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Home My WebLink About923 DARRELL ST - Building PermitsCITY OF COSTA MESA OSjpMFS,p BUILDING DIVISION , � F�g 77 FAIR DRNE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • vnvw.ci.costa-mesa.ca.us � r ° � FOR INSPECTIONS CALL: (714) 754-5626 , ``°`�°�^R°fi PERMIT NUMBER: BC10-00549 PERMIT TYPE: B COMBO STATUS: ISSUED ''"' � Sub Type: RES_ALT DATE ISSUED: 12/08120'10 _. . • ISSUED BY: ' KJB .losaooRESS: S23 DARRELL_____ST�CM'� ,, Suite/Unit: APN: a2235309 Zoning k . Vicinity: ' ' �: � � Fnmary Occ .�, Const Type: V-B - SQ: FT .�0 �Valuation � �$1�,000.00 " � � "� -- SCOPE OF WORK: HOUSING REHAB PROJECT PATCH, PAINT REPAIR MISC'.DRYWALC li EMS-.�REPLACE WATER HEATER. ADD 4 SMOKE DETECTORS. REMOVE SINK`AND STOVE IN GARAGE AND CAP GAS°LWE AND WATER LINE. ;�,: - OWNER: ANTONELLI, MAURO�AND EUGENIE Address: 923 DARRELL ST �;� Unit: Phone: CirylState/Zip: COSTA MESA, CA _ - v �- • � . I - . . �.Ib. APPLICANT: DEATON, BOBBY. "' : Address •'12512 CITRUSWOOD AV, �, - - c Unit: : Phone: 7'14-7973990 . . .'�City/Slate/zZipi� �GARDEN�GROVE;CA �,'� �� i �` 1 Y e.. � ' . . �. ,. , CONTRACTOR: ' O C C��.CONSTRUCTION License No �835628 � Phone: 714 797-3990 , �'�� . .., T. .-:Address:.=12512,CITRUSWOOD AVUniL �� ,_ , .� -.. ' . - ' Cell: �� t � �City/State:,-.GARDENGROVE,`CA �.7ipCo�de� 92840 � - -:-_,- _ _ _.. ,R � � �. , - � ARCHITECT: ;-��, ,,,, 4'' � '' LicenseNo. -,,�• • y,.. :'<�HON, '� , . _ .,. - . . . _ ENGINEER: . . _ _. License"No.. �� . _ _ - � -PHONE:.� �- � . . .. .. - � _-. .: . . � - , ., . . ... ,,:� .:: ..... . _ - _ - _ ,.- __ - COMBINATION PERMIT'FEE SUMMARY . : � ' � BuildingPlanCheck: "^ *. '. z .;' $0.00 �.�'.-� ... � '� . .. -'3 �.-.' Building Fees: �°' $3875 �� - � Electrical Fees: �; � $42.50 . _ � � - Mechanical Fees: - $0.00`;:, Plumbing Fees: '� $39.45 .: , �:b z r ,. SMIPResidenlial: - -$0:50�_;" . .- . - ...:. �,�<,., ' �. ; �� ' ...... - �. SMIP Commercial: $0:00:' Bldg Std Admin Fund -�"'�� $1.00 -., " "" - ' TOTAL FEES: o '�-,.5722.20--" � - .. - •'Refer to fee recei ts for all fees paid lor ro�ect � � '' - .-l� �: " HOURS FOR CONSTRUCTION ACTIVIT,Y: EFFECTIVE 3/18I2010 �- PER CMMC Sec 13-279 Monday thru Fr�day -7:00 am thru 7:0o pm. Saturdays-9:00 am thru 8:00 pm. Prohibitetl all hours - Sundays �ntl the following Federal h0lidays: 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be wnsidered legal, such work must comply with all applicable codes, and all required inspections and final approvai must be oblained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE N. INSPECPONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof ;201 Final Block/Retaining Wall 202 Final Factory Fire Place 0 203 \inalSign 204 � Final Demolition ORTE INTITIALS CODE 1 INSPELiION TYPE 206 Final Mechanical 20B Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Finai Planning Approval 222 Fina15ite 250 Final Building/Occupancy Or1TE INTITIpLS x i2-��urnPa�u- WORKERS' COMPENSATION DECLARATION: 1 hereby aKrm under penalty of perjury one of Ihe following declarations: �� ❑ I have and will maintain a certifcate of consent to self-Insure for vrorkers' pensati , as provided for by section 3700 of �he Labor Code, for the e rma e of the vrork for which this permit is issuetl.' ave and will maintain workers' compensation insurance, as required �by, ' n 3700 of the Labor Code, for the performance of the vrork (or which this pertnit is issued. My workers' compensation Insurance carrier and policy numberare: � carrier: S��i4-TS �-/.iiVb (ThisSedronneetlnol6e mpletetlbroepermdisvalueea(onebvntlretldollars(5100)orless.) Policy Number000 ��9 �— 1� 0� 0 ❑ I certi(y tha[ in the performance o( 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 lo the workers' compensa[ion provisions of S ction 3 00 0( Ihe Labor C , I shall fort rvl'f comply with these provi�s�i/yrts. (� � G./�—(� " �rtp tbnls , naure D e�'" WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affrm 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 eR ct . - LC �� .r c��' � nGSclo s Sionawre e�� CONSTRUCTION LENDING AGENCY: ,❑ I hereby affirm [hat [here is a cons[ruction lending agency for the pedortnance of the Hork fa vfiich this permit is issued. (Sec. 3097, Civit Code). Lender's Name: Lentler's Address: Date OWNER-BUILDER DECLARATIONS: I hereby affrm that under penally oi perjury thal I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW (of lhe f0110winy reason (SEG. 7031.5, Bu5ine55 and Professions Code: Any ciry or county which requires a permit to constmct, alter, improve, demolish, or repair any stmcture, prior to its issuance, also requires the applicant 1or such permit to fle a signed statement [hat he or she i5 licensed pursuant to the provisions of the Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Pro(essions Code) or that he or she is exempt Iheretrom and [he basis for Ihe alleged exemplion. Any violation of Section 7031.5 by any applican[ (or a permi[ subjects the applicant to a civil penally of nol more than five hundred dollars ($500).): ❑ I, as owner of [he property, or my employees with wages as their sole compensation, WILL DO 7HE WORK, and the structure is not intended or offered for sale (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 doessuch work himselt or herself or through his or her ovm employees, provided that such improvements are not intentled or oRered for sale. If, howevei, the building or improvement is sold within one year of complelion, Ihe owner-builder will have the burden of.proving that he or she did not build or improve for purpose of sale.�. . ❑ I, as owner of the.property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRAC70RS to construct the project (Sec. 7044, Business and Pro�essions Code: The contractas License Law tices 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.). ❑ I am exempt under sec. Business antl Professions Code for this reason: 305]-46 (3I01 � - Owner ID verified by driver's license. � 0 Yes ❑ No ,�. Driver's License No. Expires: � Yeri(ica�ion o( Ownership by (type of document, i.e. - property (ax biil or tleetl): . . ,. . . . ". ' . .. . . 't. ��DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: -• � ❑ I hereby ceM1ify Ihat no excavation frve (5) or more feet in tlepth into which a person is required to descend, vrill be made in connection with vrork authorized by lhis pertnit, and that no building sWcture, sca((olding, talsework, or demolition or dismaniling Ihereof, will be more than thirty-Six (36) fee[ high. (Chap. 32, Grp 2, M 2, Sec. 341, Ttle 8, Califomia Administrative Cotle). ❑ As owner-builder, I will not employ anyone to tlo work which would require a permit (rom Ihe Division of Industrial Safety, as noted above, unless such person has a permi[ to do such work (rom the division. Apo�'i<anfs SignaNre Division of Induslrial Safety Permit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: t. Will Ihe applicant or present or (uture building occupant need to file and ceAify a Business Plan for emergency response to release or lhrealened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, tha[ a Business Plan be fled 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 �han a weight o( 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard tempereture and pressure). 2. Does or will the applicant or present or tuture building occupant need ro file a regisUation form for acutely hazardous maierials? �❑ Yes ❑ No (Section 25533 of Ihe Cali(omia Health and Sa(ery Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which a[ any one time has on hand a quanti[y of acutely hazartlous materials equal �o or greater than a weight o( 500 pounds, or a volume of 55 gallons, or 200 cubic (eet of compressed gas a[ s[andard temperature and pressure). 3. Does or will the applicant or present or fuWre building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazartlous materials)? ❑ Yes ❑ No (Section 25534 0( the Cali(omia Health and Safety Cotle provides that the Costa Mesa Fire Department may require the preparation, certifcation and fling with the Fire Department of an RMPP by businesses which are requiretl to register acutely hazardous materials with the Fire Depanment. 4. I( an RMPP is presently required, has Sec[ion 25534 of the California Health and Safely Code been futly complied with? ❑ Ves ❑ No 5. Does or wiu me applicant or present or future builtling ocGupanl require (or �he work which is the subject of this application a permit for such constmction or modifcation from Ihe South Coast Air Quality Management District or from any other air polWtion conirol tlistricl or agency? ❑ Yes ❑ No (Section 658502 of �he Califomia Govemment Cotle requires thai Ihe requested infortnation be (umished on applications for nornresiden�ial building pertni[s�. 6. Will any part of the tacility to be constmctetl untler this permit be within 1000 feet from the outer boundanes of a school? ❑ Yes ❑ No Qf "yes", the tacility musl meet Ihe requirement of Sections 25534 and 42303 of the California Health and Safety Cotle). 7. If a permit from the South Coast Air Quality Management District or other air polWtion contml district or agency is required for the work which is the subjec[ 0f this application, have all o( the disclosures prescribed by California Healih and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. 'pf "yes", attach certifcale ot compliance from the appropnate air pollution coNrol officer). � � .. . CER7IFICATE OF COMPLIANCE: I certify that under penalty of�perjury the information given above is correct. I agree to comply with all state laws antl ciry ordinances regarding Hazardous Materials and Emissions. ' � - • SignaWre Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certity under penalry of perjury that I have read this application and state that Ihe information given is correct. I agree to comply vnth all state laws and city ordinances relating to building construction, and authorize representatives of the Ciry of Cos[a Mesa to enter upon the above-described property for inspection purposes. I agree no[ to occupy or allow occupancy of any building authorized by this permit until final inspection. S�i naWre ol Legal Owner s) _ O e IIr/ o�q'�pp ppptirao Daie _ � PN0.IECT ADOPESS: - OWNEfl'S NAME: y�? 3�i'�:iEI+I+ S T aooeess:+"1ATTEAU MICHELLE 423 DAR{�EZL ST COSTA MESA,CA 92527 � ANCHIENGINEEF: ADOHESS: flEG.NO.: uxrt: uxir: PEFMITTEE: ' aooeess:M.J, MA'TTEAtJ (71S)645-2$60 (�9�7�3 DApRR�ELi ST ('� �� LICENSEO CONTHACTOH'tlEClA0RT10N iiPeby allirm ��al I am licensed under'pioviswds df C a�ier 9(commencing with Sec�ion 7000� ol Oivision 3 of Ihe Business and Pwiessions Catle, antl my license is in full force antl ellect. cirv uc.: srnrE uc.: cwss: oa�e: Signature. WOBREFS' COMPENSATION DECIABATION: I hereby affirm that I have a cenificate of consent m selbinsure or a cenificate of Workers' Compensa�ion Insurance. or a ceriified copy ��ereo� (Sec�ion 3800. LaO. C�. POLICY NO.: EXP. UATE: COMPANY: I ❑ Ceriilied coDY is here6y fumishe0. ❑ Certi�ied copy is filetl with the ciry Building Division. r-� Daie'. ApplicanP. E%EMPTION FBOM WORREFS'COMPENSATION OECLABATION: (ihissection nee0 nolbe com0leletlil�he permiiisforone hunOretl�$100)orless�. I cetlity that in ihe petlormance ol Ihe work br which ��is permi� is i55ue I shall nol em0loy any person in any manner so a5 io become sublec� to �he WorkerY CompCensation Laws of Califomia. - �ate'. �"" 2 � ( � SignaNre: NO710E: If, after making �his tleclaration. you shoul0 beco uble�� o the Worker5' Compensalion pmvisions of ihe Labor Code. you mu5i brl�wiih compry with such provisions or � permit shall be deemetl revoked. CONSTHULTION IENDING AGENCY: 1 hereby aifirm �hat �here is a consimction lending agency for the perlormance oi the work for whiCh �his permii is i55ued �Set�iOn 3097. Crv. C�. LENOEH: RODflESS: OWNFfl BUILDEfl OECLAflPTION: I hereby a�lirm thal I am exempl imm Ihe Contrac�ors' S�a�e License Law �or Ihe �ollowing reason (Seclion 7031.5 Business an0 Pmlessional Code- Any ci�y of coun�y which requires a permii �o conSlmci. al�er, improve, tlemolish, or repair any slmcNre, prior �o ils issuance. also reQuires �he applican� for such pe�mii to lile a signetl s�a�emenl tha� he/she i5license0 pursuanl �o IAe provisions o� I�e Contracmrs' Siate License Law (Chapier 9(commencing wi�h Section 7000� of �ivision 3 0� Ihe Business and Pmfessions Code) or Ihai helshe is exempt Ihere�mm and Ihe basis �or Ihe alleged exemD�ion. Any viola�ion ol Sec�ion 7031.5 by any applicanl lor a Dermit su�iecls the applicant lo a civil oenalty of not more than five nunUretl tlollars ($500�. I, as owner of the property or my emDloyees with waqes as iheir sole comDensation, will tlo the wark, an0 ihe ❑ slmmure is not imen0e0 or offered lor sale (Section 7044, Busmess antl Pmiessional Code: The Contracmrs' Staieiicense Law tloes not appty to an owner of a pmpeRy who builtls or impmves thereon, and who does such work himselUhersel� or ihrough �is or her own employees, provide0 Iha� such impmvemenls are noi in�ended or o/1ere4 �or 5ale. Ii, however [he builtling or improvemen� is soltl within one year ol compleiioq �he owner will have �he burtlen o� proving he/she Oi0 no� 6ui10 or impmve for Ih¢ purpo5e oi Sale). . � I. as owner o� Ihe Dmperty. am exclusively comracting wi�h licensetl contracmrs �o conslmci lhe pwject (Sec�ion 7044, Business antl Protessions Code: The ConiraclorY State License Law does no� apply �o an owner oi Ompetly who builds or impmves thereon antl w�o coniracis br such pmlecis wilh a conlraclops�iicense pursuan�to Ihe Coniracrors' S�a�e License Law),I am aware Iha� proof oi iheir Worker's Compensation insurance shoultl be provide0 �o me. � I am exemp� under Sec�ion: B. 8 P. C. � � lor IOiS reason: Da�e'. �' Z�� Owner I do hereby cenily Ihat I am aware oi anA un0ers�and the reqwremenis ol Calilomia th and Sa�ety Catle Seclions 25505, 25593, and 2553G an� Iha� I or any �ulure buildmg occupant will/will nai (circle one) neee lo com with saitl sla�e codes and lhe requirements lor a permil for construclion or modilicaiion Imm the Air Ouah�y Managemeni DislricL Resideniial conslmction apPlica�ions are exemp� imm �hese pmvisions. , Date: ApPlicanl: I �ere�y ceriily thai I have reatl �his applicalion antl s�a�e I�al lhe above inbrmation is correct I agree lo camply wiih all ci�y an0 county ordinances antl slalelaw5relatingio building conslmclion and here�y autharizerepre5en�aiiv olihis ci�yto enler uponihe ahove�meniioned pmpeny �or mspeciian purposecs. Oale: /' 2� 7 � Signalure: Oriver's License or Social Security t6aba6 Whne—Bwltling: Green—Cotle Enbrcemem; Canary—P.OPllcanl; Pink—Revenue: Galtlenmtl—Assessor CITY OF COSTA MESA — AUILDING PEkMIT PERM NO: I.M 061477 PERMIT NO: IM 061477 PLAN CHECI{ NO; N GOVT': N SUPP; Y CONSTRUCTION TYPE; 5—N PERMIT TYPE; MEC OTH PURPOSE: OTH JOB DESCRIPTION : INSTALL 1 FACTORY FIREPLACE {ICBOJt3195) SQ FT; CLAIM VALUE; CP.LC—VALUE; GROUP OCC: ft-3 /M-1 COMNENTS: RENEW THE 'M' PORTZON OF EXPIftED PERMIT BM50007 IE if !E!k !E �1F 7F it iF if if i! ik 1F iF �E iE-IFlE �lE 1E !F it iF iF if if iF !f #�1! iF iF iE ik 1E �IE �1P �1F if �1E iF �f �F 3FiF-k� 3f iE 7f'1FiE it iF iF it )F#!k iF N- 3F iF iE-k�-k iE lh if�lE fE iE iF lE M� il� ib 1(� iE Z O N I N G, R E Q O 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 kEAR; FT ZN LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN PARKING REQ • PkUV; PARCEL: 42235309 ZhE; REF NO: PLANNING NC�T'ES> ,�I 1 ✓ 7F iF ihlE dE i(� iF �E iE af fF df 1f 3f%fE iF �%� IE 3f iF if iF �E iF 1f if 3f ik 3F-1f� 3h iE �1f jF %�iF �IE # ff 1F i(� K�-%�'lE'iF 3f� iE :F �1F 3k # iE �( *�k �lh lE 3i- iF iF 3F 3F �1( �3E iE iE ib 3(� iE?E �7E if iE iE if if if iE D E V E L O P,M E N T 5 E R V I C E�S R E Q J I R E M E N T S ZONING APPROVED BY L� DA'PE; HUILDING APPROVED BY ; ��.' DATE; •,r, APPLICATION ISSUED BY; DATE• _� , �' ik3flfiElE-IEiE�IEiE#ifif�E�1E9kN�iFlFrtiFlE�lE- it� x- a � t-lr a r. . t.. e t� iE-If�EiE3(�iFiF*iFlf�frx r lt iF�7F � fE�rtiEifif�EKiEif7fiFififafjkif3fiEiEN�iE�H�iElE7E�!(�iE�rtitiEiEiFiEffiEiEjEiE7EiEitih3(-3F3Eif4#�F31-%iEil�iFif�%�iEfEiEiFiF�(�%1EifitiElE'lF3F�iFiFiEik3f3hlFiF LEGALI7,ATION:N F E E S U M M A cc Y STRUCTURAL SEGMENT;N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 30,00 25Y SMIP/NON—RES PLAN ISSUE FEE ' HUZLDING—DIV—> PERMIT I55UE PLAN—CHECK TOTAL LAID DUE TOTALS----> 30.00 0,00 0'.00 30.00 30.00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 30.00 OVER/SHORT; .00 BLDG PMT PLUMHiNG ELECTkIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHEC_K 30:00 iF iF �IE iklF �f �lE �lE if �lf IE 1E iE iE ff �E iE %1klE fh iE 1FlE ih i(� 1E iF-% iF if� iE 3E if 1F �1E iF 3f fE iE?f N iE 3F if iE iE � il� a�t 1E 3E iE iF�)k 3f 7FiF iF %� if 3f if �75� iE dElk iE lI� jE iE �lE 3i• �!E 9h i6 if iE 3E I N D I V I ll U A L F E E B R E A K.D 0 W N •TYPE QTY D E S C R I P T I O N MEC 1 MECHANICAL RE—INSPECTION FEE END OF FEES ' UNIT COST TOTAL COST 30,00 30,00 43 �C1`3;�'1'r�0:."'.`i97.0 'T�"�5 ._. DRT:: iJo/:3�S.i Tii;'c� li�t�1 ,�-.�,.. .. . . . _ _ POOL & SPA ' . . . . . _ . CQNSTRUCTION AND'PLANNWG - � ' . ` x - - �� ' � � - � - ` � - - " � � ��APPROVAIS Permif#' � Date Inspector qppROVAIS Permit# Date inspector;, �� 1: Temporary-Electricaf Service or-Poie � - � � - " ; 52. =Pool`& Equlpmen'r Location: � �'' . i,, � i -2. SoilPipe-Undrgmd. '- � � � i"� �� 53.`Steel.-Reinforcement - . .. - ' � " '� 3. EIer.Vical Conduit U:ility�Undrgmd. - . .�, �- 54.�Forms _ � - � • � ^i - � 4, Electrical Conduit-Undrgrn`d, . � � < < ' 55. Electrical Bonding Y " ' ..L, .5.•Steei Reinforcement - -' ' � � � 56. Rou9h_Piumbing & Pressure Test N� , 6: Electrica! UPER Grnd. _: - 57..APPROVAL TO COVER-GUNITE � � 7. Footings � �� - 58. Elecirical Cooduit�Undr9md. ; 8. � Foundation , � - . 59. �Gas Pipe, i7 �U�drgrnd., Test � i � ( 9. VJater Pipe-Undrgrnd. - � ��-�. `� � 60. Backwash Lines, P-Trap, rJ�Undrgrnd. �� r . 10. Structural Floor System , '� ;� �� ' 67. APPROVAL TO �ECK -. �� %�l� ; , 77. Property Sewer Linz & House Connection - :t ; � � • 62. Backwash &'Receptor,F.inaP. ��' � t- � . ' '!�� !i-i � .� s: �- � i?. Sewer Cap � .� - 63. Heater & Vent-Final x-^ � 13. Roof Drains _. ' t � - 64: Plumbing System - Final.' % � " . �1 �,, 74. Rough Pium6ing � • - 65..Electricai-Finai _ � i,�?� � . �,�;�� 15. Rough Electrical•Conduit - - , - - � - = ` �` ��+'� � . 66: �Solar Systersi-Final , � , �ti l� ° 16. Rough Electric4Viring � 67.-Fenciny & Access�Apprqval '`'��. � � i� '� 17. Rough Wiring Sign � � 68. APP,ROVED FOR PLASTERING , `'•� 4 18. Rough Electrica6T Bar Cziling . 69. POOLISPA'SYSTEMS�FINAC � � 79. �Rough Heating & Air Conditioni�y ' - - ' - ' FIRE DEPT. REQUIREMENT � . � � � � � 20. Rough Factory Firaplace . APPROVALS Permit �F 21. Ducts, in Structure '� - - 70. Underground Hydro 22. Ducts, Ventilating i ' ' 77. Pro<luct Piping (7 Gas ❑ Qil 23. fas Pipe�Rough & Test • � • � ' �72. Underc�round Flu'sh' ' � 24. Roof Praming ' � � � . '73. Undergrnd. S[oraye Tank, C Gas C Oii 25. ftoof�Sheathing . . � 74. 0'verhead Hydro 25. T•Bar Ce(ling (Svuctura!) & Monocoat - 75. Dry Ghemicat 27. Frame and Flashing �6. Dry Standpipe '28. Laihing & Sidin9 - ' �� . 77.� FIXED SYST�EM FINAL � . � 29. Insuiation ( �. I 7$. FIRE PREV. FINAL ' 30: Drywalt Nailing _ _ I �j� HEALTH DEPT. REQUIREMENT �:' .. 31. Plaster Brown Coa: I I �� . 79. F�NAL INSPECTION , 32. Electrical Power Meter��inai � � �-�'� �' 80, fOOD CERTIFICA7E ISSUED . � � - i. :. � - 33. Finai E�ectric � � . � '�! �� Notes: � � 34.'Finai Heating & Air Conditioning � ' •� 35. fiinai Gas Pipe�Test , � � �'� � . � � � . i:%-- � 36. Hood or Canopy _ � �' �= - .�I . � 4 ., : 37. Final Factor Fire lacc . �� /� %� � . Y P �/.u?j!��!3� - � . 38. FinaiPlum6ing . � � ��=�� 39. Water Service�Final ' ' ' � � � � � � 40. Gas Service-Final i 'r� •� ' � � u 47. Solar pomestic-Final � I I I 4:. Backflow Prevenxer � � � . � 43. Backflow Irriyation , � 44. l.andscape irrigation System - � � . 45. Sound Attenuation � � 46. Handicap Regulations � • � , 1 i 4Z. FINAI STRUCTURE & BU�LDING � i �`�:- i'.; 48. FIN,ALPLANNING � I I �� 49. Electric Release to Edison �-'�'� ,� � � n; 50. Gas Release to�Southem Catiforn�a Gas Co ��'E � , 51. CERTIFICATE OF OCCUPANCY No. Date J � � � PFOJECT RUOflE55: 9 � g DARkELL S T owxexsxame: MATTEAU� AS1CHtLLE �, aooeess: 21405 BROOKHURST ST #3J8 HT7NTINGTON SEACH,CA 92646 � FNCHIENGINEEP: ADOflE55: flEG.NO.: UNIT: UNIT: PENMITTEE: MICHAEI.S ROOFING (7].4)647-5725 nooxess: 515 pUAIL DR ELSZNOftE CA 92530 LILENSEU CONTflACTOfl DECLAHATION: I here0y atlirm thal I am license� under pmvisions ol Chapter 9 �cammencing with Section, 7000� oi DiNsion 3 of the Business and Pm�essions Cotle, and my license is in � Illorce antl euec�. c�rruc.:056680 sTaTeuc.:63744�1I�1u,�\ �1��s: C 3�i� , Oate: I6 —Z 2_� ��-- Signature:�9_w�i� �� ,WOflNENS' COMPENSATION DECLABATION: I hereby aifirm Ihat I have a tenificate of conseni to sell-insure or a cetlificate af workers' Campensation Insurance, or a ceridie0 cooY ihereoi (Section 3800, Lab. CI. POLICY NO.: E%P. ORTE: ' � 'COMPANY: . � ❑ Cehified copy is here0y lumishetl. � Ceni�ieA copy is fletl with ihe ciry Builtling �ivision. _ �ate: F071icant EXEMPTION FBOM WOBKEBS' COMPENSRTION DECIAMTION: �.Q�is section need iwi he comple�e0 il Ne permi� is lor ane �untlrtN (511q) oi less). I cetlily t�ai in ��e peAormance ol �he work for which �his permit is issueQQQ I shall nWWp(employ aryryryyyyperson in any manner so as �o hecome sublect �o �he Workers' Compensation Laws o� Califomia. I� I�., ll�l 1� 1// ^_ I I I II I I��d y 1 Date� �/1 — Z2--G�Z--� Signature: ��.YI I/ LK—I{{ / NOTICE: I�. al�er making ��is declaraiion, you shoul0 become sublect m the WorkeK Compensa�ion pmvisions oi the Labor Cotle. you must forthwii� comply wi�h such pmvisions or ��is permit shall 6e aeemed revoked. CONSTPUC710N LENOING AGENLY: I here�y alfirm Ihat there is a constmclion lending agency lar t�e performance of ihe work for w�ich Ihis permil is issueA (Seaion 3097, Civ. C�. LEN�EN: nooeess � OWNEP BWLOEB DECIAPRTION: I nereoy allirm that I am exempl Irom the Camracmrs' State License Law tor ine fallowing reason ISeaion 7037.5 Business and Pwlessional Cade: Nny city ot counry whicA requires a permit b constmct, atter, impmve, Oemolish,-or repair any s�mc�ure, prior ta�i�s issuance. also requires [he apPlicani for such permi[ to file a signetl statement tha� he/she i5license0 pursuant Io Ihe pmvisions ol Ihe Contracmrs' Siale License Law (Chap�er 9(commencing wi�A Seclion 7000) of Division 3 of ��e Business and Pmfessions Code) or Iha� he/she is exempl therefmm and ihe basis lor �he allege0 exemD�ion. Any violation o� Section 7031.5 by any applicanifor a Dermii suhlec�s �he a001man1 �o a civil penalry of not more �han �ive �unUretl Oollars (5500�. ' ' � I. as owner of tAe Ompeny or my employees with wages as their sole compensa�ion, will Oo Ihe �work, an0 ihe' ❑ s�mc�ure is not imeneeJ or oifered lor sale (Sec�ion 70d4, Business an0 Pm�essional Code: The Contrac�ors' State License Law tloes no� apply �o an owner ot a pmDeRy who bWltls or impmves lhereon, antl who does 5uch work himself/hersel� or Ihmugh ' his or her own employees, pmvided thal such im0�ovemenis are not intentled or oflered lor 5ale. I( however the huilding or improvemeni is 5oitl withln one year ol completion, Ihe owner will have �he burden o� pmving he/s�e Uid no� builtl or impmve for Ih¢ purpose of sale�. � � , 1. as owner of I�e pmperty. am exclusivery conlracling wi�� licensed conVaciors �o con5imc� �he pmlect (Section 704d. Business ❑ and Pmtessions Code: The Contracmrs State License Law does not apPly to an owner of Oroperry who hmids or imDmves Iherean � antl who conVacis �or such prole<�5 with a contractoqs�license pursuan� ta ��e Cont�ac�ors' State Licens¢ Law�. I am aware ��at pmol o� ��eir WaBer'S Compensalion insurance shoultl be pwvitlea lo me. � I am exemp� untler Section: 8. 8 P. C. , br tnis reason: ' Da�e'. � � Owner: - - I tlo hereby cehity �ha� I am aware ot antl underS�anA Ihe requiremen�s oi Calilomia Health antl Safeiy Code $ec�ions 25505, 25533, antl 25534 antl ��at 1 or any fuWre building occupanl will/will not (circle one) neetl �o comD�Y wi�h saitl state cotles and �he requiremen�s for a permit lor conslmclion oi motlificalion �mm Ihe Fir Ouality Managemen� UisVici. flesitleniial cons�mc�ion applications are exempi imm Ihese pmvisions. ' Date: FOPlicanL I �ereEy cer�ity Ihal I have reatl ihis applicaiion and s�ate Iha� Ihe a�ove in�armalian is correct I agree �o comply with all ciry anA county ortlinancesanastatelawsrelalinglobwltlingconsimc�ionandherebyaNhonzere(y[��sentative/$p)Ithiscitytoenterupont�ea�ove-mentionetl pmperly for inspedion purposes. ��I(�'/ �Y-�� ` J� oate. /O ' 2�� Q7 Signalure' � �river's License oi Socia� Security x: � 1641�46 While—Bmltling�, Gmen—Code EnlorcemenC Canary—Ap0licanL Pink—Revenue; , CITY OF COSiA MESA — BUILDING PERMIT PERMIT NO: H 059667 PLAN CHECK NO: N CONSTRUCTION TYPE: PERMIT TYPE; STR �PERM NO'; B 059667 I GOC'T; U SUPP: N PURPOSE: ALT JOB DESCRI+PTION ; REROOF W/COMPOSITION SHINGLES S FT• 1 105 CLAIM VALUE: 1, 105.00 CALC—VALUE: 1, 105:00 GR�� P�ETECTOR COMMENTS• REROOF 1700SQ FT RESIDENCE W/COMP-SHINGi R EQ�J�R'E D ' it �t 1F�ftiF i'r it iF * it iE �(-it• IE �f� i(� x� ic� i( iE �E * iF ��if� �f� it 1f �E if iE �f � it ** ik if i4 iE �� It� i(� 3E if �F fF M� 3Eif iE x� ff� ****-lf M iE iE IF �t� 7k i(- x� �f iE�x� tFfE,r it ir x� x� fF i(�. u�...,..;.:;: Z O N Z N GJ ERTEB�AUCIRRSE M E N T S , � ------------ MAID2 BUILDING'---------- FRNT; FT IN REAI2: FT IN LEFT; FT IN RGHT; ' FT IN — ACCESSORY BUILDING — ' — FRNT: FT IN RE:AR; FT r IN LEE'T; FT IN RGHT; FT , IN . � � PARRING REO; PROV: PARCEL; 42235309 2NE: ' REF NO; PLANNING NGTES> � � . . - . . _ . . � � _ iF 1f iE iE iF iE IE �E iE iE �ElF 7E if iE iP iE iP iE iE itlE if iE i(� iF I! 3f !h iF iE iE if �t jF iF iF �1E iE i(�iE 3EiE iF iE�Jb 3F iE if fb �f iE* iE iF�IF iE if� iF iEih 3f K�lF iF ib 3E ib %if iE iE iF iE 9E #f 3E 3f� k 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• ,2L• ti�. iE#fflFiFiriEiE?EiElE%!ElE�kiFiEif�EfkififiFt'FiF'iFiFie'iF7Fi'ciFii-�FiFfeiFiFfe3fiFiF !"t7FiFi€'iFs'FiF3F�F�F�r3'3FiFii-'7r3Fie-%-1E%ifiEKx. . .x.�r . .x. .q.3f. �(� if� iE iP if 1E �lE if iE if iE if if !E 3E iE iE iF X� iE !k iP iE iE iE iE IE �IF jF if IE iF fE iE iE iF �E jF ik ff i! iE iE if if iF iF �t K i(-3E iE !f i4 it i(� 3F iP iE iE )FiE iE %� iP 3E iM1 iF iE i@ if 3f if ik � ih M� 1E if LEGALIZATION;N F E E 5 U M M�A R Y STRUCTURAL SEGMENT;Y �BLDG PMT 'PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES ,�GRADING PERMIT 29.00 ,50 - � 'SMIP'/N6N RE5 PLAN , � � . �;�J =— ISSUE fiEE ', ; ' t � -.� : '�; BUILDING—D'IV—> . PERMIT ' ISSUE ,PI7AN—CHECK , TOTAL � PAID=i�r-i` DIIE TOTALS----> 29:50 0,00 �,�� 0,00 29,50 29,50:;� FY.' ,00 . � �F� REVENliE DIVISION TOTALS--> OOLLEGTED� 29',50 OVER/SHORT:: � 00 � BLDz9PM��T PLUMBING ELECTRIC�MECHANIC FIRE SMIP/TO�T, GRADI�N� P{;AN—CHECK , r! -.. µ, �)'iv �j' '� 1 �**��x�**�x�-�*itit***i�**it****�t*it�t��,��t��*�xza�**�*+t*�***�x-x rtux*rt�***;ieix'��?� xx x �x*�ri� I N D I V I D b A Y, F, E E B R E A K� D O W N �� ( TYPE QTY D E S C k I P T I/O� N UNIT COST � TC�TAL COST SFR 1105 REROOF BY VALUE RESIDENTIAL NOZONE . . F,.ND OF' `r'EE5 � +� ' E/�PIRED ' . ' �' Vr�icomp��'t� Inspections � "I 3� , `/ $Ig � {�iQ ��"a"r 1,00 1,105,00 �`',i % .0rr�"' "" '; _." � r� OCT 2 2't992 � CIJY OF CQSTR MESA / �r1' \ � ' �4.. - CONSTnUCTIONAND:P4ANNINGs �_ ' ". : - - _: •�./OL&�SPA. � �-: � J � �.., �`APPROVAIS - Permit`-# -. - _ Date : Inspector - � - .� a Date' � =lnspector' u - .:.-. � APPROVA'LS Permit # - _ �' � .1.,Temporary Electrical Seryice or Role' � � ` ��,. _ �52. Pool &*Eguipment Location_ - �- . _ ' � _ � - � I- � 2. �Soil Pipe�Undrgrnd. �- ' �� ' . - �� ,53. Steel ReinFoFcemeriY � � � ' � � -� � 3. Electrical Conduit Utility�Undrgrnd. , �� - 54. _Forms� �� - � - . . � � 4. Electrical Conduit�Undrgrridr_ � - ' > i+ ; . � 55. .Electrical Boriding. _ - � � ~) � 5. Steel Reinforcemerit �', z, - '_� 56. Rough Plumbing_.& Pressure'Test ' _ � . 6..Electrical UFER Grnd. � - ' __ . . 57. APP,ROVA� TO COVER-GUNITE . �� 7. Footings - . ._ � -- - - - . * 58. E�ectrical Conduit-Undrgrnd. - - ,,�8. Foundation - � � , --`_' " -:� � 59. Gas`Pipe, �-Undrgrnd., Test - - -� ;� Y � 9. Wa;er Pipe-Undrgrnd. � ,. ': _ � � � � `�.� '�. : y 60. -8ackwash L:ines, P�Trap, O Undrgrnd. ' � .,- .� :_ ,; -.- 10. Strucwral Floor System- ' �� 61. APPROVAL TO-DECK --..:s. f- 71. Property Sewer Line�& HouseConnection , - -� " 62. �Backwash & ReceptorFinal�. � � ' y 12. Sewer CaP ' �' `- - - _ ' ' _ :- - ., .. . - �f , 63. _Heater'& Vent_F.inat , . . ` 13. Aoof Drains � • ` � , . . 64. Plum6ing System = finaf• 14. Rough Ptumbing " � `� : . - ) ` 65. Electricai-Final -. • ' � ' 15. Rough ElectricabConduit � , � � 66. �SolanSystem=F.inal ' , - � =76. Rough Electric Wiring -' _ 67. Fencing & Access.Approval _ � 17. Rough Wiring Sig� . � - � . ' 68. �APPROVED FOR�PLA'STERING . 18. Rough Electrical•T Bar Ceiling �. � 69. POOL/SPA SYSTEMS FINAL . ' 79: -Rough Heating-&'Air Conditioning - - ' ` ' FIRE DEPT. R�EQUIREMENT ' - ' " y � 20:_Rough Pactory Firepiace � -- ' �, ` � _ �" � �APPROVACS,� � "Permit # 21: Duc{s, in Structure i�� . . _ � � �70. Underground Hydro 22. Ducts, Ventilating - •� , i . �� '-71, Product Piping OGas OOiI 23:,Gas Pipe�Rough &�Test � �� ". . , ' . �72. Underground Flush ., � i �� 24. Roof Framing �� E�' � ._ ''i � � 73. �_Undergmd'. Storage Tank O Gas ❑ Oil r 25. Roof Sheathin9 . � � � ' 74. Overhead Hydro� . � . � 26. T-Bar Ceiling (Siructural) & Monocoat �- 75: Dry Chemical • �' 27..Frame and Flashing' - � 76: D'ry Standpipe � .� - � 28. Lathing & Siding � . . .� .. � �� 77'° FIXED SYSTEM•FINAL ; � . �'29. Insulation , � �� :. � „ 78., FIRE PqEV. FINAL . ��! �30. Drywall Naiiing ��. HEALTH DEPT�. REQUIREMENT „� ' �31. Piaster Brown�Coat . ; , ; � � �� J9. FINAL INSPECTION - ' - � � .,� 32 Electrical Power Meter�Final� � . I i I .80. FOOD CERTIFICATE ISSUED �, �. .33. Final Electric - � _ ! � �No{es � ��. . Z_�, c�� -34. Final Heating & Air Conditioning- � . �` � � . . ` . x r' � 35. Finai Gas Pipe-Test � . - , � I . _ '� � . ' - •� ^� 36! Hood or Canopy - , IC\. _ � �� "' , .r � �...; ' � ' 37. Final Factory Fireplace ' ' I �__� '' -. c� �38. Final Plumbing . � - . - : ��' �� , s �.39. Water Service=Final � I i _� � 40. GasService-Final I , ._ . - 1 -41. Solar pomestic-Final. � I I . , 42. Backflow Preventer - ' � � I - ' � " _43. Backflow.lrrigation � ' . ' " � � ; �'44�. Landscape�IrrigationSystem � � � . . i�"�,'t^c�' �.,� '45':_Sound A t `nuation � ' - ��'''` ��' . _ . ,.7 ;.. ,_ 46. HandicaP �e�gulat;ons � ,_ E p, ttppg ' ji ,'. -t- �' �p�9t8-�nSP� � � 47�. �PINALSTRUGT�URE & 6UILDING � I '�� "' �^ 1 i l. , �- . 1� -' �� ;i r,V 48'. FINAL PLANNING , � ~ � � - � ' "� �`^- �ii =� .,,. i '" � t�ate _.... - i . 49�. Electric R� I� ase �o; Edison I �.,� � - �'1 � � � ' �� ' 50. ,Gas Release to Southem Califomia Gas Co . ( j ' � � `' ' "ti � �'' t• .. -'=<�,, a s `51. CERTIFICATE OF OCCUPANCY � �'^=�==�^'° No. ' ''-� � Date � - .�.__., PqOJECT AODflESS! �, j DARRELL JrT OWNEa'SNnME:�,AITEAII, NICHELLE nooness:9?9 DARRELL 5T COSTA MESA,CA 92627 ANCMIENCINEEfl: aooeess: XEC.NO.: UNIT: uxrt: PEqmi"EE.M. J. MATTEAU ( 714 ) 645-2860 aoosess: 9Zj DARRELi ST rn�:TA MESAb CA q7.F��7 LICENSEU CONTRACTOfl'O�CLAflATION: I here y aifirm that I am licensetl un0er D�ovisions o hapier 9(commencinp with Section 7000� oi Oivision 3 al �he Business antl Pmfessions COAe. ana my license is in lull force and eilece � CITY LIC.: STATE LIC.: CLASS: Dale: Signa�ure: � WOPNENS' COMPENSATION OECLAHATION: I �ereby at�irm �ha� I have a cetli�icate of consent �o selbinsure or a cetlificate of Workers' Compensalion Insurance. or a certified copy tAereol (Section 3000, La�. C�. POLICY NO.: E%P. DFTE: COMPANY: ❑ Cehihetl copy is herebY �umishea. ❑ Ce�ilietl copy is file0 wi�h the ciry Building Division. �ate'. NpDlicanl: E%EMPTIONFflOMWOBMEflS'fAMPENSATI0N0ECUflRTION: (ThisseclionneeanotbeconieleteOil�hepermitisforonehundrea�3lW�oriess�. I cerlily �hal in Ihe Dedormance o� the work far which this permit is issue hall no, g6ploy any person in any manner so as lo became sublect lo �_ry�( Workers' Compensa�lio7n Laws o� Calilomia. / Oa�e: J � Z� � � / Signaiure', _ NOTICE: II, af�er making Ihis tleclara�ion. you 5houltl Decome su�lect Ihe Workers' Compensation pmvisions oi ihe Labor CoOe. you mus� fo�hwi�h comply witA such pmvisions or t�is permii hall �e OeemeO revokeE. CONSTflUCTIDN iENDING AGENCY: I hereby aHirm �hat Ihere is a constmtlian lending agency lor the pedormance oi Ihe work for whic� @is permn�is i55ue0 (Sec�ion 3097. Ci¢ C) . LENOEfl: AU�NESS: ' OWNEF BWLOEB DECLABATION: I �ereby aifirm Ihat I am exempi iwm the Contraclors' State License Law for lhe �ollowing reason (Sectian 7031.5 Business and Professional Code: Any city o� counry which repuires a permi� to cansimcl, atler, improve. demolish. ar repai� apy�stNiWre.:prior lo its issuance. also requires I�e apPlicanl lor such permii Io lile a signetl s�aiement that he/she is Iicen5e0 pursuzm Io Ihe O�ovisions ol lhe CanVacmrs' State License Law (ChaD�er 9(commencing wiih Sec�ion 7000) af �ivisan 3 0l �he Business antl Pmlessions CoOe) or Ihai M1e/she I5 exemp� Iherehom antl Ihe basis �or �he allege0 exemption. Any violaiion of Sec�ion 7031.5 by any aOPlicani �or a permit sublects ��e apDlican� to a civil penalry o� noi more than live hunOreA dollars (5500�, I. as awner o� ��e pmperiy Or my employees with wages as �heir sole campen5aiion, will tlo �he work, antl I�e -❑ slmcWre is not intendetl or oltered tor sale (Section 70aa, Busmess an0 Pwtessional Cotle: The CanttaclaK Sta�e License Law aoes not apply �o an owner o� a pmperiy who builtls or impmves Ihereon, an0 w�o tlaes such work him5eli/hersell o� ��wugh his or her own employees, pmvitletl Iha� such improvements are noi inlenAed or o��eretl lor sale. I�, however tAe huiltling or I improvemenl is soltl wilhin one year ot complelion, ��e owner will have �he burtlen of proving he/she tlitl nai 6uild or impmve lor ihe purpose of salel. - � I. as ownerof ine pmveny, am exclusively conVac�ing wiih licensed contractors lo con5�mci �he pmjec� (Section 7044, Business antl Pmfessions Cotle'. The ConVaciors' Sta�e License Law Ooes nol appty ro an owner of proDenY who bm105 or impmves thereon ana who conVacts lor suc� pmlects wiih a conirac�or(s)licensa pursuant�o Ihe ConUac�ors' S�ate License Law). I am aware that pmoi o� I�eir Warker s Compensa�ion insurance should be providetl to me. � I am exemp� under Seclion'. B. 8 P. C. ': � �oi inis �rejason: p oate: S� Z 7�( / Owner I do hereby cenity Ihal l am aware al an0 untlerstantl Ihe requiremenis of California Heatlh $alety Code Sections 25505, 25533, an0 2553< antl ihat I or any fuNre building occupan� willlwill noI (circle one) neetl ro comply wi 'ai0 s�a�e co0e5 antl Ihe repuiremen�s �or a permit for conSlmciion or mo0ihcation �mm Ihe Nir Quality Managemen� �iSVic�. flesitlen al cons�mclion applications are exemp� Imm I�ese provisions. , Oaie: NpplicanL I here�y cerulythal I have reatl Ihis applicztion ana s�a�e Ihallhe above in�orma�ion is �rec� I agree�o comply wi�� allci�y and coun�y o�tlmanceSanOslalelawsrelatingto�uildingconstmc�ionantlherebyaulhorizereprese iveso��isciryioen�eruponlheabove-men�ionetl pmpetly for mspeclian purpQose�s.T Oate: �� Z��! / Slgnalure: oriver's License or Social Secuniy a: � �� .� � 164t-A6 While-6uiltling; Green—Cotle EniorcemenP, Canary—Applicanl: Pink—Revenue; Goltlenrotl—Assessor CITY OF COSTA MESA — BUIL1]ING PEkNIT PEkMIT NO: IB 061476 , PLAN CHE�R NO; N CONSTRUCTION TYPE: S—N PEItMIT TYPE: OTH S'I'k PEAM NO; IB 061476 GOVT'; N SiJPP: Y PURPOSE: OT'A SOB DESCRIPTION ; INSTALL 1 FACTOkY FIREPLACE (ICBO�i3195) SQ FT; . CLAIM VALUE: 1,000.00 CALC—VALUE: GRUUP OCC; R-3' /M-1 COMMENTS: RENEW THE 'B' PORTION OF EXPZRED PERMIT HM50007 I i(-i(�ih3tiElflFiE�E3fiFlFiFifiEikiFiFifiElE�lt�lf3f-#iflE3EifiEiFifiE�3EifiFklFiEiE7E�3E�7ti(�N�iE%3(�iEikif-3Eik%iE�Eif1(�iEiFN�-lE,`E#�7FiF3Eif�3F�11•X-'.f1Fif1FiE3EiF�k Z O N I N G R E Q❑ I R E M E N T S • i 5 E T B A C K S ------------ NAIN BUILDItJG ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR; FT IN rRNT: FT IN REAR; FT IN LEFT; FT IN kGHT: FT IN LEFT; FT IN RGHT; FT IN PARKING REQ• PROV; PARCEL; 42235309 'LNE: REF NO; PLANNING NZ5TE5> J it iF iF i4 K� iF iE i(� iF ip 1E k 1E if iE it iE i(� 3(� fE ih iE K� if� fF K� iE iE 1F iE # 1E iF 3F �IF iE iE it� if %!f k IF iF 3E iE �1FiE 3Fi(� !E fE k iF iE ik iF iEie iE if� if 3EiF itlE iE �f-iF il� iEiF iE fE iE 3E'R� iE iE D E V c I� O P M E: N T S E R V I C E S R a Q U I R E M E N T S 20NING APPROVED HY DATE; BUILDING APPkOVHD BY : �) DATE; APPLICATION ISSUED HY; � I'S t.� CS� DATE: 2 ilitiE7tiFiFiE3titiliEif3EiFitiEiEitiFitfElE7F3F'��3Fir r an 3c��3t�iFiF� iT�k3F3�. riiteiFr�iiF3FititK�tt3E�IF�1(-itiEiPit z�w �r r� .it� 1FiE iEiFiE3kiFi(�iFieiEiE�IElEiEiEiEiFif%�iFiE3ElEiE3EiEiF�lE3EiEiFiEik3FfElElEitiFjE3E�X�ih1E�lE%!f �.a �lf�lFiFi6jEifif��7!-Ifi(�:S��FIE�1EiEiE#iFi'rlE3FIFiFlhif3F%3FiEiE* LEGALIZATION;N F E E S U M M A R Y STRUCTURAI� SEGMENT;Y BLDG PMT PLOMHING ELECTkIC MECHANZC FIftE SMIP/RES GRADING PEItMIT 30.00 SMIP/NON—RES PLAN , ISSUE FEE BUILDING—DI��—> PERMIT ISSUE PLP.N—CHECK 20TAL PAID DUE T01'ALS----> 30,00 0,00 0,00 30,00 30.00 ,00 REVfiNUE DIVISZON T'OTALS--> COLLE:CTED; 30,OU OVER/SHORT• 00 BLDG PMT PLUMBTNG ELECTRIC MECHANIC FIRE SNIP/TOT GRADING PLAN—C�HEC•A 30,00 3E iE �lE lE if iE 1E iE iE iE iE iE jE i(� %iE%aK� iF i4 jE 1f jE ik 3E 1E iElE �1F iE iE iE iE �k�f 3E �lE if i(� lE �1E lk iE X� 3E 36 ib 3i �3E rt 9f X� itiE iF N- if 1E 7f lE�%�!E �7F�7f 1F % iE 1F IF iF IE iE iF iF 1E iE 1E IE iE I N D I V I D U A L F E E B R E A I( D O W N TYPE QTY D E S C k I P T I O N DNIT COST TOTAL COST INS i. BUILDING RE—IN5PECTION FEE 30,00 30,00 cND' GF FEES 01 Q01354n9—QR1359i?� a 17 M �n �, C1P.7E: Qa12�;?3 i.j �E: 11.�G�' • _. • t i , - -�- ...-�.. . .. - '- . _ �' '- • ' _ - ' . <t,...l & SPA... � . .,. . . : -. . . CONSTRUCTION AND PIANNtNG' .�, � � �' - ' ` J Date-� Inspector " � - Date . Inspector��, APPRpVALS Permit# - , APPROVALS Permit# " -' . � - �7 �'Temporaiy`, ElectFical Service or'Po�e � : r- _ = � . 52._ Pooi & Equipment Location ' • t �". ... - - . . .. _ � ., -�2. Soil Pipe-Undrgrnd. " : = �� - 53. Steel Reinforcement . � • , ', , �� 3. Eler.trical Condui: Utility�Undrgrnd. � . � 54.: �Foims� - � � . �r° � -.� ,�' �4. Electrical Conduit�Undrgrntl. � ' - �. p e- � 55.. Electrical Bondirig � ' � ��t �"' � R� � 5. Steei Reinforcement '" r .. x� 56. Roagh Plumbing & Pressure-Test �` � � • 6. Electrical UFER Grnd.• � - - 57. APPROVAL�TO COVER-GUNIT[ * . , 7. Pootings � � _ - . � 58. -Electrical Conduit�Undcgmd. '- 8. Foundation ; - • � � � ' 59.".Gas Pipe, O Undrgrnd., Test _ - � 9: Water Pipe-Undrgrnd. �; '• � � r� 60. Backwash Lines, PTr�p, � Undrgrnd. �.� -�� 10. Structurai Floor System; �-, � v��!"� , 61. ARPROVAI. T.0 DECK'; � q .:�,-�-�:' . 17. Property Sewer Line &�House Connection ' 62. Backwash &' Receptor`�Finai � � � �' .� �`� � 12. Sewer Cap � . ' � ' � 63. Heater & VenbEinal � "�;�,,., ' � i - II i ' ^ n 13. Rnof prains � � . %' � � . ;,;� 64. PlumGing SysTem�. Fir,al j�-`;` ' (`fr ° 14. Rough Plumhing � - ��i, ^ 65. ElectricebFinal � � . � � �.y : �'�'��! 15. Rough Electrical-Conduit � �., 66.�.So�a��System-Final '!�,� � � �ti � :� � 76..Rough Eleciric Wiring• ' - � 67. Fe`ncing & Access�Approval �', i,� `• �" ' 17. iiough Wiring Siyn . - 68: APP.ftOVED FQR PLASTERlNG�n 4 ' 18. Rough Electricai-T Bar Ceiling � ' 69.�POOL/SPA SYSTEM$ FINAL i. � t 79' -R'ough Heating & AirCOndkioning- � ' - - - ' ' ' FIRE'OEPT:REQUIREMENT' � � ' " 20. Rough Factory Fireplace � , ' �" APPROVALS Permit 9''r '. ' , 21. Ducts,in Structure. -' 70. Underground Hydro j 22. .nutts, Ventilating - ' � ' 71. Product Piping-O Gas rJ Oii t 23. Cas Pipe�Rough & Tesc ' � . 72. Underground Flush � 24. ftoof Framing' , ' ' � .. 73. Undergrnd. Storage Tank O Gas ❑ Oii � 25. fioof-Sheathing . 7A. Overhead HYdro = 17.� � I 26. T-Bar Ceiling (StructuraiS & h1onocoat _ 75. Dry Chemical - � 27. Frame and Plashing • 76. Dry Standpipe j 28. Lathing & Siding ' '� "� �' � � 77. FIXED SYSTEM FINA� . 29. Insulation � I!� ��-.. 78. FIRE PREV. FINAL ' I 30. Drywail Nailing � _ (`" -�� HEALTH DEPT. REQUIREMENT � 37. Piaster Browr Coa: - � ii 79. FiNAL IN$PECTION ,� � 32.��Electrical ?o�ver MeterFinal • ' � ry". 80. FOOD CERTIFICAl'E ISSUED � 33. Finai Electric � �� y14� Notes � 34. Finai Heating & Air CondiYioning � i�yj � � � � 35. Finai Gas-Pipe�Test I :� /� . �� 36. Hood or Canopy . � � I �"� �� ' . . �� :_ 37. Finai Factory Fireplace �' � 3��, . � 38. Finai Plumbing . I I("i^'_ . � -'-��-�--�-�-- 39. iM1�ater Service-Finai . " , I i�` � ' 40. GasService-Pinal . � -�.. .. . � ..,`.'. . .. �_. _ � l �' - '47. Solar pomestic-Finai • - ' ' l f _ ' 42. Backfiow Preventer . � i � � - _ _43. Backflow Irrigation , . 44. Landscape frripacion System . _ . � � _ 45. Sound Attenuation . � , - . 46. Handicap Regulations " � - " - . � !. 47. FINAL STRUCTURE & BUlLDING . I i,. ' 48. FINAI PLANNING - � � i' ' �� - 49.'Electric Release to Edison I ��" "- . . 1�� 50. Gas Release to Southern California Gas C� ( �'� ? , ' 51. CERTIFICATE OF OCCUPANCY � - ' ^ No. Dare � • ` - � PPOJECY AOOPESSt� 9�,i llARRELL ST OWNEN'S NPME: HARTSON aooaess: g�3 DARRELL ST COSTA MESA CA 92627 RXLHIENGINEER: � ADOflE55: UNIT: NEG.NO.: UNIT: PE"m"TEE: HARTSON ( 719 ) 631-3479 , aooAEss: g�3 DARRELL ST • COSTA M£SA CA 92627 LICENSED CONTFNC70H OECUIPRTION: I �ereby allirm ��ai I am license4 untler pmvisioni ol C�ap�er 9(commencing wi�h Se�iiOn 70W) ol Dic;sion 3 0l i�e Business antl Pmfessions Code, an0 niy Irtense is in tull force ana eflecl. . CITY LIC.: ' STPTE LIC.: CLASS: � Dale: SignaWre: � WDNKEflS' COMPENSATION OECUIflFTION: I here�y aHum Nat I have a ceriificate o� conseni Io sel4insure or a ceM1ilicatc ol Workers' ! ComDensa�ion Inswance. oi a cenihetl copy Ihereoi (Section 3800. LaO. C)�. POLICY NO.: E%P. OATE: � . ' COMPANV: - = ❑' Ceriilied copy is Aere�y Wmishetl. ❑ Ceni6¢tl copy is liletl wi;h t�e city 8uiltling Division. . Date: ADVI¢am'. ENEMPiIONFPOMWOBREFS'COMPENSATIONUELUBNTION: Q�i55ectionneetlnolbecamDl¢Ietlilt�epermili5faane�mMrM�5100�ork55) � certdy Iha� in Ihe DeAormance oi t�e work lor whic� t�is permit is issue0. I shall not emDloy any Derson m any manner sa as �o became suble�� o I�e Wor4er5' Compensalion Laws ol Caldornia. . . Oaie: SignaWre: '� ' ' ' ' NOTICE: il, atler making I�is Oeclaralion, you shoul0 become suble�� o ��e Workers' Compensalion pmvisions o� ��e Labor Cotle. you must lotlhvnth compty wil0 suc� Orovisions or this permit shall Ue Oeemed revoketl. CONSTPUCTION IENUING AGENCY: I hereby a�hrm �Aat �he�e is a consimc�ion IenOing agency lor lhe Dedorman[e ol t�e work tor whi[h I�is peimii i5 iSueC (Setlio� 3097, Civ. C�. ' LENUEfl: , � � ROOHESS: OWNEfl BIIILUEF UECLAFlNTION: I �ereby aHirm Ihat I am exem0� �mm I�e Coniractors' Sla�e License law lor [he lollowing reason (Secuon 7031.5 Business ana Prolessmnal Cotle: Pny ciry oi counly whic� re0uire5 a permii Io consimct. alier, impmve, demolish, or re0air any simcture. prior to i�s issuanre, also repuires t�e ap0licanl lor such permit to file a signetl sta�emen� �hat �e/she i5licenseE pursuamioi�e D�ovisions olihe Conlraclors'SIaIe License Law(Chapier9(commencing with Seciion 7000� ol�ivision 3 ol�he Business antl Prolessions CoOe) or Nat �els�e is exem0� therefmm antl ��e Uasis loi I�e allegetl exempiion. Any violation ol Sec�ion 7031.5 by any applicant for a permii 5ubjec�5 Ihe app6canl Io a civil penal;y oi nol more than Lve �untlretl tlollars (5500). . �I. as owner nf t�e pmpe0y or my emp�oyees wil� wages as IAeir sole compensation, will tlo ��e waB, antl Ihe ❑ slmcture is na� intentletl or olleretl �or sale (Seclion 70A4. Busness an� Pm�essional CoUe: The Contractors' State License �aw� tloes nol apply �o an owner o� a pioperty who �uilds or improves �hereon, ana who tloes such work �imsel�/hersell or Ihroug� � �is o� herv own emDloyees. pmvitled ihat such impmvemenis are not in�entled or oflere0 lor sale. Ii. �owever �he Duiltling or imD�ovement is soltl within one year ol compleiion. Ihe owner will have �he 6urden o� pmving helshe did no� UuilA�or imD�ove � lor ine Durpose ol sale�, I. as owner o� Ihe O�opetly, am exclusrvely convacting viith I¢ensetl conlraciors lo consimd �he pmle�� ISection 7044, Business IA' antl Pmfessions Cotle: T�e Coniraqors' Siale License Law �oes not appty Io an ownei oi DmDeny who Oudes or imD�oves Ihereon an0 who convac�s lor suc� D�oleGs wii� a conlracloqs� bcense Oursuanito I�e Coniractors' State License Law�.l am aware I�a; pmol ol I�eir VJorker'S Compensalion insurance i�oulC be D�o'/idetl ro me. � I am evemp� unoer Seciion: 8: G P. G ' � lor ��is reason � / < / w��: �l - ��%- %�O wh� � " GiG�I�) �G�� I tlo Aere�y cemy mai I am awaie ol antl unaers�antl We reQuiiemenls ol Calilomia/ lth and $ately CoUe Seaions 25505. 25533, and 25534 and Iha� I or any fulure builtlmg occupan; willlwill not (circle one) neea Io cqh, / vnih said slale co0e5 antl Ihe reQuiremenis lor a permil loi consimc�ion oi mo4ihtaimn Lom Ihe Pu Oualily Management DisVicl FBSitlenllal consimction apDl¢ations are exemD� �rom Ihese pmvi5ions. � f� , ; � �ate: ApplicanL I �ereby cetliiy Ihal I �ave read t�is app�i[aiion an0 Slale thal ine a�ove informalion is correcL I oi4inanc¢s an� slate Iav�sielaiinglo �wltl�ng con5lmciion an� h �y aulhonie�epresentatrves o tl piOpPtly IOi ip5p¢CIiO� ppm�pO5P5, � �aie- L�� / / � 9O Signa�ure: � omers ucense or sociai secmny r: t6at 4G Wnne—Bmitlinq. Grecn—Code Enfarcemem: Canary—Appl¢ant: Pin4—Revenue: GolOenrotl—Auessor Io compty wii� all cily antl counry � to enicr upon ��e a�ove�menlione0 Ci3Y OF COSTA MESA — BUILDiNG PERMIT PEkM NO; bM OSQ00" PERNIT NO: BN 050007 PLAN CHECK NO: N' GUVT: N SUPP: N i� ,: ,, CONSTRUCTION TYPE: �5—N FERMIT TYPE: MEC STR FL'RPOSE;'OTH � JOH DESCRIP'i'ION ; INSTALL 1 FACTORY FIREPLACE (ICBO�t3195) SQ FT: 1,OU0 CLAIM VALUE: 1,000,00 CALC—VALUE: 1,000,00 GROiIP OCC; R-3 /M-1 , COMMENTS:' SMOY,E DETECTOR(S) AE�UIRED IN HOME.' '� *******r**�er*****+e***�**�r**+r** **�e*-;�**r�r*r*x�t**+�r*�***�rr*******+��rx**ru***ri�+�*�r* 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 ----------�— �IINBREARI�G --FT----IN :FRNT:----,FCCESSORY BIIZLDING --------- FRNT: FT T IN AEAR:' FT IN LEFT; FT IN AGHT; ; F7' IN ,'LEFT: FT IN RGHT; FT IN PARKING AEQ • PROV: ' PARCEL: 42235309 ZN'c; ` REF NO: � PLANNING NOTES> ' . . � ' ._i . . ' . '__ _. ' _ �If �)F if if 1F iE if iE 1f M iF iF �E iF 1E If �lE 3f 1f iF if iF 7f iF if iF K if iF M i(� if If #f If if 1f If 3f iE if if 1f if i(� 1F if iE % 1f if iE iE 1f !k fElF if ih iE %if fb if if k�iF ff if iF iE M iE * �f it �)f Ik if D E V E L O P M E N T S E R V Z C E S R E�Q U I R E M E`N T S ZONING APPROVED BY 'DATE:� � BUILDING APPACIVED BY : • � ' ;DATE:, � �.) APFLICATION ISSUED BY: � ' DATE:'. � � �V iEiE*iflfMiElflfMMlE�tiFifK�MiF�EiFiRk ifiFiEififif�fiEifN ifif MififiklEififififif{fif�fiElkifiElE1Elf1E1F1fiffEiflEklEiflEiFkMlfiEiEiEYififiFiEir M�fifMMifIFlEiflfMlVififlflEififMlFlklf?kiFifififlfiflliEifk LEGALIZATION:Y ' , F E E� S U M A R Y � STRUCTURF,L-SEGMENT:Y BLDG'PN,T PLUMBING ELECTRIC �MECHANIC FIRE �'St,IP/RES GRADING PERMIT 50.00 '. 13 00. � 50 ., � - ' '252 : iSMIF/NON—RES PLAN ISSUE FEE 15.00 BUILPING—DIV—> PEkMIT' ISSUE PLAN—CHECK TOTAL PAID .DUE TOTALS----> - 63.50 15.00 0.00 78.50 78.50 ,00 REVENUE DIVISION TOTALS=—> COLLECTED; 78.50- OVER/SHORT: '.00 BLDG PMT PLUMBING'ELECTAIC MECHANIC FIRE SMIP/TOT GAADING PLAN—CHECK 50,00 � 28.00 , ,50 if if iE K Y.-N iF M if % if k i 3f iE 1F 1E if 1f iP iE df iE if ff 1E �If if iF iF k 1f 1E K��f M M 1F if M� M 1: if 3f iF iE if iE if M if �f iE ik IE if if if IE if 1E 1E 1f iF df IE M if �f If if 1f if If iE iE if M M I N D I V I D U A L�• F E E B R E A K D O W N TYFE QTY D E S C R I P,T I O N UNIT COST TOTAL COST SFR 3000 ALTF.R BY VALUE RESIDENTiAL NOZONE 1.00 1,000.00 MEC 1 FACTORY FIREPLACE .� 6.50 6,50 �END. OF FEES �.. , tl )V 19 199 . ' ' � cirr oF cosi. �-sa � ; � _ . . _ ._..._ . .._.. _..__ _ . ..._._- - CONSTRUCTION AND PLANNING � � � P�"'"' SPA; � APPROVqLS � Permit # Date i Inspector qppROVALS Permit # Date Inspector 1. Temporary. Electrical Service or Pole . 52. �Pool & Equipment Location "; ' � ; ' �2, Soil PIpe�Undrgmd. � � 53. Steel,Reinforcement . � � ;� 3.`,Electrical Condui[,Utility�Undrgrnd. 54. Forms � � 4."Electrical Conduit-Undrgmd. � 55. Elec[rical Bonding ' �`., �J . � 5. Steel ReinforeemenC ' - ' 56. Rou9h�Plumbing & PrAssure Test ' :' 6.� Eler,trical UFER Grnd. . . ' 57. APPAOVAL TO COVER�GUNITE ' � 7., Footings � , . . � 58. Electrical Conduit-Undrgrnd. �. ��.• 6. Foundation � � - 59. Gas Pipe, � Undrgrnd., Test . . . 9. Water Pipe�Undrgrnd. ' 60. Backwash Linet, P�Trap, O Undrgrnd. 10. Structural Floo� Syttem �� 67. APPROVAL TO DECK � ' - ` �, 11. Properry Sewer Line & House Connection �� - - 62 Backwash & Receptor-final - � � 72. Sewer �Cap - . , 63. Heater & Vent-Final - . 13. Roof Dryins � " 64. Plumbing Syscem - Final � , '"� �' 74. Rough Plumbiqg �' , :. 65. Electrical-Final . �� - � � ' �� , � 75. Rough Electrical-Conduit , , 66..Solai Syscem�Final � • - 7fi. Ruugh Elearic Wiring . 67. Fencing & Access A�Uroval 17. Rough Wiring Sign ' 68. APPROVED FOR PLASTERING � 78. Rough Electricel-T Bar Ceiling � � = 69. POOL/SPA SYSTEMS FINAL 79. Rough Heating & Air Conditioning " '�" '�"'"""" FIRE DEPT. REQUIREMENT �� , r 20.'Rough Factory Fireplace � ::� • APPROVACS'��Permit # . ,:� � i • 21.�Ducts, in�Svucture � � �.. .. , -� ,- �� 70. Undeigcound.Hydro � 22. Ducts, Ventilating� � . � • �� '� 71'. Product Piping �Gas ❑Oil 23. Gas Flpe-Rough & �Test � �' ' ;�,•. � '�; '� ; j2. Under9round Flush � . � :' -. 24, Roof Framin9' . � . ' ' "'�' ' - :' - ' 73:;"Undergrnd. SmrayeTank � Gas ❑ Oil' �• 25. Roof,Sheathing �,� ` � � ' �� ,_,�;�,� .; 74rO�erhead Hyclro� � �� 26. T-Ba� Ceiling (Structural) &:Monocoat � � �_r� ��r 75r pry Chemical '"� • � .. ., . . . . . . ,. � . . � 27. �Frame and Flashin�, '" ; �_, �`�� , � ' 76: Dry Standpipe : ',;;i , '" ' � 28. �Lathing:& Siding � � . . � !•:'.:�i: � :;: � �� 771"FIXED SYSTEM�FINAL � -.i n. 29. Insulation . �. � � � .. � ' � i � I: ; 78b FIRE PREV. FINAL � , �30. Drywall Nailing �- � • � I ' !�� ; HEALTH DEPT: REQUIREMENT � 31. Plaster Qrown Coat � ' � '' i �;: j; ;,.;79:�FINAL INSPECTION �' i 32..Electrical�.Power Meier.Final, �� c, . ' i !�• �• ��80.t=FOOD CERTIFiCATE ISSUED . 33. Fina! Electric � ' ' " ' � ��-!� - 'Notes: �iFJjrriy� iE1C.Dl6�EA R8 � 9-L7-�1 �;;;' 34. Final Heating & Air Conditioning ; � � : i� ' P�l�, STeC.'1'WTJ 308 O- V��.. (,�IEii> 35..FinalG,}s:Pipe.Test'' :': . . � �'i �• �- . .: . ;. -: . �; �� 36. �Hood or�CanoPY�.�� i : . • .i �'� � �I. � � � . . . .. � . : �. _ . >"I'., . 37.��Final Factory Fireplace, , � �= - '" �' ' ' I Y�'I� . , ' . . �38. Flnal Plumbing � .. � .. .. �� . . . I .�;��'�. � . . , ;.i � . . �.39. Water Service�Final: . � � I ...':� �� • . . � � ' , .. . . �:w:`",::",�. ��' i � �40. Gas Ser�ice�Fi�nal � . � ' � � . ,_. � _ i .:� ��n� �� Q� (�f•i:• � � - _ 41. Solar pomestirPinal:�_: !'� �.. . I� � " � � .,�%: '^Y' � I ��; � - 42.��Backflow,Preventer; � , �� :. J iI r � � . .i.i-• . . _ , :*., ` , .� .43. Backflow Irrigation. . . ":;=::-.' , i ' ..' `- � ,-. "�; ' �...`:';�: , ' r �r' i ' "3.�:. ♦ ,_ _ ,�', "�44. Landscape Irrigatiop System�;,.;, ; , ;�.. ��7 �� :; �: • � . �� _. �t"' 45. �.Sound Attenuation . . , . ', ':' . . , .'` , ;`� ' �. . . - . � ,i .,, � . , ..... 46.:Handicap;Regylatiops ;'; - ; "� ' � ,� i� , . . : "" ' 47..;FINAI, STRUCTURE & BUILDING � - � r, �� 48.'FINALPLANNING� i�. � . �..':.I;': i:; � �49.��.Electric Release to Edison , � � �:', � � ' . ' . ' % i. - 50. Gas Release tq Southem Cali(or{�,ia Gas Co ; j I ;'';;; ., ; . , � ' . . . � � 5i. CER7IFICATE OF;OCCUPq'NCY , `.. �;. ��,�: � • No. Date r PP0.IECTAGOqESS: ♦C g?3, �DARRELL ST � 0N1T� � ' � ' � � � CITY, OF COSTA MESA � BUILDING PERMIT, f 'PERM NO; BM 05000 - OWNEX'S NAME: HARTSON. - ' "' � � • ' • • � � � . • � ' I ' � ' • , 1 � • . � • ' ' - nooeess 9z3 DARRELL ST �� , ' PERMTT NO; BM. 0�50007 � �. PLAN CHECK NO;' 'N ' �, ' G6VT: ,N SUP,P: -N,, , COSTA MESA - _ _ . , . . � - - ' ' , � � _ ; � . CA 92627 -' • - _ - CONSTRUCTION'TYPE: ,5,—N ' FERMI'T .TYFE: MEC STR • �' PURFG�E: OTH , _ . �' ABCHIENGINEEF: . � . � _ � flEG.NO.: ' � � . . J�H DESCRi�'i'ION ; INSTALL 1 FACTOAY. FIR�EPLACE� (ICBOd7319'S) ,S��FT; " 1,UU0� � ' . nooness: � .. � � ' . ' ; R . ' uxii: ; '.. .. . . - . , � . � - _ � .. , � . � � � .. . � . - .. � . . � ^p ' � � ._ , � � CLAIM,VALUE: , 1,000.00, CALC—VAL'UE: ` 1,0,0'0;00 . GRQUP OCC; R-3 � /M-1 � ' PEPMITTEE: -HARTSON � ' f � , ( Z�19J 631r3479� , . . .- ' � � ' ... ' - - � ., � - � " - . � - � �, � , aooeEss:� 9� 3 DARRELL ST � � ' - COMMENTS • � SMOKE DETECTOR ( S ) RE�UIRED IN HOME,.. I �. � ' �• ' . .- '- I' � ; COSTA MESA CA 92627 � '?�**�t*****�r*�e*x****t�********+t** �r***�+�*�****�*�r**+�**�*ir*****�r�r*�*+�+rr**_*+��r***+�+�*�r�r � LICENSEO CONiPACTOP OECLANFTION: I �ereby allirm �ha1 I am bcense0 untler pmvisions ol Chapier 9(commencing with Section �� , � Z � n] I N� G Fi E Q U� I, R E f"i $ i� T$ . � ' '� ' �. • ' 7000) o� Oivlsian 3 of the Business an0 Pmtessions Code. znd my license is in tull torce and eifecL � , . ' ' . ,� S E+T � B A C K Jr � ' ' ' ' � r _ CITYLIL.: STFTEUC.:� cass: � • - � � MAIN :BUILDING � � — ACCESSORY . � � � ~ ' WOBREHS'�COMPENSATIONDECLAflPTIUN: SI�¢re1bya�firmlha�Ihaveacerti�iCaieoiConsen�t05el4insure BUILDINC --------- � � ara�eniricateorworaers'� : FRNT; FT ' Z'N REAR. FT � TN : . FRNT�: FT IN REAR;' FT jN`• I � 5 Compensa�ion�nsdrance.oracertiliedcoovthereoL(Sec�ion3e00,�ao.C�. , � � , LEFT; � FT � IN FiCiHT. ,i � FT : TN .. ' LEfiT,; ' , FT . IN RGHT;� - ,FT, � .ZN� , POLICY NO.: ' ' , E%P. UFTE: � . . �, . . . • , , , ' . COMPFNV: � � ' . � i � PARKING �REQ � ' � PROV; � ' PAACEL:��42235309 _ZNE: ; , REF NO: �� X� � � � ❑ Cem�iea ca is hereb �umishetl: ❑ Ceniiiea cop'y is �iied wim tne city Buiwing oi�vision. � ' � � PLI�NNING TIVTES> , • . , : � , .� ' , , � , � � PY Y � . " _ . . . _ ..._ _ '. .: . . _ .._ . _ . . . � _ ._ . . _ _. ._' "" . . _ .. � . , . . � : i . . .-. � , ....�.. � ; ..i.- . , . T � �.. _ � �ate:� NPDlicanL + . � �1EaEifiliEiEiEiF�f3EiE�ElE'1EiEifiEiEiEififiEiFiEifaF�FifiEifiF�EiFiF3E7E1EjElEifiEfEif�f±FifiFjE9f�flflEiE3flf�itif3EiEiC�ff?fifiEiFiElf�EiEifif�FiE�lfifif*ifif ' E%EMPTION FNOM WOPRENS' COMPENSATION OECUPFTION: (Thi55ection neea no1 �e camplele0 illhe permiti5 �m one hundre0 �3100) or less�. � P E V �E j. 0 P� t"i � E N T S� E Fi �% I C E $ R E_ �[J I R� E �+j E N T� 5 � � . I ceriify ihai in �he Oedormance ol t�e work for whic� this permil is issuetl. I shall no� emplay any person in any manner so as lo become � , � 1 , ' ;�, � ' , � subiec� m tne bvorkers' Compensa�ion �aws ol Ca�i�omia. ' � , 'LONING APPROVED HY � ' i � ' • ' � ; . ' � DATE�: � �� _. - - -+ ' ' Da�e: _ ' _ ' . ' .' SignaNre: '" • . _ . . .. ;. . .. . . . .' _ _ r. .. _._ ._�' "' _ ' '" . ' " ' , _ . ' � ' ,- - . NO7�Ce: i�, a�ier making ihis deciara�ian,`you shoWd eecome�subiec� m che workeK Compensa�ion pmvisions o� the Labor HUI LD ING APPROVED �EY� ;, -n , ' ' DATE : . , � Code. you must �otlhwith compty wilh such pmvisions ar [hi5 permi� shall be tleemed revoked. ' ' ' ' ' � � - � ; , � - � ' � ' �) - � _ CONSTBUCTION LENUING AGENCY: I hereby aifirm Ihal Ihere is a constmction lending agency for Ihe pedarmance oi Jhe work fo� APPL I CAT I ON I SSUED B Y: � ' � '� � �� ' � DATE • < < �U � . whichlhispe�mitisissuetl�Sec�ion3W7.Civ.C�. , , � , .�j[.{{*K.{p{(.{(.{p*{f3!*.)f.lf3f�1[.�(..lE{(.{f{E , . ***.K.y.,K..�.�*.y. *„� . LENDEN: � , • ' . iEififif�EifiElkiEiEjF!liEifiEif3fiEiEififiElEif3EifiEifiFifK�iElFiEif�EiEiE3fiEifififif dFifiEififififiEiflE�k�E1f3FifiFlfif?fitif�f?fiE;3f�EifififiliEif3E - aooeess: ': - - _ ' LEGALIZATION:Y ' ! � ' , F E �fi S U• M A R Y� �� ' STRUCTURP.L §EGMENT:Y �� c � i _ ' . .; _ . . -.7 . . .. • r . , . ., T , . , . � �,.. � I . , ; . . , � � . OWNEBBUILUEBOECLABATION: Iherebyallirm�ha�lamexemplhom�heConVactors'Sta�eLicenselawror�heb��owingreason' -'. � Bj.iDC. pM'1'�, PL[JMBIIQri � ELECTAIC MECHANIC F'IRE SMIP�/RES GRADING �Semion 7031.5 Business and Professional'Code: �Any city of coumy which requires a permit m ionstmci, alier, impmve, demolish, or -F.1E;RM I T� � - 5 0; � � ,,,, , 4°� � . 1 3. � 0 . . ' i ' �, rj Q I repair zny simcNie. priar ta ils�issuanie. also requires �he applicant for such permil to tile�a signed slaiement lhat he/she is�licensed � , '_ , �. • � . , - pursuani m �he provisions o� ihe Comramors' State License uaw (Chap�er 9(commencing wim Section 7000� ot Division 3 ot ine susiness ' f' , � „.. '': _ , .�. 5 t . SM I P/NON—RES , . . antl Pro�essions Catle) or I�al hels�e is exempt Iheretmm and Ihe,�asis �onihe allegea�e�emp�ion. Nny,violation o� Seciion 7031.5 hy - PI.p.N �� •� : ' ', ,2 � - Y ' � � � ' � any applican� for a Dermi� suble��s �he, applicant �o a civil penalry o� noi more Ihan.five �untlre0 tlollars.�5500�. - - I SS UE FEE� '� �� ' r� ��', �j •>' ' 1 5, � 0 � � � � '�, as owher �o� me piopeny'or my emy�oyees.wim wagesas �heir so�e compensation, wil� do �he.work.-and �he� .^BUILDING—Ii1t7—> PERMIT '_ ISSUE� P.LAN=CHECK , TOTAL �PAID �' � DUE � ^❑ slmcWreisnolintentleaaral�ered�orsale.�5ec1ion7044,0u5ine55anOPmfe55ionalCode: TheContrac�ors'StateLicenSeLaw TOTALS=---> � '63.50 �: 15:.00 ,.,; 0.00 � 78:50. � , 78.50 � ' ' ,00 . does na� Apply to an owner o� a pmpetly who huilds or impmves ��ereon, and who Aoes such work himsel�/AerSetl or Ihmugh '. � .. ,, ,•- � � , • y' %: � � ' i, �is or her�own employees, pmvitlea �hat such impmvemen�s are no� inientled br oifereU�foi sale. I�, however �he huilding or � ' — � t '� improvemen�i45oldwithinoneyearo�compleiion �heowner.winhave�heburAenotpmvinghe/shenidno�bui�dorimpmve REVENUE DILISION TOTALS—"—> .� COLLECTED�; � %$.5� OCrER/SHORT: ' 00 -'ro�meo�moseoisaie). ' � � � � �. : � BLDG PMT PLUMBING 'ELECTRIC MECHANIC . FIRE SMIP/TOT GRADING PLAN—CHECK ' ` ' ' '" • '' ' S0'.00 . . , , i 28,.00 . . .50 . ;. I, as owner of ��e pmpehy, am�exdusively conVac�ing wilh Iicen5e0 contraciors to consimcl Ihe D�olec� (Section 7044, Business � , �,� - � • , , , , , � �� anA Pmieisions CoAe: T�e ConVac�ors' S�a�e LicenSe Law Aoes no� apply �o an owner ol pmperiy wlio Ouilds or imD�oves lhe�eun - � ' i antlwhocon�racislorsuchprole��swithaconirac�or(s)Iicensepursuani�otheConiraclors'State;LicenSeLaw�.lamaware ')flhi(-if3f'i6iEififiC�lEiF{fiflFlf�lEif�ElfiEiF�lEiflEiF�lEj4iE{F1E1E{EfFiE{k3f:�flfiEffdFfEffiFjfiEjEififif{F{(��(.jf.�{E**{[..�{(.*�p{p*{E{(..�{F.�{�..)(.a(.j(.*.-K.*.� ' �iha� pmo�,ol iheir Worker's Compensation insurance shaule be pmvided �o me. � . , - ' I �j D I V� I•D (J' .D. �j� i�^: F E�.' H$, $ A K� D: 0 w i� � � � �,I am e�empt under Section'. 0. & P. 0. � ' � ' �. � � � • � . : � . � ; � � • � , m�m�isieason�,Q; �� Q �� /� '-TYFE QTY • D�E S C R' I'P T I O' N � , ; � UNIT COST TOTAL COST ' Oale: �L—L�/O Ow� ' / � '� �ll ' ' SFR � �1000 - ALTER BY VALUE RE>ID�ENTIAI: NO�ONE � �1.00' ' � ' 1,000.00 � eo nere�y cem�y'mat � 5m aware o� ana untlers�ana ihe reQuiremems o� Ca�i�omia ��h anU Sa�e�y Coae Sec�ions 25505, 25533, an0 MEC ' ' 1 � FACTORY� F I REPLAC E '�' � 6. 5 0' '" , 6. 5 0 2553d and �hal I or any fuWre GuilOing occupant wi�l/will not (circle one) neetl lo c wi�h saitl s�a�e co0es and Ihe requirements �or a --- �� -� , , ' permii for consimttion or modilicaliomlwm ihe Air Oualiry Mana gement DistricL iden�ial cans�mction applications are ezemp� iwm � . � , , ' � , ' '�END' ��F t EE$' , � � these pmvisions. � � , ' . „ ' , � � ' � �x . . . ' '. , ' � • i � : : . � . . .o �r^ ., . � � . oa�e: . ' � AValicam: � . . � � , � . � � , � , , . . � I �ereby rer�ilY I�ai I hzve reatl ��is application an� slz�e Ihai the above in�orma�ion is c6rrecL I agree,�o comply wilh all city antl coun�y � • +� j ! ,� � ��19 199 �� ' ' ordmancesantls�alelav�srelalingto�uiltlingconstmqionantl� Ayauthorizerepresen�aiiveso thiscityloenleruDantheabove�men�ionetl - - - - ' - � -• - � ' : i pmperly lar inspedion purposes. � . 4 � ' � ' � � , � � j f F . , , . i � �/ t Dale:_��-90 �9na�ure: W� � � ' ' � ' ' � ,. , 1 � � I 1 � � i ..r , . C�� QF �.{��Tn ; 1 � : ;.i� JA � ' ; �river's License or Sacizl Securiry rc.' � ' , • : ' � ' . � � . . - , ' , ! . i . � , . � � f . �64ba6 W�ule—Builamg: Green—Cotle EnlorcemenC Cznary—AOPlicanl: Pmk—Revenue.'Goltlenrotl—Assessor ��' ' � '�- ' � " � ' - - �' ' - ' " -' ' '- �' ' -" - - ' - ^� ' ' . . i . � . �, CONSTRUCTION AND PL'ANNING. �-' - . , PO SPA: �� ' � ' � -APPROVALS Permit# ' Date� Inspector qppROVALS Permit# ' Date' Inspector f 1..Temporary,:Electrical Seivice or Pole „ � - � ' 52. �Pool & Equipment Location' � . `�' - � i � 2. Soil_Pipe-Undrgrnd. � . -- - 53. �Steel_Reinforcement �� r' � ♦ �� i, . v W 3z`Electrical Cond_uit,Utility-Undrgrnd. ' � � 54. .Forms - � . - t - ' �; 4:tElect�ical Conduit-Uridrqrnd. .� - 55. Electrical Bonding � 'l -� � ' •c ri ei Y-5:;5(eel�Reinforcement;� . � � ' ' 56. Rough��P.lumbing & Pressure Test " V a�6.• Electrical UFER Grnif. � � . 57. APPROVAL TO COVER-GUNITE ,_ � 'r7. Footings . - 58. Electrical Conduit-Undrgmd. � C48. Foundation ,•; � ° � � - ' _ 59. Gas Pipe, O Undigrnd., Test � ", ,. . 9. Water Pipe�Undrgrnd.' � � � 60. Backwash Lines, P-Trap, �'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 Drainc ^� , . 64. � Plumbing SYstem - Final� � � ,_i 14. Rough Plumbin'g '" . - � 65. Electrical-Final - � � � 15. Rough Electricel-Conduit , , , 66. Solai 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. POOUSPA SYSTEMS FINAL 19. Rough Heating'&�Air Conditioriing" �' ' " FIRE DEPT. REQUIREMENT -� "' - -- ' - - - - �� ^ ��;-;r�i- . - 20..'Rough Factory Fi�eplace � r r ��,� � { :r 'r.i� 'AppROVAL'5�,� =Per'mit # =' ',�'� I-i r.:i J� +i-� ;r � .. ...i �-1 ' i � I.�1-� :�.r1 .M1 H � ' �.! 1 � , �. .. rJ�_J' . '�1 1 {`I 21._Ducis,in_�Structu�e� a .... � �<- � ,_.M . ,j0. Underground.Hydro � 22. Ducts, VentiJating�� :��_ _ ry i2 � '�;qt, produc{�Piping O�Gas ❑�Oil 23.''Gas�PiPe=Rough&�Test � �� "� ,�' ��.'.:�'- �� :��-! �� -. . , i � pj ,• .. ��i i+� ,;; � .. ��. i_72. Underground Flu`sFi �, , - 24.cRoof.Framing• .�.t . �'-�!�� [� �-� �J b� "�� '.73LUndergrn8'tStorag'e`-TankOGas OOiI" �`Y. ��' < lC I.ti'} ^f 5- 25. Roof,Sheathin .�:'� =, „ � rn i�i �r �1:" �. ,- , "�`_.�_ 9 �r;, �„ ._� . n;:t �� 74.=0verhead Hydro � 26^T-BarCeiling(Structural) &tMonocoat ? � �n = �n�P:r 75�DryChemical "S ' �-� '-� =�" . t� •r.- '� ro: --r� ..Ct 27 �Frameand Flashin'• � �1� ' �' , '�• `:::= ' _, ;" -'�' � � 9� � s�r:: � i-� i.+.i 76' Dry StandP,�Be ,-.;r� :t. r,r� ;-28.�^Lathingi& Siding�_ �� r-: �-7�',r, i� :i- , ' '!� 77!='PIXED SYSTEM�FINAL'- � `x rur.� .� ` •.� .�t: i r_,. � a� �a m>. '29. Insulation �• �^ `r� '.� .. .. ' t'! ' {�, t '� . ��" � ' •^� . ...� " .. � I �r,: 78�.FIREPREV.FINAL - r :�30. Drywall Nailing - -'. � I �%'t� y' ��+ � HEALTH�DEPT? REQUIREMENT :.r� .la'.t: �n, �r tr� rr'�y , i v ' , �^ � . � :. L) li• ;.1�' �31. Plaster Brown.Coat.-,-,,.. � �,,,., j � ��; ; �z79. �FINAL INSP-ECTION ;�. �,�,y ��32.:Electrical�Power MeternFinal� �� ,. c) I (�I. �.i r80.t=FOOD�CE�RTIFICATE IS.SUED n,�„ _33:�Final Electric �,t .;� ' �� "'� � V�' `�Not'es: �J-L7-�I4"�' ��E/r,rry�'�-� TriK.p� Q.�p p8 v', /I r..;,•� Y �� _�34.•FinalHeating:&Air�Conditioning� � �� Ci''�� - P�'L S�C.'1'WrJ=.r$03 �� U�aG. �(�iEi�� -35:'Final Gas;Pipe-Test°r ru -i r I � (' - , { •Ti�`; . � p� t; - 1 . : �ti'i i r-1 i.' ( �� '�7 �.G? ��I-ILi (t• I. '�' 'G�� 13. '�� ! • •t � ✓ 1 l•� ,36:'Hood oi.CanoPY��i := i ,... _ � i ,�/�_ z. � 'io - !" i.ti . i.r ..� . 37 �Fin`al�� Factory Fireplace, , � '`-��' °' �� `� i y��!{! ± �5� ; �' �� '`� .e � ! q., i.: � i � _ I,Ji ? .I:._: .., T �n � �Jwl• m ` � :38. Final� Plumbing �i: ��N t •. .. w � e � , 1 I .;�l�k� ,_ ;.� • �-� e n�: r-i ..39. WaterService-Final' � 'i' � I i `7li i,��<, v t--u! .� -. ��.:z,a:.:,�:._-� � � i � i.: I { >� - �. ,..�..._...�i .. � . ., . .� s `:40. Gas;Service-Fihal .i, t:� v;ts�tr - r � �4 � ,¢, r�i.; 0 ,� �. ,•, - I RI �� , �x, A�-.r , } �41. SolarpomesiicPinal� ;"'� •� _ � i 1 + '� � ` li. � . .; �I 1" `� � J iv 4 tT. � j� I_' ! i� !A"e � 3'• t_ '42.�Backflow�Preventer.;. �-� ��i �K �� ! i jr � �� ._�.: ,_� .- � r -..�,i/�a, i � 4:� '!' � � li �i 'r,l-� _ PJ Y�r �i!'... � L� �. . -43. Backflow Irrigation� ;':=�-" : � �.i. � � ' u:� ,:� .' ' '-- ' '"`"�' �� ;;� i i l� �� :� � il � 4.-..�'� � r � � .,'�j:4`( � .,; � , �., � � _ _. .. ' ,_u: . �44. Landscape lir'igatiori SYstemy.;,,� 4, <� p� t7 �? �7 � :i u; !�� '>•-� ....�; �? j � `45.'Sound Attenuation' ,.i:: jr ; _ �-, � �;'�: ; r' i + �.•c� :-,�' : _ y.:.•� '�y . :!_ ITI ,r, rtl ! I -, �, W , �";i-I .i �.. ` • ,"� .� rl - f 1=1 � . .. � !. ; � .- .i � i ..� � : c.t, �xtv'. �.`46: Handica`p'RegNlatio�s ,_'i ;_; ,. � :;� u: i�^ .c ��o ,5 �r - 47'.-FINALSTRUCTURE&BUILDING � � I •'� ? ��-+.} ^ , � r-, i %'Is. � i �;• . r, ��48''FINAL PLANNING+ � �'�`' � � � ' �� `�� + � � i r-q-. nl � �"�,I.i 1�; t�i L t _� c49.�.Electric Release to Edison i .i � � �; v_ � �= '�J • ` � -�' - � iri ',. c =50,.�Gas;Rel ase to Southern California, Gas Co +, � '� � '� �� `' �"� `•'�• • `_� � - f ,�; .; I-, I_r G f��:f �, ; 51l CERTI FICATE OP:;OCCUPANCY' ' ` ,, : ;,-, ;-� i ,�. . , � r� _•,� No. Date � •�-- � fm a . y a' � � c �2 ' U Q u N y a . , . STATE OF CAIIFORNIA �. COUNTYOF Oranae- � }S5. � On this the � �q'4'H day of �iaJemher 1g 7J, bebre me Ne undersigned, a Notary Public in and tor said Counry an0 Slate, personally agonared ��t�� 1aY�'� � �ar'�'SO ✓1 an a�e.�2.r �u. S. !-Far�-so n FOR NOTARY SEAL OR STAMP to me or proved to me on tbe person� whose narne(� and acknowledged tha� . personally known satisfactory evidence to be the Scribed to the within instrument :d the same. Notary � �'.i�;.; `�� - - ��,� - ' ��T� ' , , i LIMIT TEMENT� E� STA F TO WHOM IT MAY CONCERN: RESPONSIBILITY i��TARIZA ' ;�' •'. ', �• 1•' Bidg. Permit # � � This Permit # 9a3 ,D�,� ��z� 3�3 - a9 Street Address � AP Number ,11�h�,.� J • -2�.v I, � 2� �� C�/✓ , as Owner in Title of the above referenced property, do here y authorize: � s� 1.--� ��. Street Address to obtain permits in my behalf, as owner/builder, for atthe above referenced property. c� 7 � 3 -3 `-� �' Telephone Na. Should anv nerson become an emolovee 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 Californie 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 indemniTy and hold the City of Costa Mesa and its employees or otficers harmless from any claim resulting in damage or personal injury to myself or any other parties. W �1�, �-Y..,. S �fl-��.> �� E�-� � 'I�Hzl3ow Printed Name VV ` ^ / ignature 0]]446, rev, yB] /J -/9 -�'C� � �,` ,r , �l n PFOJEC7 RO�PESS "' 9 O'j llFsRRELL ST � OWNEfl'SNAME:'HAR7`S�N - nooaess: g�3 DARRELL ST COSTA MESA � CA 926Z7 APCMIENGINEEH: aoonEss: nec.xo.: uNiT: uNir: PFpmiTTEE: HARTSON (719)631-3479 auoREss: g� 3 DAkRE1,L ST COSTA MESA CA 92627 LILENSEO LONTPRCTOH UELLFflAiION: I.neieby allirm Ihat I am licensetl untler provisions o� C�apler 9(commencinp wi�h Seclion 7000� ol Divlsinn 3 0l tAe Business antl Profes;ions Code. antl my I¢ense is in full torce an� ellec�. CITY LIC.: STRTE LIC.: CLA55: � Dale: � SignaWre: - . WOflNEflS' COMPENSATION DECLAflATION: I pereCy afinm Ihat I have a cetlili[aie ol consent ta sel4insure or a cfhifica�e of Work¢rs . Compensalion Insurance. ai a rerti6etl copY ��eieol (Seqion 3800. La�. C�. POLICY NO.: EXP. OATE: � . COMPANY: � ' ' . , ❑ Cetlilietl coOY is here�y lumishee. ❑ Cetlilietl copY is liletl wiih I�e ciiy Building �ivisioa ' - ' Daie: Applicanl: ��. E%EMPTION FXOM WOPREFS' COMPENSFTION OECUHATION: (i�is sec6on neea nol0e compleiea il lhe perm� is Iw one hunMetl (3100� oi less). '�� I certily Ihat in I�e pedormance ol Ihe work for Wpic� I�is permn is issue0. I shall nol empioy any person in any manner so as �o Eecome I su�lecl lo t�e Workers' Compen5aiion Laws of Calilornia. . � � Dale: - Signalure: ' NOTICEi Il..atter making Ihis declaration, you shoultl become sub�ect to I�e Workeri Compensa�ion pmvisions oi ihe Labor Code. you musi fon�with comply wilh suc� piovisions or �his permii s�all be 4eemeA remke0. GONSTNOLTION IENDING AGENCY: I �ere0y alhrm Iha� Ihere is a cons�mqion IenAing agency �or the pedormance ai.l�e work for w�i[� I�iS petmil is i<SUPtl (S¢CIiOn 3097. Civ. C�. LENOEB: aoonEss: OWNEfl BUILOEfl DECLAHATION: I hereby aifirm Ihai I am exempt Imm I�e Contrac�ars' Staie Li[ense law for �he �ollowing reason (Seclion 7031.5 9usiness an0 Prolessional Co�e: Any cily oi caunty which requires a Dermii to consimct, al�er, impmve, demolis�. or � repair any slmclure. O�ioi �o ils issuance. alm requires I�e aD�licant �or such Dermii to tile a signe� 5laiemen� iha� he/she is licensetl pursuam �o t�e orovisions o� ihe Contracmrs' S�a�e ticense Law �CnaD�e� 71�ommencinq vnth Seciion 7000� oi Drvision 3 0l ine Businezs ana Pmlessions Cotle) or ��ai ne/she is exemp� �he�elrom and I�e �asis lo� the allegetl exempiion. Any violalion o� Section 7031.5 by any aDDlicam br a permil subie��s Ihe apP�icaq��o a eivil penalry ot nol moie Inan tive hun�red dollars (5500). I. as owner ol Ihe D�operty or my emplayees wiih wages as Iheir sole compensalion, wi0 do the work, antl the ❑ simcWre is noi intenaetl or otlerea for sale (Section 7049. Business an0 Pm�essional Code: The Contrac�ors' Sta�e License law Goes nol ap�ly �o an owner.ot a pmpeqy w�o �uilds or imDmves ��ereon, antl who tloes suc� work himSElllherseli or IhrouAh �i5 oi her own employees. O�ovi4e0 Ihal suc� impmvenenis aie no� in�entletl oi of�ereU lor sale. tl, however I�e building o� improvemeni is sold vnl�in one yeai of [om0lelion. the ovmer vnll have Ihe bur0en oi proving he6�e Uid not bui10 or impmve - �or I�e purpose ol saie). , . I,as owner of��e properly, am exclusv>Iy contracting with I¢ensed tonlraclarsio consimcl��e pmlecl�5ection 7044, Business �I and Pmiessions Coae'. T�e Conlraciors' $�ate License Law tloes nol appty to an owner at pmperiy wtio 6ui105 or imD�ove5lAereon and w�o coniraqs lor suc� pmlects witM1 a coNraclor�s) license pursuanl Io ihe ConOacior5 Slate License Law). I am aware ��at O�oo� 07 Iheir Workei'S Compensa�ion inswance shoWd be proviaed lo me. � I am exempt unaei Sec�ion: B. & P. C. � Iot �nis reason-Q q • ' [/, // �a�e', � � /7 � / � Ow ' � ��(.f�.�J 4C� _ I tlo nereby cenify Inai I am aware oi antl untlerstantl Ihe repuiiemems of Calilomia 9llh ana Sale�y Cotle Senions 25505, 25533, antl 2553a ana ihat I or any fuWre builOmg occupant wIlVv;lll not (ci¢le one� nee0 io t Py wiih saia s�ate codes antl the requlremenis lor a permu loi consimqion or mo0dication imm ihN Air Oualuy Managemeni DislricL e5itleniial cons�mc�ian apDlications are e*empt �mm I�25E p�OVI5i0fI5 �� . Oa�e: AOplicanl: I Aere�y c¢�Idy �ha� I havP rfd0 I�is applifalion an0 Slale I�al l�e a�ov¢ inbrmdli0n i5 COrr¢CI. I agr¢¢ lo tomply wi�h dll Ciiy dnd COuniy oidinances an� slale la�n�s relaiing Io Dmlding con,�mqion and h Gy aul�orite tepreseniatrves o t�is cily �o enler u0on I�e a�ove�menlione0 propetly lor ipspecnon pmU05e5. /� 1�� ' p� 1/i(/Y�V° �ale'. ��' / / � 9 � , Signawie: . o�i�ers t�ce�se o� Social Secwny •: 164ba6 White—Bwlding: Green—Coae En�orcemev; Canary—qpphcanL Pmk—Revenue: GolEenrotl—Assessor - CITY OF COSTA MESA — BUIi.DING PERMIT PEkM NO: &N, 05000" PERNIT NO: BN: 050007 PLAN CHECY. NO; N',,' GOVT: N�SUPP: N, j� CONSTRUCTION TYPE: 5—N FF'RN,IT TYFE: MEC STA � FURPOSE:�OTH ' JOH DESCRiP'�'ION ; INSTALL 1 FACTORY FIREPLACE (ICBON3195) S�� FT; ` 1,000 CLAIM VALOE: 1,000.00 CALC—VALUE: 1,000,00 GRCIUP OCC: A-3 /M-1 . COMMENTS; SM�Y.E DETECTOR(S) AE�IUTAED IN HOME. �, ***�t�t-***r*rr****r*rr*+eft*r�*+t�r* ***�t-;��tffu�****��t*�*****ir**+t**�t*i�*�x*�**��**x�*r*�*�r Z O N I N G R E Q U T A E M E N T S , ' S E T B. A C K S . ,, , ------------ MAIN bUILDING ---------- --------- ACCESSORY BCtILDING --------- ;i FRNT; FT IN REAR: FT IN FRNT: ,FT IN REAR: FT IN LEFT; FT IN RGHT; ; F7' IN •LEFT: FT IN RGHT;. FT '.IN PARKING REQ� PROV: PARCEL: 42235309 ZNc; , REF NO: � ' PLANNING NOTES> � F . _; � , " " .. . _ . ' "" ' ' . . . if jE �f if 1f iE if if 1f iE 1f # iE iF 1E iE iF if if if 1E iF 1E iE iF if if fF if if f(� if iF if IE if 1f iE iF iE 1f if if if if M 1f if if iEif iF If M!k 1f if If if If if fE !F 1f if R iFlE if iF ik 1f If M 1f 1F M 1! 14 D E V E L O P M E N T S E R V I'C E S A E Q U Z R E M E N T S ZONING APPROVED HY � DATE: HIIILDING APPROVED BY : . 'DATE: • �,�) APFLICATION ISSUED BY: ' " �' f ' DATE• � ' � a�/ , iEiFiFlFifkiElElEitiflE�EiEiFlfRiflEififlf . F lfifiF�lfififlflEif% ffif �flfifififiFiEifififlfiEMiflfMiElEififlflflfiflFlfltfEiflElEifMiflfiklf�fifl4�f�1Fif1f 1E3EiEMMik1flEMiE*iFifiFlFiflElt#fit�fff±tififlfiFiFlfMitikif LEGALIZATION:Y ' F E E S U M A R Y . STRUCTURAL SEGMENT:Y " ` ' 'BLDG PMT PLUMBING ELECTRIC HECHANIC FIRE ;SMIP/RES " GRADING PERMIT 50.00 ` 13 00 50 � - - � '152 ' :SMIF/NON—RES � PLAN LSSUE FEE 15.00 BUILDTNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DU£ TOTALS----> 63.50 15.00 ,; ,.0.00 7ff.50 ' 78.50 .,00 REVENUE DIC�ISION TOTALS=—> COLLECTED: 78.50 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT •'GRADING PLAN-CHECK 50,00 ' 28.00 .50 1F if fF It Y.� rf �)E if if i(� iE if Y.� 1E 1f if if if if M if if 1E if � if 9f 1f if �: iE 7F iE iF iF M 3f if if M� ff �f 1E M iF k 1E aE if iF iF fF if �E 1E if if if %if it if k �f if 1F if M iF if dE ih if �F it if If k!f _.I N D I V I D U A L� F E E B R E A K D O W N TYFE QTY D E S C R I P T I O N UNZT COST TOTAL COST SFR •1000 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 1,000.00 : MEC 1 FACTORY FIREPLACE � �6.50 6.50. �END. QF FEES � � ' . . ' � � , . � . i �V 19 199 �i� . ' CITY OF COST, =' ;:<; -1A ' .- �. _ .___ _.._ . . .. . ,_...._. .._.._.__,... ,._...._.._...; CONSTRUCTION AND PLANNING - � , PO� _1 SPA. .. , , -APPROVALS Permit# - Date Inspector ppppROVALS Permit# Date Inspector. l. Temporary Elec[rical Service or Pole 52. Pool & E4uipment �ocation �� '" � 2. 'Soil Pipe�Undrgrnd. . �. 53. .Steel, Reinforcement , � � � � � .,�3.,EINctricalConduit,Utitity-Undrgrnd. � . 54. Forms � '4. Eleoirical Condui[-Undrgmd. " 55. Electrical Bonding %_� •) �-5. Steel ReinforcemenC' � 56. Rough Plumbing & Pressure Test � �. 6.� Electrical UFER Grnd. � � . 57. APPflOVAL 70 COVER-GUNITE � , ��-7. Footings � . � . . , 58. Electrical Conduit�Undrgmd. ' , �.. ' 8. Fqundation � . 59. Gas Pipe, � Undrgrnd., Test � . g� Wdter Pipe-Undrgrnd. ' - 60. Backwash Lines, P�Trap, 0 Undrgrnd. t0. Structural Floor System . � 61. APPROVAL TO DECK � . ' 17. Properry Sewer Line:& House Corinection � � � 62. �Backwash & Receptor-Final � 72. Sewei Cap . 63. Heater & Vent�Final . "' 73. Roo( Drains ' � . 64. Plumbing System - Final , "" �14. Rough Plumbipg . . _ � 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 FOfl PLASTERING - 18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning • " "" "" " FIRE DEPT. REQUIREMENT � � 20.'Rough Factory Fireplace • � � � APPROVALS�� Permit # . ' � 21.��Ducts, in, Structure � _ ' �, , . � .� , •. `90. Undeigcound.Hydro � , 22. Ducts, Ventilating� � � _ • ' 71. Product Piping OGas ❑Oil 23. Gai P,ipe�Rough &�Test � ' ;6. '-' ; � ;_j2, Undergiound Flush � . � �.: . � ` 24. Roof Framing� � • � . � � :' � � ' 73.'Undergmd. Storaye Tank � Gas ❑ Oil' �� -i 25. Roof, Sheathing �;, ; .. ' " �- ' ,',;.� ; � 7q,-pverhead Hydro . �� 26. T-Bar�Ceiling (Structural) &:Monocoat � ��' �"� ��i'i".� 75� pry Chemical '�� _ .i., - 27.�Frameand Flashin�: � "' � "' ' ' � �� ' , " '� '; �_. 76:� Dry Standpipe ;;, 28. lathing�& Siding � � , . ' !•:;';: � ;., '.. � ; 77 �,'FIXHD SYSTEM�FINAL � ., 29. Insulation ' '- � ' �� '„ ' ' � i; ; 78;.�FIRE PREV. FINAL � � 30. Drywall Nailing -� - I '��t� � HEALTH�DEPT: FEQUtREMENT ' 31. Nlaster Brown Co�at; . '' �� '� � ��; ; �.,79: FINAL INSPECTION '- � 32. Electrical:Power Meter,Final �� - r. � �,��• �� r•80.;=F000 CERTIFICATE ISSUED � „� � �c/Lrrrr7� D 148 �33.�FinalElectric ' ' ' `� • � „�� Notes: Q-L7-�1L�;�' � i'v►C. �Q,f�p 34. FinalHeating&AirConditionipg, � ; � .;, :i�• � (��s�lL Sir.(irW*J�• a03 �� (��a.� (�IEjn' 35.:Fina1 G�s:Pipe-Test'' ' -. � ,l �' _ . ' ; .. i� 36.�Hoodor�CanoPY;- ' � , .� �'� !i ' . ' � �... � • . . i ; � ... 37. �Final Facmry Fireplace,_, � ,' = � ,•' � °' ' , '" -38. Final Plur'nbing � �' � .. .- �., � � � .�,�r' � � . . � : �� . �. � �.39. Water Service-Pinal: � '. . ..'� . . .. .::' . . � . �� .. i; . , . .P'-" ... � �40. Gas Seryice-Final , , _ .�i•• - (• Qt � (�ji;� �� - - , • - 41. $olar pomestirFinal.: �� : � b � , • � � /:- 42.��gackflow�,Preventer; � ' '� :� i � �; �� "� ;;.'i , . . ;`.� `.e,, ��"".(: 43.6ackflowlrrigation� 'i:�:.:: � i '::;��-� ,' -s'.......;. � 1; r �'• j �•i:. � 44. LandscaPB Irripatiop SYstem�;��.;� , ��• �� ; , �� i-' � �� a ��: � � . �y . . .. , -.c?; . . �45.'Sound Attenuation� . .. � . . - _'� ':'. . - . - . . ;.� .' , �� .... � - � .i ,,, .� , . . ,..... � . . . . . �� .. .. � ::: . ; , , � , . � .-. � ��i - �, ,. ... , • � .� �.- ��.�. . � � ,. . . 46.' Handicap,Regplatiors , � � "� � � �0� � � : i i i':� i;� u; - __ ..... 47..�FINAL STRUCTUHE & BU�ILDING � � � � � �' "�' =�`� ' , ,.,. ��: � � �48.`�PINAL PLANNING� ' `' '' , I . �� ' '�' . � ,_, • . . �.�.i� . � i: .. .:49.�,Electric Release to Edison � � . I � j '', : _ ,�f � � - � . 50..., :� �, � - �� ' ' : Gas, Release tq Southem Califor�ia Gas Cn 'y , � 5� ;, ,, ;- �. � j,j:; 51. CER,TIFICATE OP;OCCUPqNCY , ' ., , , ,,,�_ No. Date OWNER �ristol Estates � oArE L-1.8-56 - JOB ADDRESS 9Z3 DBrrEl1 Str2Bt"� BUILDING PERMIT NO. 282� GENERALCONTRACTOR $.V.Hunsaker VALUE $ 8,856.�0 LOT 1{% BLOCK TRACT 28%3 Sin�le Res. W�fltt gdP ,__ GROUP I& J TYPE V ZONE �= FIRE DISTRICT 28l�6 / PERMITS ISSUED INSPECTIONS D TE SUBCONTRACTOR DATE I NUMBER � '. _ _ r""� � —{'�� Foundation - =Piumbing; Roug�. Plumbing, Roug Temporary Pole Wirinq. Rough Septic Tank or Gesspool/ Lathing, In Out Plasterinq Plumbing, Fin�al, Fixtures Plumbing, Fin.al GasTest Wiring, Final Occupancy FOflM 210 3M 10-55 to st. ./� .�� _ _�-� A - u\ � f!G �' / i �� _Giit�� `� `;:5� /C/�.✓ �v��:� Z _ a-a - ii .i i� U � . Q �� C);., � Costa-Mesa Bailding Department � APPLICATION FOR PERbIIT -"=`,. � P.O.Box3�� ` BUILDING COSTA MESA, CALIFORNIA 2�S � FOR OFFICE USE ONLY � ' FOR APPLICANT TO I+`ILL IN , Receipt No. Permit No. naaae� � Z 3 (�It22� Ll� S i . � v�.�e�- 0. Costa Mesa, California Receiv a ny� �� eo'Sy ate I �e� . Nearest j � � �a � �j%�� Cross St. �(,, Z��aJ //� v� . B' iltling _ , Address Owner�(� � S oL S -- ' ; Costa Mesa, California � ' Mail • nddress�'�� /�< j U/JF�� I 2• Nearest i Tel. Cross St City j �'� �i No. � -1/�� Zone ',I No.of I 7ype Grou�iv � Arohitector Lic. � Plans � Engineer No. Approved�. � ' b Date • nddress ' CORRECTIONS 'l City Lic. contrectorS'ry� UIiSA/L�/Z' rvo. Z Wg` / ' � Address S Le al Lo! / Z�r/�2 ' .i ` � � � Descr9ption I No. �`f' � I Block � Tract � .-- ; � c � � � (Attach Metes and Bounds) . � Size of Lot �e� � k � dQ� I No. of Bidgs. —� � . Now on Lot O 1 � l�seof ,_. I No.of I No.of � d, -- �7�0 Existing Bidg. Fatnilies Rooms '�� '\' � � � ��, -- - Setback �ine from - 1 Rear Vard Z ':' , p� i� �� 7� � S� � CenterofStreet C� SideVard , """-'�;}��" '�� - -•- ,%-'j DE5CRIPTION OF WORH ,-� , - _ r np�-1�R �:,;, : New ✓ I I Alteretion I I Addition I _-�„ �.... r�'.:-.+ ., Repair I I Moving I I Demolish I y '-�=1. -\ ' -- Building No.of y �1' UV�N^CVI�JhI . 6ize � d�� Rooms S Stories � . t1 Exterior Wall . I Roof •n�,� I Covering S'TU GLd Covering �L APPROVALS Use of Ne j� /, Foundation Location I Ins ector I � Date . euilding �j �Q l� �/k/i�� y �WCwi 1U�' parms, Materials, P - , r— I hernby acknowledge that I have read this Application and state that the above is correct and agree to comply Lath. Int. with all City Ordinances and State Iaws regulating building construction. Lath. Ext. Signatureot " Permittee Plaster, Int Aulhorized Agt. plaster, Ext Valuation Pe i! Fee $�L "Z„ _ 6 � Masonry Reinforced $ rj' ��j C9 � Plan Check $ � � • � O gond Beam 1S �P Total Q � Fee $ 33 • FINAL FOFM 204 IO�yS O. P. fl 5. d J a � a Street _ PLOT PLAN Show Ioeation and disCances from property Iine and between 6uildinpa � • ' ..�. .t'. ,. �. , "'I��J� ' � ' .i , T. - �..�� -:�;�.. , '-.. �.� = .. - � �' ' i -. � i 1'' f " __ , ,., � CD STt. �� !,�'�:J;`�E�� 4��'' �r;;.;b��-r r; % _ . , . - idES}t' u�� 3J.o� .j 1 :t' , ... . -- .� . � , i,:t'-� . I�� I �� -..i'i�'i��:,1 - ;«.. �+ �1. 'i . .. � .., ?. � , ,_'. I � ; I • � `/ . .� , ,! .. �:� 1 - ._; ��: . - � -�; . ' . , -_ . .. . . _ �. � i _. � _. t �Q �1 � i C:� i � � ' .... .. �:�1 . . ; . i 1 �� - . .. . . .\� i f . .. .;-:��' .. , _. �.','} �._. , __ ' . . . . .. , \'.ol � �\ f`. " .- ' i ' .0 ": ' '._ t . ' + � - :� : ' . . .�� 1) J,. `�,,' � � , _.. .- . i `, � (..1 (y ' ' .. Ci . - �, � OWNER ROMAINE, MrS. C. aos nnnxEss 923 Darrel GENERAL CONTRACTOR G2 nY No.115-583-09 LOT INSP�CTIONS coat � d . SEP 1 1 1962� TRACT RIRG ZONE -62 BUILDING PERMIT NO. 16`�S Y_ vnLUE � 600.00 n�scaiPTiOrr or woaxAdd Att.Patio Sign�ture I DAT� GROUP J TYPE �7 7.ONE � PERM: } SUBCONTRACTOR -T '�`''L 167i8. . CbSTA MESA BUILDING-SAFETY DEPARTIvIENT P: O. BOX 9f7 C08TA MEBA. CALIRORNIA For Appllcant io Fill In Complefely � TYPE OR PRINT - aooae's"s �'Z A� R�_"L `�' COSTA MESA. CALIFORNIA� OWNER'MI�S. �'NR�nt :� . M A I L /� \ a�� r_ �` nnnarcc 7 aZ 7 .V ' . J CONTRACTOR C(�.' p��' L•' / O,�S � � ADDRESS z Z� Y f' A�Z �� Z �� v� ' CITY �-• � • � � . • � LIC.TNO. / / � • �I NEO. ,ry � � -` 0� 2 [i OF LOT IO�O �Y I\1 V I NO. oP, e�Ge. r�ew oN �or � BBiBACK LINB RROM DESCRIPTIOM OF WORK 81ZE ROOMS � STOF EXTERIOR WALL - ROOF � ' � COVERING COVERING� U O BUILDING AND WORK TO BE PERFORMED a i� s � : cc 2� i�.�.� n= _ �ii.a.<T �, . f'., � r a I HEREBY ACKNOWLEDOE TXAT 1 NAVE READ TH18 MPLIGTION AND 9TATE THAT THE ABOVE 18 CORREGT.AND AGREE TO COM- PLY WIiN ALL CITY OPDINANCE6 �V1D BTATE LAWB REGULATING BUIlDINO CONBTRUQ�ON. � SIGNATIIRE OF . PERMITTEF � l�'JRG�= 'J�O ��CS " AUTHORIZED AGENT'�/�� / �� FEE RECEIVED: � � MAR 1 41962 - ; � . � FINANCE DEPT. . CITY OF COSTA`MESA APPLICATION FOR PERMIT ' BUILDING - For Office Use Only wece�rr NO. PER r+ . COSTA V ZONING " � I NO. OF � I U86.OP NE' PI..�NB Bl11LDIN� � A. P. NO. � I S �' J C1 �� O YARDS � ' . , EVES APPROVED ALLOWED (CENSER LINF 8TJ ' . ��- ' � APPROVED a :G1 THE AMOUNT BXOWN'UNOER VALUATION IB FOR TX¢ PUqPOBE OF. EBTABLIBHING A P¢RMIT FEE ONLY. VALU ION �'.//__ ^ n . pERMIT FEE $ � / ��'� vv r $ � PLAN CHECK $ `�— TOTAL FEE �� OWNER �g�$ON� WILLIAM J. DATE 7-11-7� JOB ADDRESS 923 Darrell Street BUILDING PERMIT AP No. ll- t5 -0 LOT TRA INSPECTIONS Si n SOIL GAS WATER ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. � SPfiINKLING SySTEM - MISCELLANEOUS FOUGM HEATIryG ANO AfF CONDIiIONING TEMPORARY SERVICEOR�PO�E � y UNOERGROUN� � POWEH � ROUGN WIRINC � TRENCHES PORMS STEEL NEINF. F1.00R SYSTEM BONO BERM [, STEEL REINFORCE � SHEATMING �y � �Q FRAME ANO FLRSHING ' / LRTHING — IN OUT � PLASTER,BR6WN CORT . STRUCTIIRAL, FINAL E MEATING, VENT., REFRIG. ANO A,C„ FIN�L PWMBING. FIudL AN� G�5 TEST rI RACTOR . . . ' . . . . . ' "f ' . . . ' , . ' . . .. t''. . . .. . . . . ' � - - -q /�� . - ' � . . vntu ' ; ' - . c��-1�L . . � . � �!.II: 11'77rn:c•:��i.Q79:� ::i:7r•;.��_l�.• � ' COSTA MESA BUILDING-SAFETY DEPARTMENT . �� . � ., . . P.O. BOX 1200 � COSTA MESA, CALIFORNIA 92626 . ., A L A ON FOR STRUCTURAL PERMIT ` 'For Applicant to Fill in Completely — Use lnk Only ' IiE E D TE EC V E SU ' BUILDING '. �� , A C 1 ' DORESS , / �- A.P.,NO. � � 3 ER IT NO.- OWNER � I - � O/_ . ' . MAI� _ . ' . . . : BUILDING � �{� � ' ADDPESS � � �+DOPESS �� a' � - rTEL. F y. .� . 5�.� ` y ' GT.V1 -; ,�l19.�:. �rl"-!.�'. ' NO. Y i� . � y: �� f � � TRACT . � �'. LO � BIOGK . � CON5TRUCiION ' ' ' ' � NEW AD� .A � �R P � :LENDER l,. , �,• �tc'-.,{ q _�i '.�' � A. 7- '1 . , �r.i, ��.� . ,� i . ' ?BRANCM� 1� .+.` - .-4);":i . l�3.. .i. •.a" � `" ,�.�- ./ ��C:TS.v,��\.}. � �• . ' "' - � •OWNER T ! ADDRESS;, ' . --.. ~- , i ' ,`'. '/� �u- � yALUE � -��.y� �� .. " "� AFCHITECT. - , �•` � �•��•'•r TEL .• r- , , JUS .V //WI7 � NI . 5 c./� Ro. ' � " OR ENGINEER . NO. ' . ' ' '. .(.t�i:�:,� �., •. . 'FIRE�,..'� .... . "` � � ADDRESS � " .�?-+ ZONE.'. .PE � �'�GROUP �:V�Ii..A� "'��- ". ��! ..APPROVED � i , �} �ONTFACTOR w'. �d '�J ^ � +. {,J��Nr �.BV '..0 DAT . - _ ` • . • '� : t p . . ~ a „ l r �' JADDRESS7': �,S<�. - ' � I ..:: � � \ :� � . : •. _: « : � .`� . , g. � � - �TEL.' - � -�' ZONE� '�T• NO.OF'�`� USE OF,NE '�� " qTV � ' . . � �NO. � ' � - J PLANS v BUILDING +..� � STAT,E� � ��I'1 � � "��.''-"��?� `CITY n.� i � -;.�'AFDSAPPROVED�. 'YAROSAPPROVED � � CIC. NO. ` LIC. NO._ ' _7--�� 'MAIN BUILDINGr �'AC`ESSOflV BUI_LDING ;' . {a�. SI2E � � _y.��,�r _ , NO.OFBIDGS. � (FROM� /LST E � ` 0+� ��OFLOT 1L,;w NOWON�LOT`�, }y/+I . RONT - V�r%*' FT. - 'l . j*P.`.=i i i' r 1 aUSE OF `_ ' . `�. .. 1 - ' • i J i,N,. � �,EXISTING.BLDG. � � � � � �� , � „ , ..-.. ,_ _,,.. , �� •. ... _ (' - ' FT . . ^^t . - f'r. �� ..,:.CY ' �'.�•�• r (�7,/ (4c+ . :� f ' S� . Separatepermits�are�reqairedfor ` � LSIDE FLV j� ` ' � .�FTt � F � l._ �;• , -._ � . elec[ric, plumbing and fieafing�work: .� i�� ' /! '-�' �; � � �l _ � • . Ci � .REAR-- �" FT.� ��F.T.'� - W USE OF BUILDING AND WOFK TO BE PERFORMED - , - � F � . DISTANCE�BET. BEf.,MAIN & � QQ � " � MAIN BLDGS. ACCESS. BLOGS. , `1 � VAR.�` . DATE . � ` � C.U.P.# ' APPqOVED . . Q , - � ' . . APPROVED � I'�-�/f � � . ..1 . ' . . . . � , .. , . 0.� W � p 7 hereby acknowletlge thet I have reaC this application antl state ' _ � � , � y� that the ebove information Is correct antl aeree.to comply with , � � � ell laws reguleting building constructio'n, and I shall not emplay - ` .• - ' >. z. any person in violetlon of the workman's compensation �laws of ' ' - " d- Sthe Stete of Celifomie. � � ' ' � � ' ' � m ,3 I hereGy certify ihet I-am properly Iicenud es a contractor untler SQ. FT. rv, - ffie State at Califom(a'Businass and Protessions Code„Division 3„ _ THE AMOUNT SHOWN UNDER VALUATION IS POR .m „ChepSe� 9, antl that such_licenses are in full force and eftect, o� I THE PURPOSE OF ESTABLISHING A PERMIT FEE ON Y: � am exempt fYom She provi5ion5 of the5tate of CelifOrnla Busine55 VALUATION .PERMIT FEE $ a- antl Professlons Code Division ! Che tei 9. � . ' �n � . , m , Signaiure of � .' , � 0'O PLAN CHECK � E "� 1H/� �� o Permittee � 5 / �TAX � . . E .-�+ LL . V � u. . �AuthoAzedAgent . - - .•"' ' - , � . . TOTALPAID $ � \' . . ff� S' � n � 14 P ��r+-...='2"S!"'._�.."r" _�_ _ ..._ .F.- .._.._..=..__.f' � �': 7_—'�."__.. ""' � . . .,._'1' . .. ' . � 101:.o�..�j �.-�1��-+-....� r. � ;r.r . __' "`�__' ""�.._""_" �'�'``f"".. . +F?Y� . ' �•,��.�. t , � �. � � �_ .. � '' r- _' . o '�bGK � .�_y�y m �.. _`�_._-_-, :r—f sa �e ..� i_�,d Co.or.�. fu. C .' 7 �. I1 �t `S'i� �� r. � � cr t'. 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