Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
1125 DANA DR - Building Permits
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT ,lob Address: 1125 DANA DR Suite: Vicinity: RESIDENCE & ATTACHED GARAGE Parcel Number: 41207425 Applicant: BATIOFF, JOHN Address: 1563 BARNWALL ST LA MIRADA, CA owner: TAWIL, EDWARD E Address 1125 DANA Zoning: R1 R1 Phone: (714)562-0969 Zip: 90638 Phone: COSTA MESA, CA Zip: 92626 Contractor: PRIME WATERPROOFING ASSOCIATES INC Address: 6925 ARAGON CIR #22 Arch : Address: Phone: (714)522-5506 BUENA PARK, CA Zip: 90620 License: 745045 Phone: Eng: Address: ISSUED BY: Status: ISSUED Applied: 11/29/2000 Issued: 11/29/2000 Phone: Zip: License: License: SCOPE OF PERMIT REROOF: T/O EXISTING WOOD SHAKE, RESHEATH & FELT PER MFGR RECOMMENDATIONS, INSTALL "EAGLELITE PONDEROSA TILES" (7.0 PSF). 30 SQUARES. FEE SUMMARY Plan Check: $117.81 Permit: $181.25 SMIP Res: $1.00 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $300.06 Calc Valuation: Claim Valuation: PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: EXPIRED V/ $10,000.00 $10,000.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 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 required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. li FOR INSPECTIONS CALL: (714) 7545626 2"646 (6100) L . WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the pertomiance of the work for which this permit Is Issued. My workers' compensation Insurance carder and policy number are: order: Policy Number: (This section need not be completed if the permit is valued atone hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit Is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisiQ�s. �l Applicant Signature: h'1�-1 Date: WARNING: FAILURE TO SECURE W ERS' COMPASATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE (SIOO,ODO), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. Lic. # Class # Contractor's Signature: Azt Date: �f /—'25J-r7n CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors Ucense Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Cade: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. It, however, the building or Improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet In depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, talsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 6, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .......................__....................__............................_......................................._........................... d. I.o.__.........................._.__............................__...................................................._................_......................._..............____._....... 2 Does or will the applicant or present or future builtling occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume Of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and . pressure). . ........................................................................................................................................................................................................................................................................................................................................................................................ 3 Does or will the applicant or present or future building Occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costd Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ................._................_............................_._......_...........................................................................................__...............................__..... .................................._.._...._.__........................................................_............................._.._............ 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No .............._..............._........................... .._.......................................................... __............................__.._........................._.._._.................................__._.__..._........................... ._..................... _................ __._._............. 5 Does ar will the applicant or present or future building occupant require for the work which is the subject of thisa plication ape"it for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Byes LI No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). .......... _................................_._............................__................................._._.._.............................____................................._............................._.._............................. ....._._._........__..................._......................__._..._. 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (11 *yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ............................................................................................ .... ........................... .................................. ................................................ ...... ............. .............................................. ...... ..... ............ .........._...................... ........................... .._............... 7 II a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No .... .................................................................-.......... .............................................. ... ......................................... ............................................. ................................................. .................................. ....... _......................................... ............................... 8 (If yes', attach certificate Of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. / Signature: Dale: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Masa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow Occupancy of any building authorized by this permit until final inspection. igneture OI Legal Owner(s) Dale 1 1 -e--Cb And/Or Aliffiorized Applicant Date CODE.. INSPECTION TYPE gdlf. IIiTITISLS CODE I INSPECTION TYPE QSTE ISL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final BuildingtOccupancy PROJECT ADDRESS: 1125 DANA DR OWNER'S NAME: DAVID S . KEY ADDRESS: SAME AS ABOVE 714/966-3417 ARCHIENGINEER: ADDRESS: REG.NO.: UNIT: 0 UNIT: PERMITTEE: ELECTRICAL SYSTEMS TEST. (714)898-5113 ADDRESS: 15573 COMMERCE LANE HUNTINGTON BEACH CA 92649 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of DWIsnon 3 of the Business and Professions Cade, and my license is in full force and effect. clTr uc: 0 3/J19 3 STATE LIC.: 3117 0 9 C —10 Data: X2 a . Signature; WORKERS' COMPENSATION DECLARATION: (hem affirm that (have a certificate of consent to seff4reare are certificate of Workers ^empe N0. n ls6mic� {Lr g cgrtitied copy thereof (Section 3300, Lab. C)7 / 01 / 91 ' UU 44 9 U 4 EXP. DATE: U COMPANY: STATE FUND ❑ Certified copy is hereby furnished. d Certified copy is filed with the city -9 � ity Building Division. Date: 9- /o(— 94 Applicant: Rc& 2'���Q� EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($100) or less). I certify that In the performance of the work for which this permit Is issued I shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, You must forthwith comply with such Drodyions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for Which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, as owner of the property, or my ainyWyees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale(Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself/herself or through his or her awn employees. provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for Me purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business 11 and Professions Oxide: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' Stale License Law),I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B. d P. C. for this reason: Date: Owner: I do hereby certity that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant W intwil not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from mese provisions. Date: Applicant: I hereby certify that 1 have mad this application and state that the above informadon is cornett. I agree to comply with all city and county ordinances and state laws relating to building wratruclme and hereby autMrve reDresenutivas at this city to enter upon me above-mentioned property for Date: / — Signature: ✓7yw v71"�`"�"� `"mac"' Driver's License or Social Security N: 164146 While—Building; Green—Code Enforcement; Canary—Applicant; Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 048841 PERMIT NO: E 048841 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH JOB DESCRIPTION ELECTRICAL ONLY/NO STRUCTURAL PERMIT SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: / COMMENTS: MAIL—IN PERMIT �aaae*ie it#aEae#aex-it it9e->Flt->F*tt****at�c-N-al-tt-ic-aF**+�*i��t*tttE->F+tN-�-it***�tat*rt�t**�Faa*it*aL�t�t�t*�E1t�yttt�t*#+a*->Fas>F** Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- 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: 42219305 ZNE: REF NO: PLANNING NOTES> 11.00 15.00 0,00 26.00 26.00 .00 REVENUE DIVISION TOTALS--> COLLECTED; 26.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK iE iE * fE eE aE ae ee aE eF iF iF Be ie * eF ie of iF * 1E 3E?E if * IE eF iE * fe ii iE ie ie 1E iE aE 4E iE BF BE eE iE BE iE BE * aE iE YE ie eE ae iE iE aE 9E iE iE 1F iE ee aF iE iE iE iE Te iE ie iE * iE ae ie iE aE fE D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY:DATE: iE lE ee iE iE ie of BE eE ie ee el BE ie le BE �E iE ale ie lE aL '.<� eE dE*i4 aE ie ie lE*iFi( fF,cr iF.c it e'it>rxdF a4k*eE aE BF Bf se of iE*3E iE*aE BE aE aF BF eE if aE 3E iF iF iF iE *iE aE iE iE*aE eF BE lFBF*iF eF***ee jf 9F*%aE 4f aE if lF fEiE iE iF ie ap at iF iF*iE *iE iE ie eE aE ik ae iF iF iF ie iE aF LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 11.00 50% SMTP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 11.00 15.00 0,00 26.00 26.00 .00 REVENUE DIVISION TOTALS--> COLLECTED; 26.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 26.00 *aeiekiE le kie et le4ie aE iE je*et ik ie ie ie*eele**iEk1E#eE ie iF ie Bele iekit aEkeE BE BE ik iE feiE etkie le ee iE lE iEeE lE iF eE aE ei*iE 1E iE of ie iE iE iE iE jF ie 1E**!E!f I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 MISC APPARATUS NOT LISTED REQ PERMIT 11.00 11.00 END OF FEES �I EXPIRED Incomplete Inspections G� Q� Date Sig DATE! 1Cl111/40 T,'IE= :;;:t,. V CONSTRUCTION AND PLANNIN%a: APPROVALS Permit # �� Date Inspector �L & SPA APPROVALS 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 LIFER 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 11. Property Sewer Line & House Connection 62. Backwash & Receptor,Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas OOil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas OOii 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 PREY. 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: 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 Domestic -Final 42. Backflow Preventer .)% 1.) 43. Backflow Irrigation _XP I R t 44. Landscape Irrigation System y 45. Sound Attenuation ate _M� $Ig 46. Handicap Regulations i 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING• 49. Electric Release to Edison 50. Gas Release to Southern California Gas Cc { 51. CERTIFICATE OF OCCUPANCY No. Date 4. t CIV? OF COSTA MESA CONSTRUCTION PERMIT Project Address ���� /�fi/✓fi G7K Applicant's Mailing Address Owner's Name e44L-6CICU If ✓AIA/ Phone — Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO., _ „ _ _ TRACT NO I LOT NO I UNIT NO, A P eIy S Main Building: E T Front B Rear A C Right SLeft Ping. Ref. # Plannino Notes: Address a T"—:: Arch/Eng. License No. Address Contractor's Nam _Phone Address (mailing)_U� City License No. — LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. License Class License No. to Signature .>RKERS' COMPENSATION DECLARATION I hereby affirm that 1 have a certificate of consent to Self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) Policy No. Company 8 Certified copy is hereby furnished. Certified copy is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit IS for one hundred ($100) or less). I certify that in the performance of the work fokwhiC his perm s 1 I Shall not employ any person in any mann r S 0-S ecorh j the Workers' mpensation Laws of Californi Date Signet ure NOTICE: If, after making this tleclaration, you should ecome s je to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LANDING AGENCY I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish or repair my structure, prior to its issuance, also requires the applicant for such permit o file a signed state Tent that he/She is licensed pursuant to the provisions of he Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil nenally of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure Is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who build$ or improves thereon, and who doe$ such work himself/herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement Is Sold within one year of com- pletion the owner will have the burden of proving he/she did not build or im- pr the purpose of sale). I. 0-5 owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon. and who contracts for such oroiecls with a con. tractor(S7 license pursuant to ine Contractor's License Law) I am aware that proof o their Worker's Compensation insurance should be or 'ded to me. ❑ I am exempt under Section es--�. & P.�this4+r DateW/-1� -�� Owner I hereby certify that I have read this application an s ate that the above Information is correct. I agree to comply with all city and county ordinances and State laws relating to buildio o St ction, and hereby authorize repre- SentaHves of thji cit to n the above -men' eC property for inspection pur ses. Z Z — Signature Date Drivers' License or S$ of TYPE OF CONSTRUCTION LI NEW LJ ADD ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. — ALTERATIONLJ REPAIR TYPE OF PERMIT LI GRADING LI FOUNDATION LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY— CON STRUCTION CCUPANCY_CONSTRUCTION TYPE VALUATION $ ZONE GRADINGCU.YDS. ACRES_ Remarks: Accessory Building: Parking Req. Zone Z N G R E Q M T / ELECTRICAL FEES PLUMBING FEES Automatic Washer Transformer ❑ 15-50 KW Construction Pole Sub. ❑ 50+ KW Bar Sink Showers $ Backflow Preventer Service Sink $ Cooking Unit Meter ❑up to 100amps Backflow Irrigation Sewer Cap PLUMBING Dishwasher Meter ❑over 100 amps Bathtubs Sewer Connection $ Dryers ❑Gas ❑Electric Sub Panel Clarifiers Solar Collectors ENERGY P.C. Fan Motors 00-1 HP 01 %- 8 Dishwasher Solar Piping $ P.A.U. Inc. Solar 09-15 HP 016-15+ Drinking Fountains Solar Tank PLAN CHECK 50% Fixtures Microwave Floor Drains Swimming Pool w/Spa $ Boxes Pole DeviceLight Floor Sinks Urinal �_y vy TOTALFEE Outlets Range Gas Service Outlets Water Closet $ Switches Sign Interceptors Water Heater Garbage Disposal Standing Sections Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor Lavatories Auto -Wash 1P—Trap Laundry Trays Roof Drains Reinspection Fee I $15 I I Issue Fee I $ 3 I I Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Bit. ICBO d6 Heating System & Ducting ❑0-100,000 BTU Ell 00,000 Reinspection Fee 1 $15 0865-46, rev. 5/88 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Hood or Type ❑ Canopy Type II ❑ 7* eration System 00,00013TU ❑100,000 System Repair/Alteration Fire Dampers Registers Issue Fee FEES Reinspection Fee , $15 I Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Application Issued By— $ 3 SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ �_y vy TOTALFEE $ QV PLAN CHECK 25% $ _ CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector . jL & SPA APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement .13. Electrical Conduit Utility-Undrgrnd. 54. Forms 4' Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test ' 9. Water'Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 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 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final , 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18^ Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21'. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas OOil 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 4- 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: 34. Final Heating & Air Conditioning Gr i Gn 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 Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation '`>! 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison .- 50. Gas Release to Southern California Gas Co •51. CERTIFICATE OF OCCUPANCY No. Date LIMITED STATEMENT OF RESPONSIBILITY TO WHOM IT MAY CONCERN: //,�� 1��-,✓,� vim` Street Address Bldg. Permit # This Permit # AP Number I, , as Owner in Title of the above referenced property, do hereby authorize: Name Street PAdre y7y-y9,5V Telephone No. Cis %-6 to obtain permits in my behalf, as owner/builder, for 9r2 G,1.J ] 7-f o ✓ rv� n.z �t�..r;{ti at the above referenced property.. Should zany person become an employee engaged in the improvement of the property, I shall immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other per- son, company or corporation. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties. LaJ IeU(AV�c Printed Name mrere. 1a�. M7 Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 27.1.6 11/21/94 t 2 Accessory Building: ELECTRICAL Transformer El15-50,KW C150+.KW, Meter ❑up to 100 amps Meter. LJ over 100 amps Sub Panel Motors 110-1 HP El % -8 Inc. Solar E19-15 HP; Ill 6-15+. Microwave - -' - Pole Light Range Date. Signature i Floor Drains Swl mming P001 W/Spa ) F.A.U. 'NOTICE: If, after making this declaration, you should become subject to the W rkers' ComensaYion rovisions of the Labor Code You must forthwith- Floor SInks- (-U i Io . pp , - CITY OF COSTA,MESA CONSTRUCTION PERMIT � rc - �(O ' "��' ' �7 UNI I NU. - ' G Project Address /Za _ ;f14AI Z2121 VE-. Interceptors Water. Heater' -O utlets .k ' Kitchen Sink' - Water Service Exhaust System ❑ Multiple ❑ Swit6hes - /%i7 TtIST//� -TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR Garbage Disposal P -Trap - LaundryT ra ys Applicant's Mailin/g//Ayqld�ddr��ess ;�ji>�iEGL.+f/3Y - ❑ CONVERSION ❑DEMOLISH ❑ OTHER A. P. - , Owner's Name #Afff/t.D f it V4,eD(Phone DESCRIPTION OF RK,USE OF BLDG. �i92 � $15 Issue Fee $ $ ` Reinipection Fee ` .. MECHANICAL - Address //alS YJ�1 n/1) v� llnsTA -WEVA FEES' ( S Main Building: SERVICES( Zoning Approved By - ' Building Approved By _ - Application Issued.By Arch/Eng. License No. - �- TYPE O-.,FfI'aP�-E�Rr�'MJ/IT GRtiDING FOUNDATION STRUCTURAL T Front `�� -'�' ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑MECHANICAL B Rear, �! j( PLUMBING Address _ • ED OTHER - - A b _ Contractor's Name ?hone Kp - C. Right 531 ^� Address(mailing)/77T^��ZL�,��'yci�Of 'il�ST//✓ PROJECT DESCRIPTION SO. FT. OCCUPANCY _ T0p Left CON STRUCTION TYPE VALUATION S City License No: / /3� • ZONE - GRADING CU.YDS. ACRES - Ping. Ref. # LICENSED CONTRACTOR DECLARATION I hereby affirm that I: am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes:/_ - with section 7000) of Division 3 of the Business and Professions Code, and my license is in to force and effect. ��/ -79 q I - ' License Class ' icense No. cO o I Date a%— 7- V S'g t /.ZgLP �/� PLUMBING FEES IV_1 WORKERS' COMPENSATION DECLARATION Bar Sink Showers •reby affirm that I have a certificate of consent to self -Insure or a certificate Norkers'-Compensation Insurance, or a -certified copy thereof (Section Service Backflow Preventer- Sink ; AutomaticWasher- _A0, lab. C.)`�`� �,/T 7/j Tb' C/1Nr Poi No. r 7 - Company / Backflow Irrigation Sewer Cap Construction Pole Sub. certified copy Is hereby furnished. , Certified cop s fled withthe city Idin ivisl0 y /' � Bathtubs Sewer Connection Cooking Unit I ' Date ,/�-.7�- Applicant' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Clarifiers Solar Collectors_ _ _ Dishwasher - A (This section need not be completed If the permit is for one hundred ($100) or less).. Dishwasher Solar Piping Dryers ❑Gas ❑Electric I c%tify that in the performance of the work for which this permit is ISsuetlI I shall' not -employ any person. in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Workers' Compensation Laws'of California. 27.1.6 11/21/94 t 2 Accessory Building: ELECTRICAL Transformer El15-50,KW C150+.KW, Meter ❑up to 100 amps Meter. LJ over 100 amps Sub Panel Motors 110-1 HP El % -8 Inc. Solar E19-15 HP; Ill 6-15+. Microwave - -' - Pole Light Range Date. Signature i Floor Drains Swl mming P001 W/Spa ) F.A.U. 'NOTICE: If, after making this declaration, you should become subject to the W rkers' ComensaYion rovisions of the Labor Code You must forthwith- Floor SInks- (-U i Io . pp , - Standing Sections 5 KW Trash Compactor $15 Issue Fee �FUUTEMWS: - 11adiD TL Z O N I N G R E Q M T S comply with such provisions or this permit shall be deemed revoked. r he ' ' Duct- Ventilating Fixtures '. - Gas Service Outlets I Water Closet .. $ ,$ $ $ �� • �7 �� Device 80x¢5 G CONSTRUCTION LENDING AGENCY I I hereby affirm that there is a construction lending agency for the performance of the work for which hi permit is issued .(Section 3097 Civ. C.) Lender's Name -� 3s.a sem_ - - Interceptors Water. Heater' -O utlets .k ' Kitchen Sink' - Water Service Exhaust System ❑ Multiple ❑ Swit6hes - Lender's - - - - - - OWNER BUILDER DECLARATION. I hereby affirm that I am exempt. from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or' county which requires a permit to construct, alter, Improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3-of'the Business and Professions Cotle) or that he/she is exempt herefrom and the basis for the alleged exemption. Any violation of Section /031.5 by any -applicant for a permit subjects the applicant -to a civil enalty of not more than five hundred dollars ($500). . r; I P- I I, as owner of the property or'my employees with'wages'as their sole compensation, will do the work', and. the structure is not intended or offered Lavatories • Auto -Wash - - BUILDINGtPER MIT Garbage Disposal P -Trap - LaundryT ra ys Generator E10-5 KW El 5-' Roof Drains - - - - , - ReirnpeCtien Fee $15 Issue Fee $ $ ` Reinipection Fee ` .. MECHANICAL - Firepl/Fact. Bit. ICBO # FEES' Fire Dampers for sale (Section 7044, Business and Professional Code: The Contractor's - License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or Improvement is told within one year of com- pletion, the owner will have the burden of proving he/the did not build or im- prove for the purpose of sale): ❑ 1 as owner of the property, am exclusively contracting with licensed con- tractorstd construct the -project (Section 7044, Business and Professions Code: SERVICES( Zoning Approved By - ' Building Approved By _ - Application Issued.By Boiler Hood or Type EJ yp Canopy Typ¢ II ❑ - ' Duct'Under Ground Duct - Structural I Refrigeration System PLUMBING •$ $ Standing Sections 5 KW Trash Compactor $15 Issue Fee �FUUTEMWS: - 11adiD TL Z O N I N G R E Q M T S Date _ Owner I hereby certify that I ,have read this application and state that the above information is correct. (!agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of this fjty 't enter u on the above-mentioned property foj inspection purpos I' n� Sign. re Date P -o7 -a Heating System & Ducting 00-100,000 BTU ❑ 100,000 BT 1 , - I 11 Reinspection Fee Drivers' License or 55 � CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor $15 ' Registers The Contractor's License Law does not appiy,to an owner of property who builds or improves thereon, and who contracts for such projects -with aeon-' PLAN CHECK ELECTRICAL PLAN'CHECK MECHANICAL PLAN CHECK Duct- Ventilating $ $ $ i '$ _ $ (]0-100,000 BTU. ❑100,000 BTU $ ,$ $ $ �� • �7 �� G ' SUMMARY _OF'FEES ' Issue Fee tractor(s) license pursuant to the Contractor's License Law). I am aware that r Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDINGtPER MIT $ •2t7 •�� SMIP - $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ / 3- 32 PERMIT ❑ l em exempt under Section B. & P. C. for this reason Firepl/Fact. Bit. ICBO # Fire Dampers ISSUANCE PLUMBING •$ $ Date _ Owner I hereby certify that I ,have read this application and state that the above information is correct. (!agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of this fjty 't enter u on the above-mentioned property foj inspection purpos I' n� Sign. re Date P -o7 -a Heating System & Ducting 00-100,000 BTU ❑ 100,000 BT 1 , - I 11 Reinspection Fee Drivers' License or 55 � CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor $15 ' Registers PLAN CHECK ELECTRICAL PLAN'CHECK MECHANICAL PLAN CHECK 25% 50% 25% $ $ $ i '$ _ $ ENERGY P.C. GRADING MICROFILM TOTAL FEE $ ,$ $ $ �� • �7 �� ' Issue Fee $ 3 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL a SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Polel ,. I 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 Testi , 6. -Electrical UFER Grnd. , 57. APPROVAL TO COVER-GUNITE ' 7.'Fodtings 58. Electrical Conduit-Undrgrnd.'{ 8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd! - i - 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 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 14. Rough Plumbing -• 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL >-19.) Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit# 20.,Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating . " 71. Product Piping 0Gas L)Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing - 73. Undergrnd.StorageTank EGas 00il 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 PREY. 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: F /t�do 34. Final Heating & AirConditioning ) 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace _ k 38. Final Plumbing ' , 39. Water Service -Final 40. Gas Service -Final � 41. Solar Domestic -Final 5 -` 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System .� , 45. Sound Attenuation - i 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison - - 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY W. No. Date .' A STRUCTURE CONSULTING ENGINEERS ■ CLIENT PRIMEWATER PROOF 6925 ARAGON CIRCLE BUENA PARK,CA ■ PROJECT DESCRIPTION STRUCTURAL CALCULATIONS FORE F STRUCTURE FOR NEW TILE ROOF 1125 DANA,OSTA MESA, FOR THE TAWEL RESIDENCE. ■ DATE November 29, 2000 JOB NO 2000-810 2 1 9 9 N. BATAVIA AVENUE., SUITE F, ORANGE, CA 9 2 8 6 5 T 714 998 6441 STRUCTURE TJW@PRODIGY.NET F 714 998 3403 Structure , °v - Consulting Engineers 2199 N. Batavia Ave 'T' Orange, CA 92865 T 714 998 6441 F 714 998 3403 STANDARD SPECIFICATIONS FOR STRUCTURAL REROOF CALCULATIONS: A. Sketches of details in calculations are not to scale and may not represent true conditions on plans. Contractor is responsible for installation, which represent true framing conditions. B. The Structural Calculations included here are for the analysis and design of the roof framing members. To determine whether the roof framing has the capacity for the new roof assembly loads, due to the added weight of the tiles using the guidelines of the uniform building code. The attachment of non-structural elements is the responsibility of the architect or designer, unless specifically shown otherwise. C. The owner and contractor are aware that the structures has been reviewed for vertical load only and no analysis or warranty expressed or implies included any lateral analysis for seismic or wind, unless noted otherwise. STRUCTURE CONSULTING ENGINEERS makes no warranties in regards to the structures and their ability to resist lateral forces, and the owner agrees to indemnity and hold harmless STRUCTURE and their consultants relating to any potential damage caused by wind or earthquake. D. Owners are aware that the additional weight of the tile material may cause some drywall cracking due to the increase in weight. This is cosmetic in nature and may be repaired at the homeowners expense after the roof has been installed. E. Owner hereby agrees to limit STRUCTURE's liability to the owner and all construction contractors and subcontractors on the project such as that the total aggregate liability of STRUCTURE to all those named shall not exceed the cost of the engineering fee. In accepting this report the owner or owner's agents agree to all of the terms stated in this report. F. Owner hereby agrees to indemnify and hold harmless STRUCTURE CONSULTING ENGINEERS, and its authorized employees from any action, liability, claim dispute, loss, damage, or injury to persons and property in any manner arising out of construction and/or any incidents involving the condition or security of the premises and its content over which STRUCTURE has no control. G. Copyright ©1999 by STRUCTURE CONSULTING ENGINEERS. All rights reserved. This material may not be reproduced in whole or in part without the written permission of STRUCTURE. All changes made to the subject project must be submitted to STRUCTURE in writing for their review and comments. PROJECT ADDRESS: 1 ) ZJ I' A dA C) L I �A hA ES Iq , fR OWNER: fA,tAtL.Residence PLAN CHECK: CALCULATIONS BY: Kjell A. Bo NAME not or IGNATURE DATE: /27 November 2000 W 2199 N. BATAVIA AVE., STE. F SHEET '[STRUCTURE TB7N 4E, 9C98 64841 (, CONSULTING ENGINEERS T 7 1 4 9 9 8 3 4 0 3 J 3v1 e' I 'a"' I v Rnn(.E b Q I N Khvr� ,ZYI 1, Y - 14 x`4114 � .4�f(' laV l,bKo t� e' I 'a"' I S.1.RUCIURE CONSULTING ENGINEERS 195 3ATAVIA AVE., STE. O ORANGE, CA . 92665 T 714 998 64.41 F 714 998 3403 SHLLI } v 0 \\0.y � •. \ Z 7Z ! O e 6-70 i • 67L 2199 N. SATAN AVE., STE. F SHEET S RT UCTURE T 714E 9098 9 2 64841 to CONSULTING ENGINEERS T 714 998 3403 R,o o �-" 010�\F < cr\, - —1 SPAN = POINT LOAD = ROOF LOAD = WALL LOAD = FLOOR LOAD = TOTALLOAD = 12,` USE: 2 X_A c Zggyt,� 1 SPAN= f POINT LOAD = ROOF LOAD= 3-0 WALL LOAD = FLOOR LOAD = TOTAL LOAD = @) USE: 2' x 10 @ I (,, �� L/ // p z S= %XIE -v- I 1 5 = hr;I IN' /�IJoxr.cnn, l,2 YllX�7 2,%�( IN' V= = # rl A= �1 J sC7i%�� - 5(� / _ �� INZ IN' 7i�yUC = 2'J� R1 = R2 = S= DX (�,JJLY_(IS =J`J`�IN' N50x ). G5 %Hcx� = A 0 IN' V= _ # A= /�SXa00 16-�9.S1/ =IJ? IN' 35X1 ( 5 L ( IN' R1 = R2 = R I IS 193 tAT. C AVE., 26 D I1 V1� FR7114 E 998 3.998 403 CONSULTING ENGINEERS —� f2.�sS 2iNl� 'F�.00IZ, j�I O L.0''JLo x t or L pru\ -O VW Po's V.Xc LO / _ S PAT) _ b O X. s COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 F pplicant to Fill in Completely — Use Ink Only G �/�Ses Rt:C MAIL S 508 29th StreetTEL.Ne rt Beach, CA No. 675-4910 CTIONSSECT r. —__,_ c—__�t_� TEL. cao nnrn PAIL *3tt ;GV 10-77p,h00 562-x 109. APPLICATION FOR STRUCTURAL PERMIT RECEIVED �BwyV/� DATE RECEIVED DATEIS�SIME.�D A- -NO- BUILDING ADDRESS VALUE ADDRESS XL4U 1V ba Q iNDOgriggeacia cv'vc i re unvsrr APPROVED . 30,� CONTRACTOR a BY DATE 1 VY ADDRESS TEL. O NO. OF VSE OF W CITY NO. –spy/ PLANS BUILDIN STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING W SIZE NO.OF SLOGS. (FROM nREET) 6. OF LOT A rox. 60' X 80� NOW ON LOT 0PONT FT. FT. a USE OF ,N. EXISTING BLDG. R. SIDE FT. F h FSeparate permits are required for L. SIDE FT. FT. electric, plumbing and heating work. � REAR FT. FT. [.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE 11ET��y. BET. MAIN & 0 MAIN BLDGS.—i:/ ACCESS. B VAR. {+ 'I DATE ••� C.U.P, APPROVED I a house Plan # 3 APP r ly O. 1 hereby ackriOnV1069. that I have tl this appl ation and state nia Pr 6,11 ^t rl1-LENT! - f -t• `- •• -- IY. that the above Information is torr ct and agree to comply with Q.. 4• all laws regulating building construction, and I shall not employ z any person In violation of the workman's compensation laws of the State of California. 3 1 hereby certify that I am properly licensed as a contractor under SD. FT. 2295 THE AMOUNT SHOWN UNDER VALUATION IS FOF the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ and Professions Coda, ivislon 3, Chapter 9, PLAN CHECK S 105.50 Signature TAX s 4.28 Permittee/ s 61,100. TOTALPAID $ Authorized Agent y�aG^-s�� H C 445 -not- COSTA MESA BUILDING -SAFETY DEPARTMENT P.O.BOX1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING //e7/� J 1i,, 9 / OWNER MAIL ADDRESS a TEL. CITY NO. CONSTRUCTION all laws regulating building construction, and I shall not employ LENDER BRANCH ADDRESS the State of California. ARCHITECT TEL. OR ENGINEER the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In full force and effect, or I ADDRESS am exempt from the provisions of the State of California Business CONTRACTOR v PERMIT FEE E ADDRESS / Jt TEL CITY NO. STATE CITY LIC. NO. LIC. NO. SIZE NO. OF BLDGS. OF LOT NOW ON LOT USE OF Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED 'FC -9-77 S°00 507 d***211A APPLICATION FOR STRUCTURAL PERMIT ' FIRE / ZONE TYPE GROUP APPROVED ' ZONE IND. OF I USE OF NEW PLANS BUILDING ' YARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUILDING BET C.U.P. qp APPROVED BET. MAIN & a . s s.INGRESS iI`•/�010 that the above Information Is correct and agree to comply with n all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of m the State of California. I hereby certify that I am properly licensed as a contractor under r .4/ the State of California Business and Professions Code, Division 3, ' FIRE / ZONE TYPE GROUP APPROVED ' ZONE IND. OF I USE OF NEW PLANS BUILDING ' YARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUILDING BET C.U.P. qp APPROVED BET. MAIN & I hereby acknowledge that I have read this application and state 0 that the above Information Is correct and agree to comply with n all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of m the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. r the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION v PERMIT FEE E and Professions Code, Division 3, Chapter 9. / Jt n CHECK ^� _PLANE Signature of /t � Permittee /�.d�i $ � TAX $ U �[ U Authorized Agent �(�„ TOTAL PAID E /