK <, Authorized Aqen ` TOTAL FEE ? fI m O JATION IS FOR � 3MIT FEE ONIV: v ¢ 35-,�'0 � 7 � E L `o 5 O'/✓ � LL �oT 6O - TRACT 36z5 � � ' ��i.�:��"J CbSTA MESA BUILDING-SAFETY DEPARTMENT P. O. 60X 917 W6TA MEBA. CA6IFORNIA For Applleanf fo Fill In Complefely TYPE OR PRINT BUiLDING 320� D.4KOTA AVENUE ADDRE68 COSTA MESA GALIFORNIA owNER KENKOL CONSTRUCTION C0. MAII �555 PLACENTIA AVENUE A�ORE6S rrrv NEWPORT BEACH TN�•M� 6-3� CONTRAGTOR K.W. Ko�� aoDRESS �555 PLACENTfA AVENUE CITY NEWPORT BEACH �� No. 6i�95 No: M� 6-3zz7 SRE no. oP Bi.nae. .._ 65x6� X �� IRREG _,_,,,_,,,__ � ■ 68TBACK LlN6 PROM 7I �O� LEFT I RIGHT DESCRIPTION OF WORK L � t� L �: u1.a . ,n" � �� -� 3_�. � !'�I�i��i�t �F�:. �IfY J: ^pSTA i11ES�� APPLICATION FOR PERMIT BUILDING ' � • � � Por Offite Use Only RECEIPT NO. PCRMIT NO. BUILDING COSTA MESA. CALIFORNIA LEWL � . (CENTHR LIN6 BT.) B=EOING �585 SF ROOM6 � STORIES � EXTERIORWALLSTUCCOIROOF ROCK COVERING COVERING _ USE OP BUILDING AND WORK TO BE PERFORMED LE•- AM LY ESID NCE AND ATTACHED GARAGE PLAN 3�B i NEREBY ACKNOWLEDG¢ THAT I HAVE RE�O THIB APPLIWTION AND 9TATE THAT THE ABOVE IH LORftECT AND A6R2¢ TO COM- PLV WITX ALL CIiY ORDINANCE9 N'�O 9iAT2 LAW9 REOULATING BLIILDINO CONBTRULT/ON.\ 81GNATURE OF / J n � � AUTHORIZE� ZONIN6 ov „ �yse or New LI � i' TH8 AMOUNT BXOWN UNDER VALUATION �B FOR THE PURPOHE OP EBTABLIBHING A P¢RMIT FEE ONLY. VALUATION )/ PERMIT FEE $ -7(� � S /' � �� PLAN CHECK $ �" �