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Home My WebLink About3280 DAKOTA AVE - Building Permits� (714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3280 DAKOTA AV Suite No Vicinity: WATER HEATER Parcel Nunmber: 13906701 u Applicant: STARK, Address: 7229 VAR � �� °� l ��--' ��q�") �Arch / Eng��'1 - Cl Address�i� �, �� ' !1 �r1� ,-, ,Un � ISSUEF E�� Backflow irrigation Backflow Prevente�� Bathtub \\ Clarifer System � Connect Qce,Soda,etc)� Dental Units � Dishwasher Drain, Floor Drain, Rainwater Drain, Roo( Drinking Foun[ain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) CA PLUMBING PERMIT Ll Phone: o Ea. )��.. e 3 GP '�y'wj%�-' '`�7 �, ° �'. � °�� : � ` ��`"� ��- Phone: (800)444-8865 CA Zip: 91605 ' License: 771905 n Status: ISSUED Applied: 17/06I2001 I ss ued: 11 /06I2001 ISSUED BY: ' 1L�11 11 ll �L.t�ll 11 1t1111.� l711t111C h1J ' � "-- � HEATER CHANGEOUT i i L n \ QTY 4- 0\\ ,��iL"au'i D 0' ��`"��'�� Lan� 0�0� �Fro� D� �0/'��Rec 0�0/ / Sep p� p�.f �$ew $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 0 0 0 0 0 0 0 0 Phone: ° ` � o < 'AMTZ`jQTY Nasliei �� $Q00;'�Os� ; 3ation'�� oS0.00 0�''_- '� -- °.�1 $0.00 .0, lator°" " n $OAO� ° 0 `�. (per�l0ft)l �50.00 �0� Demo $0_OO...�SO ; '.lj "� /' �'CSO.00L- 0� Line � i �I '7y $0.00 '��-0 LI�LJ-"LS $0,00-"'0 � Sink, kitchen Sink, service/mop Spa (private) Spa (public) $0.00- 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 COMMENTS / SPECIAL CONDITIONS �� S✓ 1.� Waste and�Vent System Wafer.Closet (Toilet) Water Heater / vent Water Piping Qnst or Rep.) Water Re-pipe WaterService Water Sokener OTHER VIOLATION PLAN CHECK REINSPECTION � $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 512.30 50.00 $o.00 50.00 $0.00 $0.00 $0.00 50.00 $o.00 TOTAL CALCULATED FEES: $35.80 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis 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 requlred Inepecllons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2446d8 (fl�W) WORKERS' COMPENSA710N DECLARATION: — " . ' �7 ' I hereby attirm under penalry of perjury one ot the followinq declarations: � � ❑ I have antl will malntein a certificate of consent to self-Insure for workers' compensetion, es provlded for by section 3700 of iha Labor Code, for ihe pertormance of the war�k for which ihis permit I5 issued. kers' compensaiion insurence, as required by section 3700 of the Labor Cotle, for Ihe peAormance of the work for which this permit Is issued. Insurance cgrner antl policy num6er are: lL � PolicyNumber. ��G 27 �l �96z 7 rted i/ the p i' I ed et one hundred dallars ($100) or /ess.J �-=�� ❑ I cenify that in the perfor ens w E�r �hich t�is permit is issued, I shall not employ any person In any manner so es to become subject to the worke�s' compensation laws of C INor '� n a�4 1 t H I shoul0 bacome sub�ect to ihe workers' compensatlon pmvlslons of Sec� n 3zW o�,the Labor Cotle, I shall iorthwith comply with these provi io c � Applicani5ignaturer ' . Y.='.=._Date: / �/a� WMNING:'FAILURETOSECUREWORKPR COMPENSATIONCOVEMGEISUNLAWFULMIDSHFLLSUBIECTANEMPLOYERTOCRIMINAL E ESNNDCIVIIFlNESUPTOIXJEHUNDRED TFiOUSAND DOLLARE (5100,000), IN ADIXiION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED f-0R IN SECTION 3]O60F THE LABOq CODE, IMEREST, AND ATTOFNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm that I am licensed-�f de rovi forceentleHectCic�ri� 7 (� �'S CONSTRUCTION LENDING AGENCY: 9(commencing with Section 7000) of Division 3 oi Code, antl my license is in full ❑ I hereby a8irm �hat there is a consiruction lending agency for ihe performance ot t�e work for which this permit is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lendefs Address: SigneWre: OWNER-BUILDER DECLARATIONS: Dete: I hereby aRirm �het untler penalry ot perjury Ihat I am EXEMPT FROM T1E CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business entl Professions Code: Any city or county which requires e permit to consiruct, elter, improve, demolish, or repair eny siructure, prior to its issuance, also requires Ihe applicant for such permit to file e signe0 statement that he or she Is licensed pursuent to ihe provisions of ihe Contradors Licensa Law (Chapter 9(commencing with Sedlon 7000) of Division 3 of Ihe Business and Professions Code) o� ihat he or she is exempt therefrom and the besis for the alleged ezemption. Any violation of Section 7031.5 6y any epplicent for a perrt+' subjects the epplicant to a clvil penelry of not more Ihan five hundretl dollars ($500)J: ❑ I, es owner of �he properry, or my employees with weges es iheir sole compensation, WILL DO TME WORK, an0 ihe structure is not Iritentle0 or ottered for sale (Sec. 7044, Business and Protessions Code: The Contractore License Law does not apply to an owner of property who builds or improves thereon, end who does suc� work himself or herselt or Ihrough his or her own employees, pmvitled that such impmvemenis are not intended or oflered tor sale. If, however, ihe building or improvement is soltl within one year ot completion, ihe owner-�uilder will have Ihe burden ot proving that he or she did not build or improve for Durpose ot sele.). ❑ I, as owner of the property, am ERCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS lo constmct ihe project (Sec. 7044, Business antl Professions Cotle: The conireciors License Law does not apply to en owner of properry who bull�s or Improves thereon, and who coNracts for such pmject wlih a coniractor(s) license pursuant to Ihe Contrectors License Laws.). ❑ I em exempt under sec. Signalure: Owner ID venfied by tlnver's license. ❑ Yes ❑ No Business antl Professions Cotle tor ihis reason: Venfication oi Ownership by (rype of document, l.e. - property tex bill ar tleetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTFICATION: Dnver's License No. Date: Expires: ❑ I hereby certify ihat no exwvation five (5) or more teet in depih Into whlch a person is required to descend, will be made in connection with work authonzed by �his pertnit, and ihat no builtling swcwre, scaflolding, falsework, or demolition or tlismantling thereof, will ba more Ihen ihirty-siz (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, Celifomia Atlminisirativa Code). ❑ As owner-builder, I will nat employ enyone to tlo work which would require e permit irom ihe Division of Industrial Satety, es notetl ebove, unless such parson has a permit to do such work from iha division. Signa�ure: Date: Division ot Industnal Safety Pertnit Number: CERTIFlCATE OF COMPLIANCE AND Al7fHORVA710N OF ENTRY: I certity under penalty ot perjury that I have read this application and state that ihe intortnation given is correct. I agree to comply with all state laws and ciry or0inances relating to building construction, anC euthorize representatives of the Ciry of Costa Mesa to enter upon the ebove-descnbed properry for inspection purposes. I agr�66Dt�topCc�py or ellow occupancy oi any building aNhorized by this permit until finel inspection. CODE t. INSPECTIONTYVE QL� . INTRIRLS 1676 Fixed System Final Fire Prevention 1286 200 Pool Spa Final Final Re-Rool 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204' Final Demoli(ion � � yODE� INSFECTIONTYPE 206 Final Mechanical 208 . Final Plumbing 210 Final Elecirical 212 Final Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Final Buildin<yOccupancy Ps7E 1[�BLS � � � PNOJELT AUOflESS: 3'z 8 O DAKOTA AV ,Fwxeaswame: pRESLEY, DONALD R' nooaess: 1495. REGATTA RD LAGUNA BEACH,CA 92651 • (719) 497-4017 � FPCH/ENGINEEB: AODflESS: HEG.NO.: UNIT: UNIT: PEHMITIEE: COHH ROOFING COMPANY ( 714 ) 995-904U aooness: 2q552 LOS SERRANOS DR. ' LAGUNA NIGUEL CA 92667 LICENSEU CONTBACTOfl UECNBATION: I here�y af�irm Iha� I am licensed un0er O�ovisions o� C�apter 9(commencing wi�h $ection 7000) oi �ivisian 3 of �he Business antl Pm�essions Catle, an0 my licen}e is in full Porce antl elleci. cirruc.: srnreuc.:3093'75 cunss: C-39 �aie'. _�� G — Y3 $ignaNre'. l� WOFNEBS' COMPENSATION OECNflATION: I hereby aifir al I have a certiticaie oi consent to selt-insure or a ceni�icare oI Workers' Compensalion Insurance. or a certilie� caDY �hereol (Seciion 3800, Lab. C). . . PO�ICY NO.: EXP. OPTE: - COMPANY: ❑ Cenifietl cooV is here�y lumishetl. ❑ Cenilied copy is tileE wiih IAe ciry BuilOing Division. Oa�e: E%EMPTION FHOM WOflNEHS' COMPENSATION OECLAHATIO ' �is section nee0 no� be comp@teG i� the permil is iw one huMrea (5100) or le5s�. I ceriily Ihat in the pedormance ol lhe work for w�ich I�is permil is i55ue0. I shall not employ any De�son in any manner so as Io �ecame sublec� Io the Workers Compensalion Laws oi Calilomia. ' Da�e' �Q � �-S ' S��_ SignaNre: NOTICE:I1. after making ihis Eeclaration, you shoultl bec e sublectto ihe Workers' ComDensation provisions otihe Lahor Cotle. you musl torl�wiih comply wii� suc� pmvisions o I�is Dermil shall be deeme0 revoketl. CONSTPUCTIDN LENUINC PGENCY: I Aereby allirm tha� there is a consimc�ion lentling agency �or �he De�o�mance ol �he work �or which Ihis permil is issued (Section 3W7. Civ. C�. � LENDEP: nooness: � ' OWNEN BUILOEB OECLAflFTION: I hereby aliirm t�at I am exempt imm the Contractors' State License Law for Ihe following reason �Seciion 7031.5 Business and Pmlessional Cotle: Any ci�y ol coun�y whith repuires a permi� to cbns�mct, alter, impmve, demolis�, or. repair any Slmcture, prior Io its issuance. also requires the applican� for such permit �o file a signed s�alemen� �ha� he/s�e is IicenSeA pursuani to �he pmvision5 of Ihe ConiraC�ors' Siate License Law (Chap�er 9(cammenCing wilh SeCtion 7000) at �ivision 3 Ot �he Business and Pm�essians Code) or thai �e/s�e is ezemp� Ihere�mm antl �he hasis for the allegetl exemp�ion Nny violalion ot Section 7031.5 6y any applicant for a permit sublems ihe aDPlicant m a civil Denalty of not more ihan tive hunOretl tlollars ($500�. I, as owner ol ihe pmperty or my employees with wages as iheir sole comDensation, will do ine work, and tAe ❑ stmaure is no� inlentled or alteretl for sale (Sectiond044. Business antl Pm�essianal Code: T�e Contraclors' Staie License Law tlaes not apDly to an owner oi a pmperty who builtls or imDmves t�ereon, antl who does such work himself/herself or Ihmugh • his or �er own employees. pmvitletl Ihal such impravements are nol m�endetl or oflered for sale. If, �oweve� �he builtlinp or impmvement is sola wi�hin one year ol compleiion, ihe owner will have lhe burtlen o� pmving he/s�e Ai0 no� 6uiltl or improve � br the purpose oi sale�. I, as owner ol Ihe pmDerty. am e�clusively contraciing wilh licensea contractors to constmc� lhe pmjecl (Section 7lWd, Business ❑ antl Pmfessions Code: T�e Conlractars' State License Law Uoes nol apPty m an owner of proDenY who buACs nr impmves t�ereon ana who contracis br such pmjecis with a contractoqs)license Oursuan� to the Canirac�ors' Sta�e License Law�.l am awa�e tha� pmo� oi �heir WorkeYs Compensation insuranre 5houltl be provitletl to me. � I am exempt untler Section: B. 8 P. C. �or ihis reason: � Da�e: Ownec 1 ao hereby ceNly thal I am aware of ana unEerStantl Ihe reQuirements of Cahfomia HeaIN and Safery Cotle Sections 25505. 25533, an0 2553G antl Ihat I or any IUWre �uil0ing occupan� wilVwill no� �circle one) neetl to compty wi�h saia s�ate codes and �he requir¢ments for a permi� �ar cansimclian or modilicalion imm I�e Air Ouah�y Managemenl �i5tnci. Fe5i0en�ial con5�mciion a001ication5 are exemp� Imm inese pmv7sions. . Oate: FpplicanL I �ere�y cer�ifylha� I have reatl Ihis application ana 5laiel�al�he above information is wrrecL lagree lo comply with allci�y anU counry ardmances antl slaie laws relating to �wldmg constmclion and hereby authorize represen�atives of �his city �a enter upon the a�ove�menlione0 propeny fo� inspection purposes. 1 / n �aie: � V � %'�' � J Signamre: " � „A �"�O oriver's License or Social Securi�y a: ' t66L46 W�ne—Builtlinq; Green—Cotle Enlorcement: Canary—Ap0licam; Pink—Revenue', Goltlenmtl—Assessor CITY OF COSTA MESA — BUILDING.PERMIT � PERM NO: B, '�64637 PERMIT NO: B 069637 . PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE; STR PORPOSE: OTH JOB DESCRIPTION ; T/O; RESHEATH6 REROOF W/ COMP. SHINGLES SQ FT; 5,560 CLAIM VALUE: 5,560.00 CALC—VAliUE: �5;560.OU GROUP OCC: A-3 / � COMMENTS: SMOKE DETECTORS ARE REQUTAED AS PER U.H.C. 1991 ****+�*+t*+�+��**�-**�***+�*�*�c-**********+r****+r*-u**�c-�**�*****+c*+�r+�*x��t*�c�c*+�*****�**** 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 ---------- --------- ACCES50RY 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; PROV; PARCEL: 13906701 ZNE: REF NO; , PLANNING NOTES> j /' ' if if �E iE iE if iF iE iE it iE iE iE 3E iF it iE if fE 3E iE * iE �f iE iE iE it if if 1f if if i! ik iE iE iE iE 1E k iE k i: iE if iP iE jf �F iE if i(� iE iE if iR if jf iF if if iE iE if M iF iE if iF if if iE *� if iF?P iE D E V E'�L O P M E N T S E R V I C E 5 R E Q U I R E M E N'T S 20NZNG APPROVEb.BY . DATE: r� HUILDING APPROVED BY :. DATE; .: APPLICATION IS3UED BY: (� � DATE: 't7 rZ,�,�� **�r�r�c*******�r*****�t�r�-�r**�x-�x-*�**�r*�**��e'+��+r*��*****�+c**+�*****�r*�r****� �c �* �r *�r��r*�rx�*�rat�r�r*��t+r**�rvatu*+t**+tifitit*�atit�r**�r*�*�t�tit**�******+��r�r+t�ar**�rr�+t**itit'jr�ar+t*��*�it . LEGALIZATION:N F E E S U M M P. R Y r STRUCTUAAL� SEGMENT;Y � �: BLDG PMT PLUMBING ELECTRIC MECHANIC FIR1E SMIP/RES�' GRADING PERMIT 81.00 � �`' S6' PLAN , ':g, ' SMIP/NON�YRES ISSUE FEE� f; � ' BUILDING—DIV—> PERMIT ' ISSUE PLAN—CHECK TOTAL �1 PAID� �DUE TOTALS----> 81.56 0,00 0,00 81.56 81.56 �� ,00 � REVENUE DIVISION TOTALS--> COLLECTED: 81.56 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANZC FIRE SMIP/,TOT GRADING-PLAN—CHECK 81.00 ,::56 7 :lo �{ � if if if 1F iE if iF if iE ff if �E iE 1E 3E 1E �E iE iE �E iE jt 1ElE 1k iE iE iE i4 if iF it it 1t jE iE 1E iE if iE it iF iE 1E jE if jE iE iF iF iF iE iE 3E iE iE iE iE if if �E 1F 1f iE iE iF:f 3t iF ff jf iF if 1! iE if 1E iE iE I N D I V I D U A L F E E B R E A It D O W N ,� TYPE : QTY D E S C R I P T I O N UNIT COST ,.,TOTAL COST � SFR 5560 REROOF BY VALUE RESIDENTIAL NOZONE r�. 1,00 5,560,00 END OF FEES ��. � � 1 r, r,r S��IaKE C7�1 E�TC�R� DaTt01�U%2�193RE�tt- uy�:R'�� 31<5b_. <' f/ 1 � t ��CONSTRUCTIQN AN� PL'ANNING ' 4 . ; P(... _ & SPA. - Date Inspector Oate 'Inspector APPROVA(.S Permit # - � � AP IROVALS Permit ?k :i.-Temporary. Electricai Service or Pole -� 'a � 52. Pooi &' Equipment Location . 2. Soif Pipe�Undrgrnd. . . "�� • _ 53.. Steel Reiniorcement � . � 3. E�ectricat Conduit Utility-Undrgrnd. � � ` . - 54. Forms; � � - 4. Electric'at CPnduiFUndrgrnd.. � �;�� : ' 55. Electricai Bonding � � , 5. Stee! Reinforcemenc 56. Rough Piumbing & Pressure Tzst . I i s. Electricai UFER Gmd_ - � - 57. APPROVALTO�COVER-GUNITE i 7. Footings � ;� � 58. Electrlcat Conduii-Undrgmd. ! 8: Foundation � � - • - - ' �' �f 59. G�as P.Ipe�, G U�drgrnd., Tesc � ,� � I 9. Water Pipe-Undrgrnd. .. .. ., . � 60. Backwash Li�es, RTrap, C; Undrgmd. ��'. � � 10. Svucturai Floor SYstem �..� ,� �� 61. APPROVRL TO DECK . � t i. Property Sewer �ine & Hous"a'Connection ,�, ' -i . �� 62. Beckwash &'Recepior�Fir,al , A ' . ' . --� S2. Sev''er Cap -. � � 63. Heater�& Vent-Finaf 1 73. Raof prain5 -, . � 64. p�um�siny System � Pinal �� 74. Rough Plumbing .. � 65. E�lecfn'cal-Finai _ � I 15. Rough Eiecirica!-Conduit � 66. Solar System-Final „ i6. Rough Elec2ric Wiring . � 6). F.encing & Access Approval � t7. Rough Wir;ng Siyn � '. ' 68..APP.fiOVED FOR-PLASTERifVG 4 i 78. Rou9h Electrical-T Bar Ceiling � 69. POOLlSPA SYSTEPIS FINAL 19. Rough Hea:ing & Air Conditioning ` ' - " "- �FIRE DEPT. REQUIREN7ENT ' +' 20. .Rougn Factory Fireplace � . _ _ � � APPROVALS Permit # ( . i . 27. DuMs, in Siructure '� , � " � .• . 70. Underground-Hydro � 22. Oucis, Ve�t;lating � - 7}, pioduct Piping C Gas OOi� 23. Gas Pipe�Rough &�Tesi � ` -� 72. Underground Flush 24. Roof Pramin9 � ' 73. -Undergmd.StorageTank �Gas ❑Oii 25. Roo; Sheathing � (B��q� (�� 74. "Overhead HYdro I 26. T�Bar Ceiling fStructural; & Monocoat A ' �� 75.,D�ry Chemical • ' � 2Z Eram: and Fiashing , I , 7g,`Dry Standpipe � � i 28.�'La.hing Fu 5iding � , , . - • �• • � 77,"FIXEp SYSTEM FINAL . � 29. lnsulation � . � -� � . � . 78.�rFIERE �PREV. FINAL � 30. Drywall Nai�ing - , . . I HEALTH OEPT rREQUIREMENT 37. Piasier Brown Coat . . . � ' . .79. 'F�3NRL INSPECTION � 32. Electr.cai Pow2r Aqeter-Finai � � . 8Q.'�FOOD CERTIFICATE ISSUED i 33. Finai-Electr�c Notes� . .' . ' 34..Finai Heatir�g-& Air Conditioniog � �/ ' ��,, I .� � . �. 35.�FinaiGasPipe�Test �{�'; ; . �� ' 36. Hood or Ca�opv � , � i . . I � - I 37. Finat PactorY �+�eP�ace � : i ' . � � .38. Final Plu"mbing , � � W' , . , 39. Water Service-Final , � I , , 40. Gas Service-Final , . i � � � 41. Soier �omestirFinai � � � � : i ' ' �, ' . � . i 42. Backflow P�eventer � � ' ' . � p_i?- -,�� . �� v�,a��-�=� _43. Backtlow irr,gation � , �L,�' � � i _44� Landscape Irrigation System� ,; . - _ - - - ;s 45. Sound Atce.nuation � '- -` �' !.." I . �46. 'Handicap Regulations - - � � � ' � > r? I /-- � � ... 47�. FtNALSTFUCTURE&BUILDING /(�1��4� �p'�Lt`�L'`. 5,.�,i/¢� � �.� - 6[,LG�F """ r --_!� z- .," 46�. FINALPLANNING- ' ' - ' � ` i,,+ ('; ` 49�. Electric Release to Edison ' � � ,� �"(1t r�. 50. Gas Release to Southem California Gas Co �. _ � . � • � ��' � 51'. CERTIFICATE OF OCCUPANCY . = • -q No. Date � "� - PNOJECT RODPESS: 3 Z S O DAY.OTA AC� owNensxnme: pRESLEY, DONALD R aooness: 1995 REGATTA'RD � ,,,-'•�' LAGUNA BEACH,CA 92651 (719) 497-4017 uNir: APCHIEN:1NEEfl: flEG.NO.: pODBE55: r ' - IINIT: PEHMITTEE: DON PRESELY ( 719 ) 497-9017 aoosess: 1495 REGATTA RD C.M. CA 92631 LIGENSEO CONTHACtOH DECIANATION: I hereby aflirm I�a� I am licensetl unGer provisions ot C�apter 9(commencing with Seciion 7000) o� DiNsion 3 of �he Business antl Pmfessions Code, an0 my license is in full torre antl eifect. CITY LIC.: STATE LIC.: CLASS: � �aie: Signalure: WOflKEflS' COMPENSATION UECLFflRTION: I �ereby affirm Ihat I �ave a cenilicale ai consem m setl-insure or a certificate oi Workers' Compensalion Insurance, or a cetli�ied copy ihereo� (Sec�ion 3800. Lab. C). POLICY NO.: EXP. OPTE: � COMPANY: ❑ CertJied copy is here�y �umished. ❑ Cenifie0 copy is ti@d wilA tAe city Buittling Division. Oale: Applicam: _ E%EMPTION FPUM WONREBS' COMPENSRTION OECIAHRTION: �This Set�ion neetl no� he comDle�eU il lhe permit is �or One hunOreO (5700) or less�. I certify ��ai in Ihe Oerlormance ol lhe work lar which ihis permit is issued, I shall no mploy any person in any manner so as �o �ecome sublect lo Ihe Workers' Compensation Laws ol Calitomia. Daie' — SignaNre: �NDTICE: II, a��er making �his eclaration, you shoultl become sublect to the Workers' Com saiion pmvisions o� t�e Labor � Code. you mus� lotl�with comply wii� such pravisians or t�is permil s�all �e aeeme0 re k. CONSTflUCTION LENDING FGENCY: I here�y allirm Ihal there i5 a cons�mction lending ag nc for �he peAormance oi �he work tor w�ich Ihis permi� is issueA (Section 3097. Civ. C�. � LENDEP: •�� AOUPESS: �. " . - , OWNEfl BUILUEP OECLABATION: I hereby afiirm that I am exempl Irom ��e Contracio�s' Sta�e License Law �or the following ieason (Section 7031.5 Business antl Pmiessional Cotle: Any city oi counry which requires a permit m cons�mc�, al�er, impmve, tlemolish, or repair any 5trucNre. prior to iis issuance, also reqmres the applicant for such permi� �o file a sipnetl sla�ement �ha� he/s�e is licensetl pursuant lo Ihe pmvisions of Ihe Comracbrs' Sta�e License Law (C�apter 9(commencing with Seclion 7000) oi Oivision 3 0l �he Business and Pmfessions Code) or t�at helshe is exempt Ihereimm anU Ihe basis br t�e allegeA exemption. Any violaiion ol Sec�ion 7031.5 by any applicam �or a permi� suble��s IAe aOP�icanl �o a civil penal�y o� no� mOre than live �undretl tlollars ($500). I, as owner ol the pmpeny or my employees with waAes as their sole compensation, will do the wark, an0 ihe ❑ s�mc�ure is not inreneee or otierea far sale ISection 70a4. Business an0 Pm�essional CoOe: The Comracmrs' Sta�e License Law Joes nol appty �o an owner o� a pmperty who Ouiltls or impmves �hereon, and w�o does 5ucI1 wofk himsel�/�e6el� or NfouAh his or �er own em0loyees, pwvitletl t�ai such improvemenls are not intentletl or oflereA �ar sale. II, however the builOinA or impmvement is 5010 wilAin one year oi com0lelion, the owner will have t�e burden ot pmvinA �elshe tlitl not build or imD�ove ' for Ihe purpose o� sale�. I. as owner af ihe pwpeny, am exclusively coniracting with licensed coniracbrs to consimct ihe pmlect (Section 7094, Business ❑ antl Pmiessions Coee: The Comracmrs' Stale License Law tloes no� apply lo an owner o� pmperty who 6uilUs ar imOroves �hereon antl who conlracis for such Orolects with a conirac�oqs)license pur5uan[to �he Contractors' Siate License Law),I am aware ��ai pmol oi lheir Worker'S Compensa�ion insurance shoultl be provide0 to me. ' � I am exempi under Section'. B P 7 Q q q B. B P. C, mrmisreason. OWNER BUILDER Oa�e'. ��14�q� Ownec ' � I Ao hereby ceriify I�a� I am aware ol an0 understand ��e requiremenis ai Cali�omia Neallh an0 Safery Code Sectio 255 5, 25533, and 2553a and thal I or any fuWre bmltling occupan� willlwill no� (circle one) neetl �o comply with sai0 s�a�e codes an he re iremenis �or a permi� lor cons�mciion or motlihcation Imm the Air Duality Managemem �is�rim. Nesitlential cons�mction apDl' a�ions re exemp� from Ihese provisians. , �ate: NpPlicanP. I hereby ceitify�hal I have reatl Ihis applicaiion an0 slale�halthe aboveiniorma�ionis correcL I agree to comply with all city and counry ortlinances antl slalelawsrelatinglo Awltling consimclian and hereUy aulhonze re0resentative5 oithis ciry�o enteruponihe a6ove�mentionee pmneny lor insnec�ion puroases. � .. Da�e: ��Za"q� SignaWre: L�+�- C� od�ers �icense o� Sociai Security a: ` i64i�a6 Whue—Budaing', Green—Cotle EnlorcemenL Ganary—ApPlicam: Pink—Revenue; CITY OF COSTA MESA — BOILDING PERMIT PERM.NO:•B 069697 PERMIT NO: B 064697 PLAN CHECK NO: N ,GOVT: P7,SUPP: N• CONSTRUCTION TYPE: V—N PERMIT TYPE: STR � PURPOSE: NEW JOB DESCRIPTZON ; INSTALL 2'X4' SKYLIGHT ; SQ FT.: SOU CLAIM VALUE: 500.00 CALC—VALUE: 500.00 GROUP OCC: R-3 /M—i COMMENTS: ICBO NO. TO BE PROVIDED TO BLDG INSPECTOR PP,IOR TO FINAL APPROVAL �*+�x�*x�*+t�r�r***+t*****+�*+r**x�r*�r*****�***+��***�*+ru+�*�*k***�:�****+�**x�c��c+o-*****�*�*** Z O N I N GS ERTEH�AUCIKRSE t�( E N T 5 � ------------ MAIN BUILPING ---------- ---------'rACCESSORY 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: 13906701 ZNE: REF NO: PLANNING NOTES> ^-" � �(ij �' - *ir�-**x�*****�c�r�r***�*�r�r*�r*+rit****i�**�rx�**�r�r*+�**+�*+t�+�***u�**r**i�+�***±�*****�•*�*+�**�r+�+�* D E C� 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 %:i � 4 20NING APPROVED BY ,, DATE: +.% BUILDING APPRQVED B�Y ; DATE; �� APPLZCATION ISSUED,BY; � DATE: �c� � � itjtit�xftititiri�r�t*xir�r�tif*.i�*atiF�iFiF3F�tiFiFiF7FiFiE'xx�*iriF'��F'iF�r�F3F'�F�iF'iFiF�t�k**x�i�***** �F'� ,�,�F�. �� if iF it tf k iE fE k it iE if iE 7E 1E if !f if iE if if if 1E iE iF iE fE iE 1E!! k if iE iE iE if if iE if it %iE 1E iE iE iFlt if iE iE iE iE iE it 1f iE i(� 1E K iE iE if iF if if #� 9E �f iF iE if +� �E iE �E iE iE �)F �lE �1E LEGALIZATION;N F E E S U M M A R Y STRUCTURAL �EGMENT;Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RESt� GRADING PERMIT 15.00 • . gp . SMIP/NON� RES PLAN � < ISSUE FEE ' f BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL� PAIL��'" DUE TOTALS----> 15.50 0,00 0.00 15.50 15.50 �� ,00 REVENUE DS�'ISION TOTALS--> COLLECTED: 15,50 OVER/SHORT: ��, 00 HLDG PMT PLUMBTNG ELECTRIC MECHANIC FZRE SMIP/1'OT GRAL�ING;�PLAN—CHECK 15.00 .50 ` � { � jEififlE�EitifaEiEifitjEiEiEiEifiEiEifitiEiEifiE1ElEifiEiEifiEjEititiEiEifififilaEiEiElfiEiFififiEiE#iFififiEiEiElEkiElfiEMififMiFiE3�EiFiEifififiEiEi�j4iF I N D I V I D U A L F E E B R E A K D O W N � � TYPE QTY D'E S C R I P T I O N UNIT COST TOTAL COST SFR 50U ALTER BY VALUE RESIUENTIAL NOZONE .1.00 �f� �500 00 ID END OF FEES 1 �'� �pjj1 � �T ' PI OCT a,993 ' (�1T,Y �;�Sl;",,P�"ESA� . ij � I� f -� � � .. � CO?1STRUCTION AND Pl.ANNING � . . POUL & SPA � ' �-�� APjPROVALS Permit# Oate - i�spector APpR�VAIS Permit# Date inspecror' t. Temporzry_ Electriwl Servfce or Po�e � 52. Pooi & Equipment location � ! - , 2. Soil Pipe-Undrgmd. � r ' 53. SCeei Reintorcement i 4 ; 3.. Electrical Conduit:Utility-Undrgrnd. . - . 54. Forms � ' a, . o. G " �'� � k l.�J ; 4. lectrical Conduit-Undrgmd. _ �`/. 55. Electrical Bondir.g . � 5._$teel Reinforcement � _ 56. Rough Plumhing & Pressure Tzst .6.��.Electrical UFER Gmd.. 57. APPROVAL TO COVER-GUhUTE 7' Footings � -, . 58. Electrical Conduit-Undrgrnd. ' SS, Foundation .� =• j 59. Gas Pipe, i� Undrgrnd., Test �� , - 9. Ntater Pi�e�Und�grnd. - 60. Back4vash Lines, P-Trap, Cl Undryrnd. �� r 70. Structura� Floor Svstem = � 61. APPROVAL TO DECK �j' t 11. Property Sewer �ine & House Connection -�✓ '. 62. Backwash & Rcceptor�Pinal %� r, 72. Seiver Cap � � t 63. Heater & Vent�Finai � , � �- 73. Roof Dra�ns , - -� . �" �� ' � ,. , y,,..__ � 64. Plumbing System - Pinai ' � �� ' i4. Rough Piumbing "' , - 65. EiecVical�Flna1 , - '� . � ,•� 15. Rouyh Electricai-Conduit , � 66. Solar SYstem:Finat 'f �� , '2 /�, � � 16. Rough E�ectric Wiring�' _ 67. Fencing & Access Approvai � ' ' � 77. Rough 4V�rinq Sig� = - ` 68. APPROVEO FOft P�ASTERING ' � ;; 78. Rough Electrical-T Bar Ceiling _ . � 69. POQLISPA 5YSTEPAS FINAL � �� 19. Rough-Heat�ng & Air Conditioning " -- ' ' � �PIRE DEP7. REQUIREMENT "' ' v 20.�.Rough Factory Fireplace �� - � �� -' �APPROVALS� - Permit # � , , 21.; Ducts, in Structure ; _ �- � � � �70. Underyround-HYdro . j 22. Ducts, Ventilating - � . . 71. Product-Piping � Gas D Oil 23. .Gas Pipe;Rough & Tzs. , �� 72. Undergrour.d Flush' � 24.._Roof Framing� -�:r . -, -•�- � , "73.�Under md..5tora e"�Tank ,G'Gas GOii 9 9� . 25. Roof Sheathinc �' � 74. Overhead Hydro ��. _� 26. -T�Bar Ce�ling (Structural} & Monocoa: _ • 75. Dry Chemical � � 27. Fram2 and F!ashing _� lD.,,Z,p�'7l �'L��yL 76' Dry Standpipe 28. Lathing & Siding " � , .�;-r . -. � • 77. � FIXED SYSTEA9� FINAL �29. Insuiation ' - ' ' ' ;, - ` � 78..�FIRE PREV. FINAI - 30. D�ytsali Nailing ' � HEA�TH DEPT. REQUIREMENT '-.37. Piaster Brown Cwt � � i _79. �FINAL WSPECTION � � ' (32.-Electrical Power Meter-Final , ' , 80. �FOOD CER7IFICATE ISSUED 33. Finel Eiec,ric. � �/�y � Notes: .. , 34. Final'He2ting'& Air Cond�tioning_. . � / � - � � -, � `/- 35. � Final Gas PiDe�Test ' '-� ' • 1 t� � � � - , � , . 36. Nood or Canopy � , - ' � , , � � . . � "�37. �Final Factory Fireplace - � ' � ; � � .38. Final Plumbing �. � � � . , � '_ � 39. Vdater Service-Final � � � � • - 40. Gas Service-Finai ' . _ � . •41. Solar pomesticFinal � •• � , 42. Backflow Preventer , , ; - - , . . 43. Backflow trrigation • . � , ,� "" : � -� 44�. Landscape irr;gation System , � „ � � . - '45� Sound Attenuation � � , - � � `�^�.'- 46. Handicap,Regulations � � - � �-%,r ` i � ' 47� ,FINAL 5TRUCTURE & BUILDING GC`/n.��' �'G(/4L.., S �"""v �'�GCi �' [�"'-;� �� j N' 48..FtNAL PIANSVING , � ; � � ` " � • � 4/ � , .49i �Electric Release to�'Edison �� , - ' - . i .�y ,50; Gas Release to Southern California Gas Co . '�_ _ , - - . � � 51. CERTIF�CATE OF OCCUPANCY i� J . No. Date V ' � _ � �"-� ' , , - � Appl¢ant to till�in all spatts ezcept those withidheavY bortler,linez antl sign all�apD/opnate tlecla�abons..Y __ _ �ri _� , � ,l _ � ' # - � � CITY OFcoSTa�MEsa i CONSTR CTION�PERMI�T i"' j PERM NO �� ; •TRACT NO. : LOT NOS � UNIT NO: ' � ' ~ � -' x� � � S t � r.- ; � �.. f 1 ' � . 1 ' � `2�� %�� /E�� F1i � . � ' .Project Atldress 1 � , � , � 4, � � � � Applicant's Mailin � ddress � 1 , � . ' i TYPE OF CONSTRUCTION � � NEW' ADD : ALTERATION REVAI R - • , � � � _ . � OTHER � �Owner'S Name �%L� / ' �� ' � 1 , � CONVERSION ❑'DEMOLISH � � q,p.#� � -._ � . , , : . � Zone'. ^ 7 Phone � " �- _ e_ _� i- _ 1— � t } �+ �. . � �� ':DESCRIPTIONOFWORK/USEOFBLOG. -� -t�'- � ' � ' � � Address ' - � � � � ' � ; q� � , ; • , � t . .. . I � � �' S Main Bwlding. , - � j � Accessory Bwlding ", � j• ,{' � , n�, - . . . . . E . - � � Z � Arch/Eng� ' � � ` - License No _-oT�7/�� TVPE OF PERMIT � GRADING FOVNDATION O STRUCTURAL _� .! �T Front, � • � � ' ' s ' � p . �� r N � � Address • ' { � � 7' !" ��I � � i.� TENANT ❑ EiECTRICAL'1GPLVMBING �' MECHANICAI. ..' B Rea�' � ' � ' � • ' � � t � Contracto� s Name Pho e ' � � oTHEa , � - . ' . �� Right � � - - � - - — �r "`j . ' "*"' ' �N� ;� - ' - - PROJECT>:DESCRIPTION � SQ. FT. � � OCCUPANCV K - , � ; ;�� ' G . - F, Address (mailing) �. ';� ,� . . .. i _ . , . . { � O • , �p .CONSTRVCTIONTVPE - - � VALUATION,S � S L¢ft . 1� ; , , j i .R Gry License No. I' ''�� , i -> . 7- �. -. . . , , � 'ZpNE � GRADING�CU: VDS. � ACRES p�n �Raf. # ' � ' Parkiri Re � LICENSEO CONTRACTOR DECLARATION � � + ' - - ' � � � 9� � g q./Provided { � � Q i '� I hereby affirm that'I am licensetl untler.provisions of Charter 9(commencing '' Remarks�- q'��' �� - � '' Planning Notes: ' ' ; f � '� ry� witMsection �OOO��of Division 3 oT the Businezs antl�Professions Cotle; antl � �� "i � '- + � • � ' i • � � ' ' � my Imense s in fi)� f -antl effect. � � � 1 ! f': t 4 � .. - - ' - ' ` ' �T Licen C s�' /�� i V � -� . i .t- i ;'7� � -�!_, � � � .i � �� - S Jj� �j(�/: IiC se � n � . C, ' ^ ' oate��Bj��^� Si9nature 1 f� i . „ci �. o ' � : �PLUMBING � • j _FEESr .. . ' ` � ', t..� ..1 - - � ��_ ' � , ^� /ORKERS' COMPENSATION DE LARHTION i ' � - ' � � + Bar Sink i - Showers � ' -.[ '� ' 'f + i.: ELECTRICAL - � � i � FEES � , , i he�eby affirm tbat I have a certificate of consent to�5¢It-insu�e o�,a terLfiCate � .- � �� %� '�• i i f �, of�Workers' Compensation Insu�ance, or.a:certitietl co y�thereof.(Section ILL ' • � � � � � ��l. . - - . � � � _ ' � 3B0o Lati. c.]n� � ' • i Backflow Preventen , � ' � Service Sink - . Automauc Washer � . � } > ' � Transformer`� 15 50 KW ' ? -- Policy N �. '/U � Q� R � � Company ' Backflow Irrigafion� 'S � _ • Sewer Ca � ., ' . . - ' ' - � � ' � ' '0 W + KW; ' . �erLLetl copy is�hereby fumishetl. F � P -C . Construction Pole Sub + er ifi- y' � 'letl`with the city ' �g i i ior(!)� ; �, p,.�' ^/� ' : Bathtubs ( Sewer Connection � � � - � � � : Cooking Unit- � � ` i � Meter ❑up:to 100 amps ` , �Date- � r ' APPlicant �� L�d/-�-�'`�'�'-= ' ' i � .. , ,-. ' ,� -- � j . . � .EXEMPT.ION FROM WORKERS' COMPENSATION DECLARATION � Cianfiers ' y Solar�Collecrois 1� � Dishwasher � �� Meter ❑over 100 amps , . j � (Thissection neetl not be'completetl if the permit is for one.huntlretl ($100) or , I � . - • - - 'Y"' A �� , - .Sub Panel � : _ � less)!. � � � . ' �� l . , . � r • ; . Dishv`idsher', _ ' - SolarPiping � Dr ers'OGas ��OElectnc ' �� I certify that in the; petformance of the work for whicb this perm�t is iSSuetl, I. I � ' ' - �- shall�not employ any person'in any manner so as to become subject m the ' Drinking'Fouritains t i� Solar Tank �� - � Fan � ' � � Momirs.00-1 HP O1'/:-8 ` � S Worke�s' Compensation Laws of CalitOmia. � ' • - � _ . i � - .. ; 'l Datej ' � ' Si9nature � � � � � " ' J. Floor�Drains � � � Sw�mming Pool w/Spa • ' G� � � F.A'.U.�' , ' - Inc'Solar �9=15 HP'�16-15+� ' _ .NOTICE: If„after making Ihis tleclaration,youu Shoultl.become,su0ject to the, . _. ' — ' ' ' � - Workers' Gompensation provisions ot the Labor Cotle, you must Porthwith�'• '' FIOO�SinkS � 1 ` ; U�in21 ' � Fixtut¢5 ' ' comply with zuch� provisions on this pe�mit shall be tleemetl revoketl. � Microwave� � _ � � CONSTRUCTION LENDING AGENCV � � ' � '"� G25'Servic¢ f� Outl¢t5 � Wat2� GO5¢L ; � � � i � D¢viC¢ BOx85 � r I hereby affirm that�[here:i5 a const�uctlon lentling a9ency foi the p¢rformance � �. POIC.Light� r� :,' � � � ot Ihe work • (or wM1ich this permit is issuetl (Section 3097 Civ. CJ ' " ' - � ' ' ' � . � - - - Interce tors � Water Heater } i Outlets � � Range �' � � �entler's Name �� '� � P ! � � ' ', � . Lenaer:s;Aaaress._ . ' ' � �' _; ...F� Kitchen Sink.l. �_•. '_"ri.�r.:._ :�Wat4ecService '._ "' ' � ",,_.. ' _ Switches.� .__" _ " }" . ' _ ' 'g'9n .- � . .i __.; _.. '� OWNER BUIL�ER �ECLARATION - ' � ' ' �� ' I hereby affirm that I am exempt:from the Cont�acto�'s Llcense Law fov [he � _ Lavatories ( ' . AutO�W25h � Ga�hag¢ Di5pos21 � � Standing $eCtiOnS ' • ( followin9.reason (Secilon 703L5 Business antl Pwlessianal Cotlei Any ci(y,or ' ' � � • � county which re uires a ermit to construct; alter, im rove, tlemolizh or re air ; � , � ' y� y � � Generator DO-5 KW��S-]5 KW Trash Com actor � any st�ucture„pQor. to its issuanc¢; also require5 the applicant for such permit P-T�ap 1 , L3und� �T�3 5 P ' , " r o fiie a signetl ztatement thai he/she is licensetl pursuant [o the�provisions of- � � i . � ' � ' � , / �! Roof Drains ( ' � - • � � - - he Contractor.'s Cicense Law:(Chapter 9(commencing witM1 Section ]000) of - '? � 1 � • . � i Division-3-of.lthe$usine55antl�Profes5ion5;Cotle�-o�-tM1al.be/she•is.exempt= -y � _ _ _..� . __ _ , ' , 'i the�e(rorti dntl the basis�for the allegetl exemption..Any violation ot Section , ! , » t�� • _ � � ' ' � � ': � � � 7031.5 by any applicant for a.permit subjects the applicant to' a civil � � I � - ' enalty of not more [han five'M1untlretl tlollars (E500). ; : t . � e - - ' � ' - ' ' - t ' � I, as awnei ot the^ property or my emoloyees with wages'as their sole • Reinspec[ioni Fee� $15 : ' . ; laue Fee � . $� 3 , s ' ' ' �� _ � ' ' � - � � .. � - compensation, will'tlo�the work, antl the structure is not mtentled ocofferetl �' � Reinspection Fee $15 � Issue Fee ' �-- $ 3 ' tor sale (Section. �044,. Business'antl Professionab Cotle::The.Contractor's �; � + MECHANICAL' � � �'FEES� �� . LicenSe LaW tloes not apply to an owne� of a property who builtls or imp�ove5 � � • - .�� thereon, antl wno tloes such work nimselt/herself or-mrough his or her own • � -�• • �� • i DEVELOPMENT-SERVICES REQUIREMENTS:' ' ,,, , �� employees, provitletl that such improvements are not intentled or otferetl for � Boiler , j .Hood or Type I'❑ ' . - � , � ; '! - .. � • _ � z sale.� It,.nowever, tne builtlin9 or improvement is soltl within one',year of com- � . , � �Canopy { Type I I ❑' , �~� Zaning Approved By� �_ � Date pletlon,'Ihe'owner will have the burtlen of proving he/5M1e tlitl not builtl or im- Duct - UndCr Ground� ' ,. - � � ,� ' '� ' -` ` � � ' : prove for tne Purpose of sale). ' , � . � � � ' - � • '� • ' " - - Building Approved By � ' Date� J . . �.. . • ��=I�, as owner. oi the property, am exclusively contracting;with licensetl con- � Duct -StrucNral „ Refrigeration System ' � , Applic5tion Issued By ' Datp �/^��Q'7 � iractors�to construct the project_(Section ]044, Busine55 antl Profes5ion5 Cotle: '' -' � ' - } 'The Convactor's.License Law tloes:noYapply�ta an owner of property who ,' Dutt- Ven[ilating ❑0-t00,000BTU� 0100,OOOBTU r ( ' ' ^ � . ' ' : SUMMARV OFFEES � j "y �� , .`' . builtls,onimProves'thereon, antl who Contract5 fo� suchprojecls with a con- - � ' � - ' ' , ' ' -- • ' , tractor(s1' iicense pursuant.to`.the Contractor's License Law). I;ain aware•thaY . ' ' ' - - � � - ' BUILDING PERMIT' $. � SMIP � $ - - � Exhaust Syscem ❑ Multiple ❑ System Repair/Alterenon � � � i f proof of their Worker's Compensatian �insuFance Shoultl be proviAetl [o me. � . _ � : ` ` � i . - .. . - . _ ' PLAN,CHECK ' $ —�.� -�� PERMIT. ' ' .,. � ❑. I am exempt untler Section ' , B! &'P: C."�for this reason� F.irepVFacL 81t. ICBO �k ' Fire Dampers ' ' : ' i , _ . . -. � � • . . � - . . 1 , P�UMBING f . $, � . ISSUANCE �. :$._ � _ �' VV •' `�Oate ' � " � ' Owne`r ' ' Heacing System'& Ducting :.� _ , Regisiers � � - � ' ? ' . , p�,qN CHECK � •25% 3' _ � ENERGV P� C.- •$. � I heretiy certi�y �ttiaf I have reatl ttiis�applicatioB antl state that�the above , �0-100,0006TU 0100,OOOBT � ! �, y, � ECECTRICAL . ''$' -GRADING _' �$ - � i' information is correct.,l agree to comply wiih all�city antl county Ortlinances - ' �_ � 1 . . � -!- ' r z� antl state laws relating to builaing construction, and hereby authorize repre-� , - , � � _ ._ �� - . �,7 � � -�PCAN CHECK � 50% $, . � MICROFILM. �$ � O ' sentatives o/ this c'ty to- en�, .,upon the above-mentionetl- property. tor, , �= �j r ' . j • .. � Y � ' � ' . �yjECHANICAL '� �� $ � � - � . TOTAL FEE �$ � . inspection r o ' • � ' Si natare � � ^Dale� . - ^ � � � � , �-D'r9ivers`License or 55 �� Reinspection Fee! � ,$15 •; � �., , Issue'Fee � • $ 3 � � � P�AN CHECK �25/0' �$' ' ' � � � � ' ' ' � � ' CMF 0865-46, rev. 10/E4 Pink - Accounting; Goltlenrotl - Assessor � � � �� -.�. ..-... .. ....T..- -. . ..� ""_ _: t�_.. �.�Y . . . . . . ... .. . .�.�.. ..a...�.�.i . .v. .�. _.0 ..� _ 4- . � . 9 � ' i . . . 1 .. �. . . .._.. .� ... ..v . . �CONSTRUCTION.ANDfPLANNING .�. � ,� ' ' � �. POOL&SPA.. , ...�•�,r� � � : �� ±, l � ' . . ....1. .. ._ ..�..r. _ •. . a . . . � � Date ! Inspector � � � �� ' � Date ��! Ins ector �; APPROVACS ' Permit;ik ' , i � � APPROVALS Permit # - �� p � � i , 7. �Temporary Electrical�,Service or',Pole � _ � � - �. . 52. Pool &,Equipment Locatibni � � , - 2. Soil Pipe�Undrgrnd.�4�, �- �`� � � � 'y � 53. Steel Reinforcement ' ,� � ' � � ., � , ' �� 3. Electrical Conduit Utility'Undrgrnd. � � , i 54.: Forms � _ ' ' ; ',A: ' ' . 4.-Electiical Conduit-Undrgmd. , , �� . F � � � �55.��Electrical'Bonding �� c `•" � � E1. 5.r Steel�Reinforcement�i � � � � 't " � � .56. Rough Plumbing & Pressure Test- � i � � - � � ' ', 6.�Electrical UFER Gmd.,� � ,� i�'- ��. ,�. � , i: 57. APP-ROVALTO.COV�ER�G,UNI�T_Ei- � �7. Footings �'• ' �,'� � -+ °' � � �� 58� �Electrical Conduit-Undrgind:�� ; , � __ t t. , . . , - . _ . . ` ;" - - ' ' - � 8. Foundation ' �' ; ' ' � �� - -59."Gas�Pipe,'0 Undrgrnd., TeSY'� � ' i , ,.• - � r ' . ., . •. . � _ � 9: Water Pipe�Undrgmd. �. «,,...� .. ..:.,., ..,. :..�... �. 60.-Backwash Lines, P Trap, ��Undrgrnd. � � � 10 �.Structural Floor System� � � ��_ , � r ., � ' �� ' 61.� APPROVAL TO DECK � ti:i , � , � '11. Property Sewer Line,& House Connection � � ' ' � ' � � , , � � r� i � 62.. Backwasli & Receptor-Final � 12.; Sewer Cap ' . � ! ' ' ' � 63. Heater &� Vent-Final ' , � • �� .13. Roof�Drairis� + ' �< "� � ' � � � � � � f� . . "+. 64. Plumbing�System.- Final . , , 14.'Rough Plumbing �5� - x �' � ' � . . i� 65. Elect�ical-Finil ' � �. • � , . � � 1 15.� Rough �Electrical-Conduit :' - � � , ` ' � } '66. Solar System-Final � '� ' • `' � ��; , � ') - '� 16. Rough Electric Wiring� - "- "�"'' , ' �""'- 'i' ' "�' ' 67.� Fencing & Access Approval � � �,�� t � � ;'17: RougF Wiring Sign" ",` ' • '." �' , �' �i ' � �� ' 68. 71PPROVED F,OR PLASTERING ^ • �18.' Rou'gh Electrical-T Ber Ceiling�'� 3 �� - ' �: ; -� r , �69. POOL/SPA'SY,STEMS FINAL ' ; - � 19J Rough�Heating & Air Conditioning " � ' i : .� � FIRE�DEPT. REQUIREMENT , , � � : .. , .. =. ` 20.�'Rough'Factory Fireplace + � �. � . � � APPROVALS i Permit # ' � ' � �� '> j � � A 21. Duc[s,iin Structure` • ; , � ; ' . •` � . ' � � 70. Underg�ound Hydro �: � . .. �� . ' � 22. Ducts,•Ventilating', , -. a � � . � ' � i ' � 7j, Product�Piping OGas OOiI � � ' � 23.', Gas�Pipe-Rough & Test,' �• - �" �� =r � i . � � - , 72. Underground Flush , , , , ti � i 24.' Roof Framing ' ' � . � � ` ; � � � ' 73.. Undeigmd!Storage Tank��O Gas�' � Oil, , . � - ' • 25 � Roof Sheathing . � ' , r _ � r ' � 74. -Overhead Hydio • � �� ! � �• � ' � . '" � " 26.` T-Bar Cei,ling �(Structural) & Monocoat �, , � . � � � �=. i 75.`�Dry Chemical ' , �'�� :_r � � � _ 27.4Frame'a'nd Flashing;- �. -- �`��;`' i ; ��-' 76. Dr�yStan�dpipe'Tr -'� �': y i ` = � • a � 28.. Lathing&Siding �. , ', f �,- "' ' + �' � ' ; 77,. �FIXED,SYSTEM FINAL � c,' . ' , � 29.�� Insulation , , t' . ^ �� ; . ' • � 78. FIRE PREV. FINAL � - ' ' . ' r � 30.: Drywall�Nailing ; � � - { �' ` �, , _i H'EA_LTH DEPT. REQUIREMENT � � ; ."' � u � , � ' � ` 79.'FINAL�INSPECTION • � . 31 .' Plaster Brown Coat ' • � . , � � � 32.: Electrical Power �Meter-Final ;� �r 4 ; - I � . 80.<FOOD CERTIFICATE ISSUED�.. , ;�. � . �''� �' _ 5 ... � 33. Final Electric � � � � � � � . � j Notes`8,•$/ $7. "L(,RP"' �iCp�. Z„��'. � � � � - � 7� 34.� Final Heating & Air,Conditioning�; '' . 'r,'� � � � � - � _ ,,�Q••Z,?•1�`r � ' ' � .. . , : ;. . . ._, . _. _.; _ _. . -_ -.,_...� _ .CAt�it,¢t_ AS � �o�3'vf� C:,�p.• ' 35. Final Gas Pipe-Test � � i � t � � ; ; � . ' � � ' � � ' . ? - .- --- . -- _ .. _. _._,. ___. __.._ .._ ... ... - - - 36:,Hood or Canopy , . ' � � � *� � ! 37. Final Factory`Fireplace ^'� ° ��; � <. f " � � � � . . i.- '� ., ' . . . i . • i:38" Fin81 Plumbing `:�. .` , ' �,� �. � - " � � - �� . , - ;'t'�. ' � . . . , 39�. Water Service-Final,, - . . " . ; - . � . . � - ,f` - � ` � - �. . . . , . „ _ . � . . _ . �40: Gas'Service-Final`" � . . ,�, . - ' - , ' , ;}41. Solarpomestic=Final�° - _ _ - � � � � �� i � - � - • � �.42. Backflow Pre'venter � ,: ,.:;': � � .. • _ � � � � ,. . i�"� �,43. Backflow Irrigatiori. �.' � . .. ��r .. � ' ' � � .. . . . , ' ' �. ��44' Lanclscape Irrigation Sys4em - , � . . �• �� . • �.� : � . , � , . .45 �Sound Attenuation . � ,. _ � . . - � � �-+�:�:'-'� . '" .''` `�' r, � F.46.,Handicap Regulations. . . . . ' �; `' 7... ' � . ; . 47t FINAL STRUCTURE & BUILDING �...� . ' � f' ' � � � ' � ' � � ' - : .'' . . _ 7 + ' • 1,. -. - _ �48.<SPecialRequi�ementsCompleted.- -'''� .. . - . .t':r' .,%, . ' ��'� . - � � ��} �� '.,'. a : 49.,Electric Release to..Edison- - , �� ' ,% , •. ' , ; � �� ; -. 50. Gas`Release.to Southern-California,GasCo � . :L; � . ' ' � -,, j. � " . . ' 51�."CERTIFICATE�OF"OCCUPANCY,`- • - , � w,. ` . ', ,' , � . � � -` • - ��' No. " - � � Date. . , .. � _ . _ - .. . . , - . �. . r .. ` . • '. -- � - - - � - - ' -��• � ' ' . . , � ' t. , ' . . � _ .. . ' � � � • ' . . . � . "iot �a Tr 3�22 E RECEIV ED � ' - �> ., �� A ^iq . . . . FC - " .' F_;:a,�il'0 . . 1 L- '7�6Q- - COSTA MESA BUILDING-SAFETY DEPARTMENT ' �� ' P.'O. BOX 317 �a�.A M��. ��.�FORN�� . F�NANCE DEPT: � ., For A litan+ fo Fill In Com lefel CITY-,OF .COSTA �9ESA - PP P Y APPLICATION FOR PERMIT � TYPE OR PRINT -` - , BUILDING Aoo E's"s 3280 Dakota Avenue ' � COSTA MESA. CALIFORNIA � FOr Of}IC@ Use Only :_ ` � ' � RECEIPT NO. I ERMIT�NO. OWNER K�& E Develo ment Co � Inc � ;. - MAIL � - ' - RECEIV D BY ` DATE RECEIVED/� DATE 195UED ' AODRESS' " �P centia ave - ` '` I �-. / O- D d ;�. ,� ,oe„ cirr Ne ort aeach No Mi 6- 7 BUILDING , V ADDRESS wecHt7Ecr ' .7E�. COSTA MESA. CALIFORNIA � OR ENGINEER� NO. ' ADDRE55 � FIRE' 1�-' ZONE �.TYFE � � GROUP CONTRACTOR� � K.W. BA� APPROVED � � . BV DATE ZOIdING v ADDRESS ]_ P � � ' ' - ZONE - � NO. OF -' U6E OF NEW cin Neu�ort E R-1 I PU`N8 2� � I Bl11LDING W att Oal . 0 LIC.TNO. O�j N�. � �� DEBCRIPT�ON ' O+ G TSC L G2 SIZE 1 NO. OF BLD69.o . " - _ � OF LOT 67 � 17X1�� irre rvoW ON LOT p, p, ryp. . O USE OF � YARDS EVES . EXI8TING BLDG. N APPROVEO ALLOWEO 88TBACK IJNB PROM . ' IGENTER LINC 6T4 � ceHieR oP erneeT SO � REAR YARD ZO � FRONT FT. IN. , SIDE YARD ILEFT � IRIGHT � ft.SIDE ' FT. � IN. • DESCRIPTION OF WORK - �. S,oE Z� FTI � IN. NEW I IIALTERAiIONI IIADOITION � I REAR� �� FT. IN. • REPAIR I II MOV�NG I II OEMOLISH I AP�'�?OVED � BY ' W. L. D. DATE lO-lO-6O BUILDING � � y�s NO. OF . - � . SIZE " ROOMS .SiORIES � " � - OVERINGwAL� CCp I COVERING'�d Sha'ke$ ' " ' '-.4 � ' � USE OF BUILDING AND W�RK TO BE PERFORMED � ' ' - a �' li' _ . . . and Attached Gara e Plan"6-A � • . 1 HEREBY ACKNOWLEDGE THAT 1 MAV6 READ TH19 APPLIWTION '��{g AMOUNT BHOWN IINDER VAIUATION 16 FOH THE AND BTAT¢ THAT.-THE ABOVE I8 CORRELT AND �AGFEE TO COM- pUfiP086 OF . ESTqBLIBHING A PERM�T FEE ONLY. PLY WI'!H ALL CITY OROINANCEB AND eTAT IAW6 REGULATIN6 � emLDINo coNeTR �o ' � VALUATION - ��— BIGNATURE OF � PERMIT FEE $ PERMI7TE •/ �� 'j� �%.3 j �J �J q $ � f � PLAN CHECK S //J '•'/ AUTHORIZED AGENT �_ �� 0 _ TOTAL FEE LL