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HomeMy WebLinkAbout925 DAHLIA AVE - Building Permitsi� 1 � �i PNOJECT AOOXESS: � OWNEfl'SNRME: y%S DAHLIA AV' aooness: BAILEY, MICHA:.L E HAILEY LINL�A A 9Z5 DA.�ii3A AVE COSTA ME5A,CA 92626 APCMIENGINEEN: NEG.NO.: noonEss: UNIT: uxir: � PEflMITTEE: ' � aooxess: MICHAEL BA L'LEY ( 714 ) 979-5$06 925 DA:-ILyIA AV n q LICENSEO LONTflACTOH OE6'lAA T10N� 1 heGrEUy a��irm tha� I am Iicense0 untler pFo�isionYol��pter 9(commencing with Section 7000) ol �ivision 3 0� Ihe Business an0 Pmtessions Cotle. antl my license is in full force ana effec�. , CRY LIC.:, STATE LIC.: � QASS: . Date'. SignaWre: � WOHNEPS' COMPENSATION OECLIIBRTION: I �ereby aifirm ihat I have a certiticate o1 consent ro sell-insure or a cenilicate of Workers' Compensation Insurance. or a cenifie0 coDY Ihereol (Section 3800. Lab. C). POLICV NO.: . E%P. �RTE: , ' COMPFNV: . , ❑ Cenified copy is Aereby Iurnishe0. ❑ Cenilietl copy is filetl wi�h ihe ciry BuilJinA Division. �ate'. ApplicanP. ' ' E%EMPfION FPOM WOPKEBS' COMPENSRTION OECLABATION: Qhis secti mpletetl it Ihe permit is lor ore hunOrcd (5100) or leu�. I ceNly �hat in �he pedormance of �he work br w�ich this permii i' ue0, I shall ¢mploy an De�son in any manner so as ro became - SUGlect la the orkers' C mDensa�ion Laws oi Califomia. . Date: � SignaWre: � NOTIC : If, after aking ihis declaralion. you shoul Oeco e Workers' Compensation pmvisions ol tAe Labor CoOe. you mus� fotlhwith camply wi�h such pmvisions or Ihis permi� shall be Oeemetl revoked. CONSTflULTION LENDINC AGENCY: I hereby affirm thai Ihere is a wns�mction lentling aAency for �he pehormance ot �he work �or which this Dermit is issuee (Section 3097. Civ. C). IFNOEN: FODNE55: OWNEfl BIIILUEfl OECLFBRTION:, I hereby ailirm Iha� I am exempL�mm �he ConVadors' S�ale license Law for Ihe following reason' (Section 7031.5 Business antl Pm�essional Code: Any ciry o� coun�y which requires a permi� Io constmct, al�et, improve, tlemolish, or repair any stmciure. prior lo i1s issuance. also requires �he applican� lor such permi� Io �ile a sipned sta�ement ihai Ae/she is Iicense0' pursuanl io �he pmvisions o� ��e Comracmrs' S�a�e License Law (C�ap�er 9(commencing wi�h Sec�ion 7000) o� Division 3 ol ��e Business anC Pm�essions CoEe) or Ihat he/she is e�empl there�mm an0 i�e �asis br the alleged exemplion. My hola�ion o� Seciion 7031.5 hy any applican� �or a permii suUle��s ��e apPlicanl �o a civil penalty ai noi more �han tive hundre0 Oollars �E500�. , , . . I. as owner ol ihe Omperty or my employees with waAes as'their sole compensation, will ao ��e work, and ihe ❑ s�mcWre is not intended or ottered for sale (Section 7044, Business antl Professional Code: The Coniractors' State License Law Does nol apDly �o an owner ot a pmpetly who Oui105 or impmves �hereon, an0 who does such work himseli/he�self or Ihrough - �i5 or her own employees..pmvitletl thal SUCh improvements are no� inten4e0br ott¢retl tor sale. I�, howevef �he OUilOing or impmvement is soltl within one year o� complelion, Ihe owner will have �he burtlen oi pmving he/she Aitl no� Uuild or improve lor Ihe purpose ol sale). I, as owner ol Ihe pmperty. am exClUsively coniracting with licensetl wntracmrs m coreVuct the prole�� (Section 7044, Business ❑ antl Pwlessions CoOe'. The Conirac�ors' Stale license Law Ooes not apply �o an owner ol Dmperry who Omltls or impmves Ihereon an0 who coniracts lor such pmlec�s with a conVactoqs�license Oursuant to Ihe Conirac�ors S�a�e License law�. I am aware Ihat pmol ol II�eL Worker's Compansetion Insuranca shaulU be pmvlde0 �o me. QI am exemp( untler Sectio¢ � 8. 8 P. C. � far�hisrea n: BP%O4�} � j �A1.L WORK BY OWNERL.R���y�n. . (��� Date: Owner: �� I tlo hereby ce fy ihal I am a are of ana understan0 ihe requiremenis oi Califomia Heallh an0 Safety Cotle Sections 25505, 25533, anA 2553a an0 ihal l or any INure builtling occupant will/will not (circle one) nee0lo comply with saitl state cotles anA tAe reQuirements lor a permil for cans�mc�ion or motlihcation �mm �he Air Ouali�y Managemen� DiS�ricL Fesitlential conSVuc�ion applications are exemp� �mm I�ese pmvisions. �ate: Ap0licanC 1 �ereby ceriify Ihal I have reatl I�is applicalion and Slaie Ihai Ihe above in�ormalion is rorrecL I agree Io comply wiih all ci�y an0 county orAinances antl s�atelawsrelatingtu �uiltling consimclion antl hereb Il�wi�e�req sentaiives ofihis ciryto enierupon�he a�ove-mentione0 ' pmpetly lor-i peclion rposes. ' - � �alel ' Signaiure� /) Oriver's icense or Social Secunry M: � � �� ��,� �.� v� ' i6aba6 Whi�e—BuilOing: Green—Cotle EnlorcemenC Canary—Appl¢ant; Pink—Revenue; Goltlenroa—Assassor +• CITY OF COSTA.MESA — BUI�LDIi�G PEkMIT PERMIT NO; B U58329. PLAN CH�CR NO: N CONSTRUC?ION T,YPE: 5—N PERMIT TYFE; STR JOB DESCRIFTION. c REMOVE SHAKES & REROOE WITH CO,MP SHZNGL& PERM N�: H Q583:4 GOGT; N SUPP'; N PJRPOSE; ALT SQ FT: 3,540. CLAIM VALUE: � 3, 500, 00 CAI,C--VALU�; 3, 500, 00 - CROi7P OCCc; R-3 /,u-1 COMMENTS; INCitJDES 3'/8" CDX PLY O/EXIST, SHEATAING � �'�������(��T�}� �*at�-*�at*�rx�+t-x�-*�r*u�*it�+ex+t�iF�**��r���*,�*��i*x���*k*�ir*kx�*�-���tti'r�x�*±rx�ie�i 7r - . Z O N I N G R E Q U I R E N. E� N T S: ' ��pUIRED �� . . S R T A A f K fi � � FRhT FT LEFT: FT ,�2AIN BIIILDING Zt� REAR; IN RGHT; i --cT Y IN FT IN --------- ACCESSORY HUiLDING --------- FRNT.; ; : T IN REAk; ' FT IN LEFT; rT ' IN RGHT; FT '-IN PARKING REp• PROV: PARCEL: 9121833% ZNz:, REF NO: PLANNING Nf5TE5•? . . , . : . _ , _ �'k'�- ... . . � _ ➢' . iF ie it'�F 3EiE �F iE iF if 3f iE iF'f,3F if jf 3E iE jE iE �f if IF if if �1F �Jf !F if iE ik �f iF 34 iE af � iF if i'r 3e 3F %� iE iF if # iF iE'r� 3E 3f if if if IFlF dF-!E �F iF 3E aF iEdE if','s�('iE if )f �1E ae1i� iE iG if 3F D E V E�L O P,N E N T S E R V I C E S R E Q U Z R E M E N�.T S 7UNING APPROVETf BY „ ; ' llATE: ��' BUTLDING APPR6l�ED BY ; ' ' � ' DATE: �' ' ' � � _ __ _ " APPLICATION I$SUED BY; � DATE• ,�2�� �— ififif�ii-iflFiF'7F1EiciFiffi'i{'?f'*iF3fifii'3fi! Y'�iF/F ' `-�'TifFh� 7�n '£iFiFiF3h1f�i43Fif'1Fif'iEY� ft%'Y: ac'I(' iEiEiffEiEiEMaEiF?riEiEififif•if�}Eiei1�)f#iEk#F#FitM.�ilihifii�iFiFiEfFifitlfiEif�IfiFiFiF '�iFiE+fiFiE#ie#if-a6leieiejt�aciElf•iF14iEiF'4iF�iFiEii�lFii��Y.�i%a(-� LEGALIZATION;N ;, F E E S D M M A R Y S,TRUCTUftAL SEGMENT:Y - . � , , . . . ' . ' . .V1 � , $LDG PMT ?FLUMBInG 'ELECTRIC MECAANIC FIRB SMIP/Rc5 G�ADING PERMIT 63.00" � 50 r�. Pi,AN . SMIP/NON—R=S'� I5SUE' FEE' ' ` . , u L'o. BUI�DING—DIV—>. FERMIT .S55UE PLAN—CHECK TOTAL' PA�TD. ��' DUE TOTALS=---> ''63.50 O,QO 0.00 63,50 63.50 ,pd REVENUE DZ�ISION 1'OTALS--> COLLEC.TED• 63.50 OVBR/S30RT: !�{00 BLD53P00 PLUMBING ELECTRIC MECHANIC FiRE SMZP/TOT� GRADING PLAN-C�IECR � � . , � ,�. 3F �1h3f.3F if iF f4 i(, 7F 1f 3f 3Elf� fF i(� if 3f 3f if fF If ik IE i(� N� iF'lt #. 1F iF ie if 1f i4 iF jF iF iF#� if N-if iE �lf � k if -lE #f iF iE i4 iE 3f if� 3E�f ih i4iF if fi �lf iE iE iE=f.� af # 1E iF 1E 3f ?F,�t�� �lE iF 1E :I N D I V I D U A L F E E 3 R fi A K D O W N ''��+ TYPE QTY D E S C R I P T I p N UNIT COST TOTAL'.�CO$T r_ SFR � 3500 REkOOF" BY C'ALUE RESIDENTIAL NOZONE I.UO • 3,,5,0(Yjs00 � ENU OF FaES , ; F, , �r � . i ' e i r,o i7a;as-0012034U "E' � T ',3. `,:j DNTE� 0?/28192 TIii�: OE:1� � CONSTRUCT�ON AND,PLQNNING � ' � '• . - � _ .^� PV�� & SPA � ' _ . - - � � Date = llnspector ' � � Date -��Inspector `:tAPPROVALS Permit;#, - APPROVAtS_ Permit#'. � �,'t.�Tempowry!Electrical Secviceor Pole - - �. � �52.;Pool &cEguipment�Location�, � _- . ��``� ^ � 2.�SoilPipe-U�ndrgr�d. ;' _ y ' `s�-. ->� �53.:Steef�Reinforcemeht` .. _ �'j`�`' �� -'�,'i � 3. ElectricalConduitUtilify-Undrgmd. � -�-�! � . 54.��Forms��` - ' � `" ..� - k f 4. Electiical Conduit�Undigrnii. , .'; � �' ' � 55. Elect�ical Bonding� ' � � - - ° 5. Steel Reintorcement . ' �' � i• ' �: � _ " 56. RoughPlumbing & Pressure-Test - `"t � _ ' . 6. Electrical UFER Grnd = ' ?�' � 57. APP..ROVAL TO.COVE�R-GUNITE - 7. Footings - °- � ?�� ' S8. Elecfricat Conduit-Undtgmd. ' _ 8. Foundation ,� �' - � ` � 59. GasPipe;O'Undrgrnd.�;Test � ..,+ - ,i 9. Water Pipe-Undrgrnd. _.� • r�.j� _� 60. Backwash Lines,;P:Trap,�0 Undrqmd. - ��^� _ 70. Structural Floor System �' �� � ?� f, � °� � = 61. APFROVAL TO DECK '- ' � . ^ � � - / i- �- 17. PropertySewer Line&�HouseConnection `u" � 7�.-"''� ' ' . (1 �.. 62. �Back�vash & Receptor�Final� ?'� � ' r� 12. Sewer CaP - . _ .� : u - ` � � ` � � , , ; 4 �� � . . ;� � - j s 63.�Heater�& Vent�F.inai C . 13. Roof Draini ' _ . T y � �� � ' 64. Plurriti n`gg System - Final- - � �, � �� ' 14. Fough Piumbing� . ' � 1' ` 65. Electrica�-Final. `� -� � L i5. Rou9h Eiectrical-Conduit ' � ,' _ - : 66. Sola�:System�-Final' � � ,'r�'= � � � �-16. Rough Electric WiringE � - � _ � 6�.,Fen,cing & AccessApP�oval � � p � r 7�. Rougb Wiring Sign ` ' � - � 68. `APPflQVED POR�PLASTERING � 18. Rough Electrical�T Bar;Ceiling " __ , 69. �POO,LLSPA SVS7EMS�FINAL � . ' �- 19.'Rough Weating &=Air'Conditioning` --' `-`- _ � � ' - -' FIRE�DEPT.-"REQUIREMENT�' "- - " ' 20. Rough Factory Fireplace APPROVALS� Permit # � 21. pucts, in STCucture , " �. 70. Underground Hydro 22. Ducts, Ventilating � .. �7. Product Piping � Gas ❑ Oil 23. Gas Pipe�Rough & Test � � 72. Underground Flush - 24. Roof Framing 73. Undergrnd. Srorage Tank O Gas ❑ Oil 25. Roof Sheathing �� 74, Overhead Hydro � 26. T-Bar Ceiling (Structurel) & Monocoat �� • � - 75. Dry Chemical - 27. Frameand Flashing " . .' 76. Dry Standpipe ', 28. Lathing &$iding . . �• 77. FIXEp SYSTEM FINAL 29. Insulation � � . 78. FIRE PREV. FINAL � 30. Drywail Na�ling . �; •�~ HEAITH DEPT. REQUIREMENT 31. Plaster Brown Coat .' . i 79. FINAL INSPECTION - 32. Elecirical Power MeterFinal . ;. 80. FOOD CERTIfICATE ISSUED 33. Final Electr�c . � j�:� y��Notes: ' � 34. Final.�Heating & Air Conditioning . � - �'f - � � , 35. Final Gas PiPe�Test ' � � � � � _ � ..� ' . 36. Hood or Canopy � ;I �- � , � �i• 37. Final Factory Fireplace . ' � L.r _ . 38. FinaFPlumbing . . ' . 39. Water.Service�Final � � 40. GasService-Finai . , .. , ' - -- 41. Solar pomesiicFinai � . '� � . 42. Backflow.Preventer -�� ' � - � � . - . ..43. Backflow I�rigation . - � - 44'. Landscape Irrigatfon�System . �� � � � _ � � � - � � 45. Sound Attenuation • �- - . " 46; Handicap Regulations , • . ' - - � ' 47. FINAL STRUCTIJRE &�BUILDWG !( G�'Z �6!- �� _ - � 48. FINAL PLANNING • " ' - � � ` . � • . . 49�. Electric Release to'Edison , �j � � ri_ G+,� _ S�� �� ��'y' . 7'v �_ (f'- � 50�. Gas Release to Soutfiem California Gas Co j(�.f ��, '� -. � 51'. CERTIFICATEOF-OCCUPANCY � ' No. Date : �Y.-: =--... - � . ' �`} , � AVP"cPEtReMIT'NOall spaces eacept thoTRACT NOavy'boraeLOTeNO a sign a I,aBLrpopriate tleclarations _ _ � �.,, , � , �_ --.� - � .STA MESA� ! � j � � �. .7- -5 - ��' , � f' ,.� , � C �i CTION,PyRMIT i i."i {, r L �: r,� '. � E. �— �, �{' i G c. , � � �� I .i ., i,r., � , i �;•1' { ,f � � ,i f .• � �' > . , , . . . • , . • . - , - � w � j � : i . . , PrO�ectAddfe55' � - � , �•:TYPE�OFCONSTRUCTION ^NEW ADD� ALTERATIONr �REPAIR� ' � �� �9Oc�E� 'LIII'9/liL �� .I^��'r7%T�, APPlicant s Mailing Ad� ess � .`' � - � � � .� COIV V ERSION rO DEMOL ❑ Orl-`E � c � � '. l " . _ ,.'-; �A P. # � � � � •��.- - S ,'._ � Zonei . I - ; � �.' k, . • . � ._� �7,�` ' • ." ,���� ,�p C.DESCRIPTION'OF WORK �G^�� '� � � � � Owner s.Name r fi-� /} � P . _ � �."Phone�s.-^—"v�-�% ,. ,� . s, , � : . - i ' o -- a .. , n, � � � ^ i . ' ;n - � � t - � �r ' , �� . , . , ', ' S, Main Bwlding:., � -' �Accessory Building i . Z -9.:�s-.Y�/Y��iF1' ,w ^- :: .?:� _ ` � . _ . e ., � �o +`•.:. Addre55 n ^� � . � � ,� � . TVPE OF PERMIT. , '� �GRADING ❑ FOUN�ATION ' � �STRUCTV RAL - C ' T^ Froni -; � � , n. � �S , � r � f - � N �Ll� /�-- _ � O TENANT ❑�ELECTRICAL''� ❑ PLUMBING �O-MECHANICAL^, � B. ^ � •t � � I 'Arch/Eng �1 liA/�i �e+ ' License No .� 4 ` � 5 . . i .•. � -. . � � ` � Rear ;, { r• '.�. .i � ' ,"� rI ; " . l, � � [.s'J' i ' ' Addre55� •.. - t . _ r � ,- . .: y '.Q .OTHER '� : " � _; . i . A . . N : Contrector s Nam ' � �yPhone ��- 4 8 � , PpOJECT DESCRIPTION � 5�. FT. � " ' �' � �OCCUPa V � ' - i C: Right � � x � , � � , �� / , i, _ �. t' .G , ' Address (m i n�l � %1`J� � �I�TE ✓�r /J. - . � . ' � ,' � . � a�n Ks Left: . 1 � y� ( 1 , ' L .. f, o � . . ,] � �� � . E i � j�yQ •D� n/'jy� CONST.RUCTION TVPE � VALUATION $ L' ,$' y ; �, `�f ' � . , � .:t' -J�� =, � �� ��ZONE�� � •� � GRADINGGU.VDS.' ACRES �pj� Ref.# 9 `; ' � Park.Fees ' U f � ' ' CitY License�No: " � . • . � -. ' , .s . i . � . . , 9. . I ,. r �' .�, $ f G .. LICENSEDCONTRACTOR'DECLARATION .i : � �' ' :. ; Remarks: .•�•i;•. -'S! y�" i � � ",i �.P2rkin9Req./Proditled � �. .r � i : ti i. a • �- � I�hereby,�affirm that'I'am Ilcansetl untler provisions o� Charteq9 (commencing � : , , , _ � • \ with section 7000) of Dlvision 3 of the Busineis antl Profeszions Cotle„antl i� ' � , � j � ! �' _ r� 7 �' '� - � ` ;USeof,Bwlding:- i p 1 ,j • � , .{ , :1 ' "�� � � - R , . \ mvJicense is in tull torce and ettect. � � � .. . ' i . i ° ' -i � ' . . �' � . . ' 1' , ��" � E � �D `.Icenie�C ss� '�/ '- ienseNo.�3�-S9G�n � ' , ,', ' PLUMBING �., .FEES, :P�annmgNotes:. ' ! ':i � ' E � ,� ate��/� 5 9 t •. ' . • / �� r .. � ' Bar Sink � � Showers ' f - �� � i ' . . . , . '' . � • ; � N . . JJORKERS' COMPENSATION DECLARATION.� � � � ' '� • • , � 1 . V 1 ,T � \ I bereby'affirm that I have a certlficate of consent to self-insure or.a•certilicate ' - ' ' !,. �-,... - F- .- . . ' -.� - ..S . Of Wo�ke�s' CompensatiOn Insurante, o� a certifleC�copy there f(58cti n v ' Backflow�Preventer^' ��rServiceSink'*' -, �� `t• - .'��—" \3800, Lab.' • � -i ' �^ - ' Backflowlrrigation SewerCap, , , r - ' � �' � ELECTRICAG ;� d♦ � FEES ! , Policy No.��, in�_K3 , ComPanY� 4� ✓%. ( - `• � i Certified c py is nerety fumisnea. ••' �� ' ( 4 Bachtubs . Sewer Connection' � � �Automatic Washer � ; Transformer, � 15-50 KW • ❑ 50+KW erti)' tl cop flletl with the uty qu�1p In9 D on. ,. . . -. . �- � �NL[,iy�._ ' p(�� � Y . . Clarifiers � Solar Collectors ' _ � � �Construction Pole Sub. , �� _ i_ _ . , ., _ . �.' oaie y.t AOPIIcant� . �.... _ . ._. ... , ... -� .. . . � EXE fF�710N RO WORKERS' COMPENSATION DEC RATION DiShovaShEf t� ' � Solar,Pi m '� ` t ' ' � �-' � (Thissection neetl not be completetl i/ the permit is tor one huntlretl (E100) or ! P 9� t Cooking Unit , • Meter ❑up to400 ampsti }• less) ' ' � ' ' < < � � + .. Drinkin Fountains � ' � � � � ' ' I certify�that in the.perto�mance O( tM1e work fo�,whlch th15 pe�m�t i5 ISSuetl; I 9 �} � Sola} Tank !- . i- .� Dishwasher � � .� Meter �Dover 100 dmps .r �� f � Sha1P nOt employ any pe�sOn In any mann¢r So a5 to becOme subject to the � . •, � ' • '' ' ' . workers' Compensation� �.aws o( Caiitomia.� . � . Floor Drainsy. . �� � Swiwinai.�-Reei-w/Spa ON� ' Dryere �Gas ❑Electric Sub Panel' � Date t ... � . ' . Si9nature'� '. . . ��1 . , .�� ' _ . , . � . . . . : � . �' . NOTICE:If,�after making this tleclaration,-�you shoultl become�subject to�the��� -; Floof�Sinks'. -� � • � - Ufinal-• --� - - ' -- �� Fan'• ' � ' ""�'- � r � - Workers' Compensation provisions,of ihe Labor Cotle,you-must.torthwith _ �. � � Mo'torsOO-1'HPO1�/x-8'""'' '"1'; comply with� such o�ovisions or.this,;permit shall betaeemetl revoketl.'.' •� GasService �Outlets, -WaterCloset .� `�� "1 �'F.q�,U. : ' InaSolar�9-15HP�16-15+� CONSTRUCTION�LENDING�AGENCV � � � ' �' ' ' ' ' ' - I hereby attirm that there is a constructlon lentlinq agency for the pertormance � � Inferceptors I' - . Water. Heaten � �. � -;Fixtures � � . oi the �work for which this� permit is;issuetl (Section 309]' Civ. ;G.) � � � ' - ` � �Mictowave { , Lentler's Name � , M � Kitchen'Sink Water Servme ' � � . � � � , . . Lentler's �Atltlress ' ' � � � ti � .� ,Device Boxes � Pole Light;. } , OWNER BUILDER DECLARATION' � ' _ , � .� .,. . � CaVaiorie5 . 4 . - i: ' ' • _ � " Outlets . • ,flange . I hereby affirm that I am exempt from the�Contractor's -License Law toi tne' p. T�a � '' � - followin9 reason. (Section 7031.5 Business antl Professlonal'�Cotle: Any dty or P. ' �:' ' I' �� ' _ l t+ Swi[ches � ' " '$ign � � ' � ounty which repuires a permit to construct, alter, improve; demolish orrepair , . � , y _ . � � _ ' _ � ry structure; prior to Its'issuance,�also requires the'applicant for such permit � r- FooffDreins' ; p� ' -� '.Y ' ' Garbage Disposal Standing Sections ' ' a tll¢ a signetl statement that he/sh¢ is licensetl pu�suant to the provi5ions Of " , - " � � 4he Contractor's License Law (Chao<er 9 (wmmencin9•wlth Section 7000) ot 'f . ; ' ' � ' ' � ' , , _ � � ^� Generator �0-5 KW 05-15 KW Trash Com ac[or �"' � ' Division 3-ot Ihe Business antl� Proiessions Cotle) or that he/sne:is�exempt . _ . .� � �. P • therefrorrm antl the basis tor.the alle9etl exemption: Any vlolation"o(,Section � - , • 4 - . � � - - , - , �7031.5 by.any applicdnt for a permit Subjectr ".the applicant to a civil . - " . ; � . ' � ' ' � - • . ' - ' • �- enaity ot not more Ihan five huntlretl tlouars (g500). s� � � Remspaction Fee � � � $25', .' ' laue Fee � �$ 3� � I, aS;Owner of the.property O��my employee5 with wa9¢s;as th¢rt sole ���,ReinSpectiOn Fee $25 '�uue Fe i �$ 3� compensatlon, wlll tlo the work, antl the•structure is nof intentletl or otteretl < < •-. -� MECHANICAL � , FEES - � � for sale• (Section ]044, eusiness antl' Protessional Cotle:1 The Contractor's - -: PUBLICSERVICES REQUIREMENTS: � . .. License Law tloes nol apply to an ownef o( a plopelty who'builtl5 or Improv¢5 � BOil21�' . . ' HOOd O� . Type I'❑ " .. - , . . �- � thereon; antl who tlOes such work hlmself/h¢r5elf or through his o� he� own - - �� . ZOOIng Approved By - � Da�te ' � employees, provitletl tM1at such Improvamenis are noi intentletl or offaretl for , ^- ,. Canopy Type II, ❑ �� � . . Duct - Under Ground : . � . " ' • j .•i � sale. If, howeveq the bulltling or improvement is soltl within one year of mm-' . . . Building Approved BY . Date pletion, the owner will have fhe burtlan of provinq he/she tlitl not builtl or im- ' . • � ' -� Duct - Structural . Refri eration S stem ' A lintion Issued B' : / � �rove for the purpose of sale). i • � . � ; 9 Y . C. PP Y ��' � Dat 1 as owner of the.property, ain exclusively contracting'with Ilcensetl con-� - , �,��, , - i tractorstb construct the project,(Section �044,,Business antl Protessions Cotle:,,;.. . . Duct = Ventilating ❑0100,000 BTU ❑100,OOO,BTU � : . .. � SUMMARVnTp FEES� � � , . ' ' The Contractor's License l.aw does;not,apply to aroowner oi•proper[y who . �� , � . � �' ' r � �� SV �' , � ; builtls or improves thereon;,antl.who contracts for such praja8s with a com 4 Exha sYSystem �� Multiple �� System Repair/Alteration ' '; BUILDING PERMIT $ SMIP; $ �� � , Vactor(s) license-pursuanrmSne Contractor's License L.aw1:' .n �;"� . � - . � � PLAN CHECK :$ � � l/. %" t' ' ❑ I am exempt untler Section �' '� � , e. & V. Gifor thls reaion �'� FrepllFact. BIL ICBO # � � ' � � . � P.ERMIT. 1� �� - .., , . . . ' �- ,�.,. � , . ��' _.,_ . :• � � PCUMBING � '� S �'w-CL ISSUANCE ' $ ; Date ' 1D �� Owner. ' " 4 ' � . -:a � '� ' Hearin'gSystem&Ducting i ' ' .i � � �' pLANCHECK �25%i$ - ENERGV.PC I$ } ' � -I hereby certify.that�l' have�reatl this�appliwilon autl state'ttiat tne above-.- 04100,OOO,BTU O100,0006T� - - . �- � - - � - - 6 , .1 • )� GRADING� , t$ ' �� '1 iniormation Is-correct. I agree to comply„wlth.all city�antl munty ortlinances � • � � , ,� , ELECTRICAL ,$ � . , , , � antl'state�laws relating to bwltling�construction,�antl hereby.authorize repre- n �r1 �� , ' � � MICROFILM 9$ �. �„sentatives ofjthisfaty enter? p �jthe abovementionetl pro erty or , �� '� � � ; '� � _ � � ' • ;_�PLANCHECK 50% ;$ • ' /�q� �, inspection.purposes. �' ' � /"`� -� "� � ' � � � MECHANICAL � � � lp�tT� i' �Si9nature' �+ � ' " ' � � Date �' � � .e � :. , �' . �§ ' TOTACFEE .. `$ . '� . , $ � t� - T � . „ Reinspection Fee �$25 � , � �Issue Pee � � . $ 3 �7• PLAN CHECK ,25% ' � . y � a Drivers' License on55.�. . � i . ._.... __-.._... . .._...�. ._ . .. . . ..._. .. . . .. . _. .. . . 1 CMF�0865-46 rev. 12/83 White - Builtlin9; Canary -APPlitanp Pink -Accounting; Goltl¢nrotl -ASSesSor . � ' � � �. - - ` ��:' � �" - ` , . �y �`�-�:` , ,•'�CONSTRUCTION�AND'PLANNING `a j�: � � ,L & SPA , , , , , �,. , ;' � ' � � Date � �Inspector � �' ' . ' Date Inspector'., APPROVALS , Permit�#� ` � APPROVALS � Permit # . - . ; , 'c ' ' 'i' _ - . - - , TemporarynElectrica`I SeFvice drPole.,� -�� �� '` � 52.- Pool & Equipment Location 9r), �'�' '�^^' - ���:��1% '! I �:q. - _ ci2s Soil�PiperUndrgrnd= c =�! � ' �' `' -. ^rf� �- � 53. Steel ReinforcemeM � }. � r _ i �,A : - � I �. ��_ : • , . .., � - • . . C � 3: Eler,trical�Co�duitlUtility-Undrgmd;.� � ''t ' "Y� . 54. �Forms . � \ b,'j ;' . •.. .' e , , _ .i . �. _ _�' � �'' 4.�Electrical ConduiriUndrgr,nd: � - � � 55. Electrical Bondin � � � � i , � , -� rn 9 ; . � ' � r 7� ` M1 5. Steel Relnforcementy+'{- � �� � � "; 56. Rough Plumbing & Pressure Test �� � 'v � > .l ` � ),' . �, 6.��Electiical'UFER Grnd:'' ;�., � J' . . 57.' APPROVAL TO COVER-GUNITE: u -� v I; - 2"�' -/!' �.. 7. Footings.if- .I � ;.��;q, ' r ,�' � �� . ;�.. ��' - 58. Electrical ConduiriUndrgrnd. � �i'-7-�j�J � ,�� � ' % 8. Foundation' �. '� °� .�% � � j� . � ' , _ 59. Gas Pipe, O Undrgrnd., Test� � _ � - � '�r'� r :.,. z:, �. - ,y�, � : �•; -� Si .d. •n, 9. Wate�• Pipe-Undrgrnd.� "� � 4' .t'_� %� 60. Backwash Lines, P-Tra ❑ Undr md. � :�� i, �, � �: . . P, s S- �: v y�V-. ' �10.-Siructural Floor System �- �.� : _•��'� "� � � �` � � 61. APPROVAL TO DECK �C- - � � f/, '� 17. Prope�ty,Sewer Line,& House�Connection •� ���; ;�, � 62. �Backwasli & Receptor-Final - � � �,,, �. �.. ., . 5 z r,v 12. Sewe'rCaP ,,�r� y� . L I' �t}� �tii' .. - 63. Heater &' Vent-Final .�..^''� . /.�:! , 13. �RooF Drains ': r¢' �,�-r . ': �; ' � l� 64. Plumbing System - Final � _ . ' ` �� � i � ^ 94. Rough`Plum6ing„,,� �'�' �- • ' �-Y :{ � -� 65. Electrical�-Final � -� � i� . � �. =�15.��Roug�fiElectrical�-Cond'uit��,'-"��� - '"� � 66.SolarSystem-Final ' �, ��� -'. �. . •� ���16�-Rough:Elecf�ic Wiring! ,.�. � _� ', .' , .� "' . " - ' 67. Fencing & Access Approval ' � , . + -_ �'17.``Roug yWiiing',Sign'; ,`'. � . . � � � 68. APPROVED FOR PLASTERING � , � `L� � P 18. RoughxElectrical�T'Bar.Ceil�ing� � ' �' � � 69.� POOL/SPA SYSTEMS FINAL ��/� �^� 19: 1Roui�hrHeating & Air Condi foning� � , • FIRE DEPT. REQUIREMENT . �` ._ h _ - � � � � , �' 20' Rouqh.Factory Fireplace' ��� �, - APPROVALS Permit # - � i �'21.' DuC[s,�in Structu�e�; ; � j�i� � � � ' •�, ' 70. Underground Hydro � � � k22. Ducts,iVen{ilating � � t- �� , � i � 71. Product Piping �Gas ❑Oil � , . � ,,,23�Gas'Pipe-Rough & Test �_' • . - ' ..� . 72, .Underground Flush � � � .. ,�, i:`2�4.,�Roof Framing`, • � � : �; ,, t � , - � �^ � :. � 73. Undergmd. Storage Tank O Gas ❑ Oil - ' • ! �� ';� 25. �Roof Sheatfiing �. � � ' � ,%•�{ �' - � t : ' �74. Overhead Hydro " � ' � � �- � 26.�T=6ar Ceiling (Structural) &�Monocoat - S ,75. Dry Chemical � � . � ' ?P=27? Frameand Flashing;.�� ,- ��:; " �� t • { 76. D,ryStandpipe � � � � � "� 28. 'Lathing & Siding' ' . '�' _ � � , �77. FIXED SYSTEM FINAL � - r � �_ , 29.,,In'sulation - - � _ ' � � � �� � I •� 78. FIRE PREV. FINAL � � , - : ;30. Drywall Nailing ' ��'r"""' ' �� ' �� � HEALTH DEPT. REQUIREMENT � � .�-� ;r31. �Plaster Brown Coat �,.; ' i' � � 79. FINAL INSPECTIOM _ t `32. -Electrical Power Meter=Final ! �;� � L�i 80.' FOOD CERTIFICATE ISSUED � i '� �"33. Final-Electric ' � • ' , � 'Notes: S �-gy' �(�(ZOY L D . C S N127/I/6 � 34.'Final•Heatirig'&'Air�Eonditioning�> • � �. � � � _ C.aP OC= �i - t' c0/ z1_ ' 35. Final Gas Pipe;Tesi ' = ' `',' 1 ' � � w •7 h ' �. ' !- 36. Hood;or�CanoPY�. 1 .. f �. _ � , � E . � - . . . � . ' -. �- 37. Finil�F.actory�Fireplace � � : ' . � � . ' . o' 38. Final�Plumbin9 � .� ;. .' � ! �, � _ . 39. Water'Service=Final� � � � . � , ' � - • ` n : -r � 40. Gas Service-Final .� �� • � ' . r ' ' � 41". Solae Domestio-Final• � � � � ,- . ` . ' �• 42.�Backflow�Pre'venter` . ).'� i i� � ' � '., • • . " � . � � 43..Backflowjlrrigation�; � �- . � � . . , . " . �, , • (�•+ , � � �f�: - _ �,.„,..,i,..,.i;-.•, �. . . _ . • ' i . -�44. ,Landscape;lrrigauon System � - . .` � _ , f �� 45. So,u�nd Attenuation� ; t (' ' � �- y . _ . I' �46.�Handuap,Regulations � {� ; , ' . ' � � � . . - 47.FINALSTRUC{URE.&BUILDING q }-_', '. � ' .� �� � � . ''.: . , � � � r ,. . , 48. Special�R'equiremenis Completed, � . � � � � . ' ' .:i :.,: � i � � i �, < .. , . � ' i � -. . - . .. . . , . ,. 49. Electric.Release to Edison I� i .� j ' .:� 50. Gas Release to Southern California Gas Co ;� ' � � t . ` . � � • � � � � :�' , 51. CERTIFICATE•OF;OCCUPANGY `'--� � .- - �-- - - � - �� � "��..� � + - • ��t _. _. No. � .,. . . -_.y 'a� Date• �:; ..�,� M� t- ,. ' , . ' 1 . . . � ..,,. �, . - -'`- - - - .. . . . __ . . . ,_ . . ... _. -- - -- - .. _ . . . ��,� � , �. , � • � _ � � . . - --�-- . --:, � - , � ., ...__. . . . ._.__- - - ._.._. ... ._ --- I-Z.Sf�j%i�G�f% Iluil.din& ' . � Address ��� /)f�%Jf%� � (�mer ��J�,r',��; Contr�ctor �.��� ndar�ss r.. - Pecmi[�Ua[e ��-,L���Number � Issued CITY OF COSTA MF:SA � DGFAR7MP,NT � �r BUL6DINC SAFETY Registered Deputy iluilding_inspector Ceitificate of Conpllance ��3'�� Date of this CertiEicace To the Director of ISullding Snfety: �"'` - I hereby cei[ify [hat [he following portions of work on the buildtngs a[ [tte ahove address which required continuous inspection and which I was employed to Lnspece, were inspecced by me and comply wtth--the provtsLons 'of the Building Code applicable thereto. . 1) Concrete 3) Wclding 5) Sper.ial Cases 2) Masonry � � 4) Heinforced (�ypsiun Swimming Poo1 Size �,2�(��',.- - Gunite �� tiand Pack Sacks Cemen[��p"_� Tons�of Sand_�_ _ Apptoxima[e % of,wa[er ln aggrey,a[e_����_ This report covers worl< comple[ed durinf week ending S^_�-��.. RL•MARKS: . � � 4� � RE(� S'CF;R D . TY RUII.DING INSPECTOR / / . N:une � �� I� � ZL=L.i 3 A, �i1 h—N, . Add[c9s ' UI�I�GR�a ��4�H . t. / . . � Lnbora[ory T�Lyrt/�,c� � Telephone � � ��j��(� Foxm BU b ;: <�� � � - I . 64' ' _ . _ ., rF�o lU2:i�8 ' ',3�Or�aig , ; .i;UC'15-72cr�snOO1�013� *** , t °, - ,-401CCOSTA MESA BUILDINGSAFETY DEP.ARTMENT � � � ;r . ` . - . � . F.O:.BOX 1200 ':COSTA MESA, CACIFORNIA 92626 `�_ _ „ , , � ` � � BLICATION FOR BUILDING PERMIT . ' � ' �For.Applicant fo FiII in Completely �' �'^: . RE I V � V'. DATE RECEIVED DA E ISSUED' - � BUILDING ���7 , . . . .. „ /' ' � �� � � � 7 ' ADDRESS p� � `� f9��`�[� . ' . _ �. . . . ,- . � ' �,. v'n. ': _ , . . y.r . , c 'PERMITKJVU ' ' owNea arw' ou he n a' f. Inc. A.P: NO �_ �� � ' -BUILDING ^� �.,ADORESS-.LGZSS VBRCl1Y3..BIVCI�. � ,. �y' . �+DDRESS o� ` - a cw.>.� � ciTv. Encino, C811E. ' ' � � NOL�9HC)'HH9O ' `TRACT�, �I,� '� LOT, BLOCK � ' ZZ " -Q,' ' CONSTRUCTION' '. �^-•: � -0 '�'�� . • .. ADD A R P . _ o N �eNoea .r• Larwin Southern Calif. . ' � �_, �eaArvcH ' 16255 Ventura Blvd � ' > "� , ,y, � �,'/ �+ . : �' .J tn . �. . - . -OWNER � N �� C C� ' . Q W � .ADDRESS , .. � ,�. , L .. . " /Q . 0] J ' � .�.'i! .'' ' �J , yALUE �(0/� . m� ARCHITECT .�. . i.� TEL '' S �'G—� -. 1'/�. T%«�(�— 3 " J Q� ' OR ENGINEER'-. L8YW1R _,,;+ r� ' N, Z�3-�F�FC)�F�' '. ' U� � .� . -.. ... - . ._' . ' . �FIRE � %� - Z'a ' �:ZONE TVPE V �GROUP W� nooRess 9100 Wilshire Beverl� Hills . w Z CONTFACTOR LdYWlil S011CE10iR C311P . ,i ByPRO DATE � �7 J� . . . . - ' . . • . � . m'- : .: . ' . .. .. .. ' '. . .. . .. . J� ADDRESS 16255� Ventura Blvd-_ - � '� � � ` � � '� ", .. " `� `. " _ . .r j�/ / w w TEL - � ZONE NO OF', TUSE OF NEW �/U I / v' Z� ciTv .Encino,'Calif. No 986-8890 __ �',. P��.� BVILDING W h �R .. W'�, ��STATE' .. . ' CITVr "'� �ARDSAPPROVED. - VARDS'�APPROVED � , � K . LIC. NO.'191311", +� LIC. NO - B_ 1''. _ MAIN BUILDING • ACCESSORY BUILDING � �O � - -r - - '�IFROM_GLST EET) . . SIZE .. . . . . . NO.OF BLOGS. " ` . ,. : . � - Of'LOT ' GS :X. JO ' � - ' NOW ON LOT� O' "� FRONT ' � FT. . FT. ` ' USE OF - ' - ' ' ' " ' . � � ' EXISTING BLDG:: " � � � �' .S F � FT''-.. . .. ., �.... . , . �. F� SI2E OF. . . , ... _NO:OF : .. . . ..... - . . . .. .x - . .. .. Z NEWBLOG. 1-784 �� ROOMS - �� STOFIES 1� r1.51DE - 'FT.-' • FT. ' a . EXTERIOR WACL ,. " ROOF'- '.� '. ? �� �- � � � •V COVERING �$ O�� + COVERING d':�`'Shin� le.�'' -Reaa�.. �T."' _ 'FT. ' " i , 'r. J�� 'USEbF BUILDING AND WORK�TO BE,PERFORMED' " . DISTANCE�BET: -� BET: MAIN & " � ' - a. - ' . . � , " MAIN BLDGS: - ACCESS. BLOGS. � - " ' . � Q ' . . � . '" VAR.�i-` � , �; _ . DATE . . ..' , O . :. .:. , '. y. �. . • . 'C:U.P # ..i�, ; ;. .. APPFOVED _ ) F . . . ' . . APPROVED ) / �L '7 FATE N" }L' v� o st uct sin le famil dwel`lin w. O� . � � ' ;.V I�heretiy�acknowletlge,ihat'I have read,this application and state�� HOLD'FOR`SPECIAL RE UI ' � =� �'ffiat the sbove intormation .is wrrect antl agreerto comply with _ , � -all laws'regvlating building consvuction,'and I "shall not employ � ... � .. . , Y'; : F- � any ,person ,in violation of the workman s compensation lawrof � ��" ', y, , the State ot Calrfornias � -;�� " . . .' � � . ` ' � ��'j '- � / - . � . z J hereby ceruty that I�am properly I�censetl �as�a contractor untler Q SQ..FT. `�d o� . . _ 'rthe State ot California-Business antl Professions Cotle, Divisicn 3, � '- THE AMOUNT SHOWN UNDEF VAWATION IS FOR �� ._ "�Chapter.9, antl that,such licanses are in full force and effect, or I'� THE�PURPOSE OF ESTABLISHING.A PERMIT FEE ONLV: m' ' .� . � am exempt from.the'provisions ot the Sxate of Cilitornia Business • .. , �, VALUATION � m � -antl Professions Cotle, Divisian 3, Cha{iter 9. , . .,� �, _ ' . � - � O�� N � .. .� PERMIT FEE $� � ) .• s� - . ' SiOnatureof /\ ' � - ' 'Q�C.�'. ' ',. Q�Q m �/�/� J D. Downs � . Permittee �d/Ji]_ L�,� - S. �G _ �� PLAN CHECK $ . E �` . � , o`-. . . � �. Authoriietl ABent '; . ' . . � . . � � � . . = ' j LL . ' - TOTAL�FEE $ L �� '