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HomeMy WebLinkAbout993 DAHLIA AVE - Building Permits_ _ �, _ _ _ _ _ __� , _ _ _ _..,__.Applicant to.tiil in all spaces',excev� those_within heavy.�ortler-lines anO�sign�all apD�opnate�declarations. --.� ._ . ---__� .-�__ ,_....._. _r...' ._..----- .. _ . . -; . ..,_. , _._ _ _. _._- --�.. �.---} q� � c � 5/ 1,4 j95 I { f'pQG ; -TL � CITYOF COSTA MEj$ � C�(�jj�� ST�n.RUCTION PERIVIIT , i . �" PER f��i� S� SR4ACT NO � LOT NO. � �UNIT�NO- i> `y �G � _ ( �- ; t� ' S • G ; j „� p� _ , ' �' '� ' � �' ; - Project Addr`ess � �`/-� it%/% -//���� � � .� �. ' • � : � � Y � .. . - i ^ I r" � ��' j t' � . f ) : r- � r. � Ji"J � j � � r `' � � T ' 7 � ' � _ �' � I TVPE OF CONSTRUCTION� NEW � ADO �ALTERATION� �REPAIR ' t �; i " = ! .> '. _ � i : _- G i' ; i�Applicant s Mailing Address, - � a ' O �DEMOLISH O OTHER � f ` ; ' � � " � ' i' . " • ( . � ' f i ', ' t .; Zo�e i ' 1 `' , {� q /�� , '0 CONVERSIONti � ' A.P: # � � - r . � .. �' ' ` � Owner s Name�. � { /�f6�1= ��Phone � ' " • '^�� 1 - ' � " ' T i i -DESCRIPTION OF WORK/USE,OF. BLDG. " + ' - � � , . .� Aiidress� . ' . �� ' f � " � � � �. � r .: � � . 1.=; . ' .- � r . ' � . . f �. � `. � a = t r � � : S Main Bwlding 'r E i ' , � � � �Accessory:Bwlding � �'r j �� _ � �� � ' - .l '� 1. i � f . _ . ! r j Arcli/Eng._ License No" ' �= TVPE OF PERMIT r . "' � � T.. � i'` , � . „ ' � I � � + �. �- Oi : � � " � - � '-�� GRAOING• � OUNDATION ' STRUCSVRAL� 'n Frant � E i � �'� � ` Address{ � � ' � . � � � s�-TENANT ❑ ELECT.RICAL,�VMBING �❑ MECHANICAL� , � � I "B� Rey� j � f" i'_ ; }' -y , _ � p _ I . �, ; e:'1 �� �N - � 1':� �OTHER ' `.. : = c, � _ i � `. 1 ' a � .. ' �A . ' ' _ . 1 n �"' � � 1 Contiacmr'sNam P ne� ' � � � • � y . , .. . ,., � C Right � ' ' t �� G ' . ; <' � - i ' '� N� M t � PROJECT�DESCRIPSI'ON 5t3. FT: ' � • � oCCUaANCv � - � - ' - ' � � 1 . Address (mailin �) ' � ' � � � � �K . . _ G _ 9 � ' . � ' CONSTRUCTION TVPE � " � VALUATION $ � � I 'S L¢fD � ^ �. � � �� . c_: � < - . � CitV, License No. ! " ' c.: : ' ' f i � , i , I :'- 3 _ ' j . ' ' • - . . ; '- R 1 �ZONE GRADING CU. V,DS. I ACRES � LICENSED CONTRACTOR1DECLARATION i � ' � � � 1 � - � ' ' � . . , Ping. Ref. # � � 1 � � � Parking Req:/Provided, '_ , � E� ,, I�.her¢by at(irm Na[�I am I¢ensetl untler provi5ion5 04 Citarte� 9,(commencing � Remarks: ; '� � , ! � � I � ' f '" Q' � � ', r � . '� 1 v y � P.lanning Notes: t i f ."t �� - I ' M witn section _]000)'of Drvision 3 of the Business antl Protesslons Cotle, antl � � mY license.is in h �e antl effect. I 1 • � ���p � i '- � � ' .� .' �. r , � i i(�Yny - '- � Ti , Y �-�1- : ` S' i LI<ense ss' • ' � i e . o: ^ � � ' ' .. � l " ." �' 7ate' - �Si9natvre� ' S , ' .. . PWMBING ' '� '.FEES � i ` ' � ' i i �� t�� `' t� + '�-� i f VORKERS'COMPENSATION D CLARATION, '� �� � ' � � � ELECTRICAL � ( 1 FEES �� Bar Sink • i , . � � Showers ' ' � ; - : ' ' � I he�eby.affirm that I have a certifi[a[emf con5ent to Self-insure o� a certifitate � . � � . . ` ; . � � • � -� ' � , - ! , � -of-Workers'- Compensation Insurance; or-a certifietl �copy th r ot f5ettion� - "' �^ -+ — ""• —T' '- "-- -� " � " '- � � � / � i f� � � � Backflow Preventer i " , Service;Sink� ; ! ' ' Automatic Washer , ; t i � �Transformer ❑ 15-50 KW ' � � 3800, Lab. n� �j '/ (� ��/ �{�/Q�� ' � \ PolicY No. �`�.'/��'/��J ComPanY�{�-��`�'---� � Backflowlrri ation, 1 - . .• • j ' � 7 �, ' ; .� SO+KW i �i � �ertified co � . 9 . � � Sewer Cap + i � i Construcbon PoleSub , . j i � py is hereby tumishetl. ; ' � ) CJ �Certi 'e p tiletl with the, city il 'ivi i ' � , � Bathtu6s � �- i ` i Sewer Connection � �' � � Cookmg Umt ��' � Merer ❑up to 100 amps �. � ! Date Applicant � � � � - � � - EXEMP ION.-�FR�RKERS' C 5 ION�DECLARATION• � - ' _ _ Clanfiers.,. ,_ F _ �:. _Solar Co11eCtOrS+_. - ! - {. - i.�. - .Dishwa5her- � - � �-- , — - --- .Meter �over,T100 imps��-- � — � (This section neetl not be campletetl if tne permiryis for ane huntlretl ($300) or, t ' ' �� Iess). -t , , i • � � _ � � . � . Dishwasher ; ? � � Solar Pipingl ' , j ; , Dryers, 0' Gas ❑Electric Sub�Panel } �� . t I ccrtify� that�m the performance of tne work tor which this perm�t is issuetl, I , � ' . ' ' : , . ' -' � - ' ' . ' shall not emoloy any person in any �manner so; as to become subject to.the � �. �rinking Fountai0s ' �- Solar Tank � ' j . j � _ Fan' . � ' � ' Workers' Compensa[ion Laws of California: � . � , �. { ' ' ' ' _ . ! �{ �ai 1 � �- Motors�0-1 HP O1% ,8 , � i , Date � � � � Signature � ' � '� ' ' - � ' � . Floor Drems �� � - � � � Swimming Pool w/Spa� . + + ' - � � � �'F.A".U. ' i � `InaSolar,�9,75HP�1615+ 'NOTICE: If, zfter making this tle<iaration, you shOultl become Subje<t to�the � � - � � ' �- i � �- � . . , � � � 'Workers� Compen5ation"provision5 ottthe' Labo�'Cotle; you must forthwith �' 'y' Floor�Sinks" .�� �,-- � � �U�indl r� ' �~�! i � � �r . Fixtut¢S' � � � � � � -�_ wmply �with; suchpp�ovi5ionsN or..this.permit� sM1all �be; tleemetl �evoketl. . • � ` -' � � � i � �, MiC�ow3v¢ � i � . 't . CONSTRVCTION� LENDING�;"AGENCKs � •^. � C� � � -' � � ) , `�- Gas Serv�ce�` r OUtICtS �` • '� Wdt¢f CI052t G� ( �. � `� 1 I L� � � ' _ � r � ` Lhe�eby a(fi�m that there' is a construction lentling a9ency tor the performdnce � � ' � � � �' � Devic¢ BOxES � I { ' POI¢ LIPub.� '� ' of� tfie �work �fo� �whichi this permit� Is. issuetlT�(Section ��3097�, Civ iC:) { Inteiceptorsj _ r 1 � � � j � .Wate� Heater {' � '_ � .. � �! � � Outlets �. * 1 1 �� , Range�� � � Leniler's Name't ' " � _ . �. � . . . , . . . . _ � ._ . I � � � ' ' 1 .` Lentler's Atltlress ' f' i � .. � �; � '- � a : :, 1 �' � � ! Kitcheri Sink � ti( i �a, '4 i ;. '. c � ' ~ � � :� : ' -Switches( ' .. t . OWNER BUILDER �ECLARATION � • � - � '= f �. +• � _ � _ ; W�IBfS2/vic2 j �I • , - *. � � � I ' f� Sigp � , • � �.- , _ �- � ' i ' I herebyaffiim-tliat 1 am'exempt from the Contractor'z Licenie"L'aw foG the � C Cavatories: 7.; � j�;• i ' Auto Wash „^ ��_� j t: � �,c,.�'�d� �, GaFbage Dis osal- � ,� }' � � � ' � ' � � 'following'reason (Section']031�.5 Business antl'Professional Cotle:.Any cirybr { ' ' - - � p i; Standing.Sections � � r - � . . ,. , i , � V � { •, . � ' . county ,which requiressa petmit to construct, altCv,-,imp�ove, tlemolish or repait P T�ap x ' � � f ; `�L2und� T�d 5; , �, t' 1+ i- ��" � - ' -' � "'any structure, prior to its_issuance, alm requires'the applicant for sucn peimit i ��T' ' r t Y � V Generam�r �0-5 KW �5-15'KW 1 - f Trash-Compactor �. �-� 1• �� ' b tiie a signetl statemenbthaYhe/she is Iicensetl�pursUant to the provi5ion5 of � i' ROOi�D�di05 C' , ` � � � �} ,' � � � f . �, J - � `� � � , - � ' � ' ' � he Conbacror'S�Cicense Law (Chapter:9 (commencing with $ection 7000) of � . - - • - � � ' � .� � � �, '1 i' � � ; � Oivision 3' of Ne Business'antl Profe55ions�Cotle) o� tna[ he/she i5 exempt � +- r � ^ , � + - � � ( � �therefrom'antl the basis for'[he alleqetl-exemption. Any�violation of Sectlon � - �' ` 1 � C' ' ^� - ' � � = , t� ' • , � . - . � . ` .' ']031.S,by any� applicant tor'a pe�init SubjeG[5 the`applicant=to a civil � ' K � � -� ` � + ^= � T ' � �' 1 - � - .� � '- � ' � � � ''i _ � `< 'r „ .�enalty of;not more than five huntlretl tlollars($500). _, ; � � � „ ; � .. . � - - ^ � ' _ ' � � : � pn � � �. ' �- i � ,,- � -. {. f ' LJ I,-as owner�ot the-propertyior my�employees with wa9es as theu sole �* �Remspec[ian.,Fee F. �$75 ;; � Issue Feev' � f; { $^3 j 'compensation, will tlo the wo�k, antl the:s(ructure. is,not Intendetl or offeretl ' - �'� ' ' 'for sale (Section;�04a, Business .antl Protessional Cotle: The Coniractor's � � s, p' � �� �MECHANICAL � �' j ' x. FEES �Reinspeetion Fee i� j�$15 i .� ! luue Fee� S i ; �$ 3 � License'Law�does.not apply.to an owner,of�a propariy who builtl5 orimproves ^ • � � � - , thereon� and who tloes such work'himseif/herself:or,tnrough his or.her own f . - - � _ � � . � . . DEVELOPMENTSERVICESREQUIREMENTSi ( ' • � � � ' employees, provitletl that suchpmprovements are not intentletl or oRered tor i � Bmler ; ' � � �� Hood orj Type I. ❑'� ; C` . t- - ' ' , � ; sale. I(,�howeveq fM1e builtling or improvement is soltl within ona year of com- � ' Cenopy � Type II ❑ 1 _ Zoning ApproV¢d By �� � � � Date � �'�� ' plefion,�the ownet will have the bur0en ot Proving.he/sh¢ tlitl n0[ builtl o�. im- , DuCt - Und¢! Grou�d � ! ' , � �"� - ( • � � , � ' ' ' . prove for thelpurpose of sale). j r .; � � I 1 - ' � ' ' � � � - Building Approved'By � Date � , ❑ I, as,owne� ot Ihe propeiiy,�am.exclusively mnl�acling with liGeosetl mm � Duct-$t�uctu/dl � � i � Refrigeration $y5t¢T � ��f ApplltetiOn ISSUBd 6y � � � � Date 1� ' iratto�s to construct the Oroject (Section ]044, Busine55 antl Protesslons Cotle: f - I � I �' � � 1 The_Contractor:s:License_Law_tloes not apply..to.an�owner.ot;property.who._ ., Duct-Ventilatin � �-•-----� -- OO-100,0006TUwO100,000BTU -- - ' ' ' ' I ' � buiws or improves thereon, antl'who mntracts lor such projectz with a com' ' � • 9 � ' � �' � � - • - _ � �� t 1 (, ,SUMMARV OF FEES � f � { {� + j. � tracior(s) 6cense pursuant to me`contractor's License Law). I zm awaretithat � Exhaust5ystem O MWtiple O� � System Repair/Alteratwn • � ; BUILOWG�PEHMIT $� � � SMIP '$ 1 � �� ' � proof of their Worker's Gompensation insurance shoultl be provitletl to me.{ ; ' - i � � � 'p�qN CHECK � � $ � � PERMIT �. • j � ' �� ❑;1'am.exempt untler Section e. & P. C. for this reason � � FirepVFact�Blt ICBO`#� � � �Fire Dampers' ' • � ISSUANCE ' : � �. . . .� . . . ., . , . . . 7 � . 1 1 PLUMBING $ � .� 1 f $ - . ; � � Date � F E- owner� ' ' % ' � ' � , Heatin9 Sys{em & Ducting j Reyister,s } � ! � , ' ' ' ' � � , _,. _ _ _ . • PIANCHECK� �25%' $ � f ENERGV�P.C.� $ � j. I hereby ceitify thzt I�tiave'reatl diis`application antl etate that ihe above � �❑0.100,OOOBTU��100,OOOBT • . � y , ' � � ' ' GRADING �'$� i � � . information is correcL I agree to�comply with all city antl.county ortlinances ; 1� + • - f . � 1 ' ' ', EIECTRICAL , � $. � ' '� � ' � , antl'state laws relating�to building consVuction; antl,hereby authorize repre- , � � � i. ' � � � � � ' ' : { . MICROFILM ' $ � � + sentatives oi; tnis� city, to e ter' upon the above-menboneC Ipr perty .for ' i � �' .'i ;` � � ; , f i ' � PLAN CHECK - 50,6i $ . ` j ; inspecLonyyy(((III���y,,,o x ' . ���}��p � � - ' � � � � MECHANICAI , $ ' � � � /� � [ ' ' Signa[ure( � �/. � Date--�'�-�_!--'�,F, , � ' � � f 1 � 1 n � �TOTAL FEE' . $ ' �2 �' ""�/� - Appllcant: Pink - Accounting: Goltlenrotl - Assessor ' - � ' - ' !^!,_nt... .l . . .. ,�, � '?r^ - . � . . ./`�.�. ^'iT. 'r,; ,.,t^., . .� ... _ ,. � . . �.- ... '"\R i � ` . " ` CONSTRUC'f.ION AND PLANNING - - - F. .. & SPA . - .. � . � , _ ,� , Date �� Inspector � � � -- - ' � ��Date ' Inspector.� � APPROVALS� Permit# :APPROVALS, °.Permit#. . ,��1 . Temporary Electrical.Ser.vice or Pole � . � � . 52. Pool & Equipment Location - - . � . - 2. Soil Pipe-Undrgrnd. � � -_ � � . 53. Steel Reinforcement .- � � : ' �3. _Electrical Conduit Utility-Undrgrnd. � - � 54: � Forms� . • � ' � .- � . � . 4. Electrical Conduit-Undrgrnd. ' � 55:' Electrical Bonding �, '. • � 5. Steel Reinforcement . • , ' _ . � 56. Rough Plumbing & Pressure Test � - � �6.•Elect�ical UFER Gmd. � . -, � �57..APPROVAL'TO;COVER-GUNIT.E � ,', ' 7. Footings � ; - � . , 58.`� Electrical Conduit`Undrgmd. � . - +' 8. Foundation ,'' • ' . � 59.`'Gas Pipe, O�Undrgmd.,-Test *'s •- ", �,9.WaterPipe-Undrgmd. � , ' ' � 60..�BackwashCines,P-Trap,�O.Undrgrnd.- - � � i ' 10. �Structural Floor System • � �� � � 61. •APPROVAL'�TO DECK , , ' , . - , � 1;1,. Property Sewer Line & House Connection � " , � 62. Backwash &`Receptor-Final ' ' _ � , • ,.., .12. SewerCaP ' � ' . -'� , : . .' ' _" .. . . ,. i,� � . 63.'Heater &.Vent-Final , , . �;13. Roof Drains - � � , • 64. Plumbing SYstem - Final : �. ' - ' . . • � •14. Rough Plumbing ' � _ � �. 65. Electiical-Final �:� . . - . . � ': � . � '15. Rough�Electr:ical-Conduit - - -� - -r -� � 66. Solar System-Final- - - �'-- ' - . ;,1�.6. Rough Electric Wiring,. ' . �• - 67. Fencing &'Access Approval ' - - ^ - , - ��1.7� Rough Wiring Sign � � - : , - � � � ' 68. �APPROVED FOR PLASTERING � � �18.'Rough Electrica6T Bar Ceiling ' � � , � � � 69: �POOL/SPASYSTEMS FINAL ' ' � ' �� � 19: Rough Heating & Air Conditioning' - � � �'_ FIRE DEPT. REQUIREMENT y�• ` 20�1Rough Factory Fireplace ,� ' � � � � ' � APPROVALS Permit # ' � ' �21�. Duc[s,in Structure,. � �I � -70:�Underground Hydro � � ',� �22. Ducts, Ventilating:� . •� ' , � � , , � j7, ;product Piping OGas .�❑�Oil i � � � ��23. Gas Pipe-Rough &�Test � ��-� � ', � ��� � � �72. ,Untler'ground Flush � ,'� � � -,- -' - ' � �- �,._ ' 24. Roof Framing , � N': ! �,, � ,; �� , 73. �Undergrnd. Storage Tank O Gas _❑ Oil `���,;,, � '25. Roof-Sheatfiing � • � � ' � ''�' ' ' ' �•74. Overhead Hydro • ' , ��.�a � � �26. T-Bar Ceiling'(Structurall�& Monocoat � � � i ; � j .; �� 75 �Dry Chemical , � - �; _ , , ' i � � .�27. Frame and, Flashing � � ' 1i � �� ,` � � 76. '�Dry Standpipe � . . " � , � -. Q8. Lathing &�Siding : s ` , �, �� � � � `� � .77, � FIXED SYSTEM FINAL ' , , ! � � � . � ^ j u29. Insulation� �� : ' I � �� ' � � � 78. �F.IRE PREV: FINAL ' + � � :30. Drywall�Neiling ' �� � � ; , � � �� ' '� ' ' , i HEALTH DEPT. REQUIREMENT � � � 31. Plaster Brown Coat � ' � � � � . � t 79. FINAL INSPECTION � - �v , -� � ' .32. Electrical Power Meter-Final � • � , � � 80. FOOD,CERTIFICATE,ISSUED , � � '33. Final Electric • � � � � Notes. � ' , , ' , � ' � 34. Final^Heating�& Air Conditioning ; ` � ' � ' , ; � . � ,, •� . , I , 35. Final Gas Pipe-Test. ' � . � - ' � - � . � � , � � '' ' , '� � 36. Hood or Canopy -. i � , ' � 1 - � � ' ' ' " ' ". . : - 37. Final Factory Fireplace , � ' . �� r � � �- � � • . - - - - , . : � , 38. Final Plumbin { � � , � 4 , ' � i i - , r ; � � . . 9 �'t2-�6 �c,�v ; �_ F- 39. Water Service-Final � _ ' � � ' , . � � • ' . � '�� .. ' � � .. � 40. Gas Service-Final � ' . �:�:r • � 1 : j � ' � � ' � . � , � � � ,. ' .. - .� ' �41. Solar pomestic-Final ' � ' S�' , � � � �j � ' . � ; _ . ' , � '' " ' , � { � ifi ' ' - - ' -. . 42. Backflo'w Freventer , , � � :,T, t �. LL�. i � ' � I ' ; ` � . . t }� j�� . � �- _� .:y , . - ._._�_, _�-__ _ 43. Backflow, Irrigstion !� ' . � , - ' � , . � � , . ' ' _ , , - ' � - � � � , i { ¢ i J _ . '. +_ i ' �i - . � �., � � � �44. •Landscape Irrigation�System � �.7_ , i �� ! . ' . i�' � .� � ' ' . � " . 45. Sound ��Attenuation � � ° �� - � � , • . , - • � � - ". ; . - . � i r ':a: - j , i� _ 46. Handicap Regulations � ; ' � �-�, � � � ' . '� � " ' � 4 �, . � �_ � � . '� 47. FINALfSTRUCTURE & BUILDING ' � �, ; i ; � � , ; � � 48. Special'Requirement'sCompleted.� '„ , � � , ' , ' ' i r � ' � ' : �. 49. Electric Release to Edison ; � - - �-, � - -, �- -. - ,- - ��- ; -- `���. � � , ,' � 50. Gas Release to SouthemjCalifornia Gas Co 1 � , - �' � � !, ."' j, � � ' 51. CERTIFIGATE OF OCCUPANCY, • - � , _ �._ �_ I i , F_ _ ' : J; ,' . No. " � - � Date ` ` I � _. ,- "_ „ '� 1 � I _ {� � . -- - - ' �� + � � _ _. . . � � r PPOJECT AOOflESS: 9 9 3 DAEiL IA AV owxeesr+nme: LIPSHIRES JEFFREY A aooness: gg3 DAHLI�A AVE COSTA MESA,CA 92626 APCNIENGINEEfl: RUOflE55: flEG.NO.: uNiT: UNIT: PENMITTEE: NEWPORT COAST ROOFING ( 714 ) 631-6991 nooncss: $17 W 17TH ST COSTA MESA CA 92627 LICENSEO LONTBACTOB OECLAflATION: I hereby allirm ��at I am licensed under pwvisions of Chapfer 9(commencing with Sec�ion ]000) ol Drv�sion 3 0l ��e Business and Pmiessions Cotle. antl my license is in WII force an0 eifeq. ciTv uc.: 0 5 916 5 sTaTe uc.: 6 5 3 2 O���ss: Oate: �� 9� 9y Signamre:: �� WOHNEflS' COMPENSATION �ECIABATION: I �ereby aflirm �ha� I �ave a certiticaie oi con � to Sell�insure or a teRiFica�e ot WOBers' Compensatmn I 5 ranc g�r$c,gr�ilietl copy �hereol (Seciion 3800, La�. C) POLICY NO.: �� 1�`J V`J' 9 4 E%P. UATE: 1 O/ Q S I 9 4 comraxr: STATE F[JND ❑ Ce� copy I5 �re�; �umishea. � Ceni�ie0 copy i=�il��e city ' in Divisian. oate: 9 -� FpplicanC '-/ - - ESEMPTIONFNOMWOPKEflS'COMPENSATIONOECNFpTION: Qhisseclionneetlnot�ecomple� ilthepermi�isioranehundre0($1W)arless�. I certity tha� m ihe pedormance ai Ihe wark tor w�ich this permit is issued. I shall not employ any person in any manner so as to become su�lecl to t�e Workers' Compen5aiion laws o� Calitomia. �ale: Signature: , NOTICE: II. atter making this Oeclaratwn, you should Uecome suble�� �o tAe Workers' Compensa�ion provisions ot IAe La6or Cotle. you must fonhwiln compty with sucn D�ovisions or ihis permit shail be Oeemed revoke0. CONSTPUCTION LENOING RGENLY: I hereby allum �ha� Ihere is a cons�ruction lentling aBency lor Ihe pedormance ol ihe work �or which Ihis permit is i=_sued (Sectian 3097. Crv. C�. LENDEN: aooRess: . OWNEH BUILOEfl DECUflRTION: I �ereby allirm that I am exemp� irom ihe Contractors' State Litense Law br Ihe followinA �eason (Seciion 703L5 Business antl Protes5ional Code: PnV ciry ol counry which requires a permii to con5tmct, alier, improve, demolish, or repair anY stmc�ure. priar lo iB issuance, also reQuires Ihe applican� tor such permi� �o lile a signetl s�a�ement �hai he/she is Iicen5e0 pursuaN to t�e provisions oi �he Coniraclors' State License Law (ChaD�er 9(commencing with Sec�ion 7000) of Division 3 of �he Business antl Pmiessions Code� or I�at he/she is exempt Iherelrom antl ��e Easis �or t�e allegeA exemp[ion. Any viola�ion ot Section 703L5 by any applican� �or a permil su�jec�s �he applicanl lo a civil penalTy o� no� more �han �ive huntlretl dollars ($5011). I, as owner of the pro0any or my employees wit� wages as their sole compensation, will tlo the work, an0 t�e ❑ simcWre is not inten0etl or olferetl for sale (Section 7044, Busmess and Pmfessional Cotle: The Coniractors' State License Law aoes no� apply m an owner oi a pwpetly who �uilds or improves �hereon, and who tloes such work �imsel�/hersel� or Ihmugh �is or her own employees, pmvi0ee t�at suc� improvemenis are no� in�endetl or oHereA for sale. If, however �he huiltling or impmvement is soltl wi�hin one year of comple�ion. �he owner will have Ihe burden oi proving he/she tlid not build or impmve lor the purpose ol sale�. I, as owner oi �he property, am exclusively conVacting wiih licensetl coniractors �o cons�mct the D�ole�� (Seclion 7044, Business ❑ antl Pmfessions Cotle: The Conirac�ars' Sta�e License Law does not appry to an owner af pmperty who �wltls or improves thereon and who contrams for such pmle��s witA a coniracmr(s� license pursuant to the Contracmrs' State License Law�. I am aware �hai pmo� of t�eir Worker'S Compensaiion insurance shoultl be pmvitle0 to me. � I am exempt untlei Sectlan: B. b P C. for I�is reason: �aie: . Ownec I do herehy cetlily I�at I am aware o� and understantl ��e requiremenis ol Calilomia Healt� anJ Safery Cotle Sec�ions 255U5, 25533, and 2553a antl Iha� I or any luture building occupani willlwill no� (circle one� nee0 b compty vn�h saia state codes antl Ihe requiremen�s �or a permi� �ar mnsimclion ar modifica�ion irom �he Nir �ualiry Management Disiricl. ResiOeniial conslmction ap0lication5 are eKempt �mm �he5e pmvisi0ni �ate: NpplicanP. I hemby ceNty Ihat I have reatl �his applicalion antl state �hal �he ahove in�ormation Is correcL I agree Io comDly wlth all cily antl county or0inancesantlslalelawsrelalingbOuiltlmgconsimc�ionanU�e���orizere0�esen ivesof��i5ci�y�oenteruponlheabove�mentioneA pmpetlY �ai in50eclion purposes. �ale'. z'_���� Signalure:� '� � od�ers ��cense or Soc�ai Secudiy n: t6at�a6 White—Building: Green—Cotle Enlorcement; Canary—Appliwnl; Pink—Revenue; Goldenmtl—Assessor CITY OF COSTA MESA — HUILDING PERMIT FERM NO_ B 065999 PERMIT NO: B 065999 PLAN CAECK NO: N GOVT:'N SUPP: N CONSTRUCTION TYPE: 5—N PERMIT TYPE; STR PORPOSE: ALT JOB DESCRIPTZON ; T/O , RESHEATH 6 REROOF W/COMP. SHINGLES SQ:FT: 4,000 CLAIM VALUE: 4,000.00 CALC—VALUE: 4,000.00 GROUP OCC: R-3 /M-1 COMMENTS:' SMOKE DETECTORS REQ'D PER 91 OHC, REROO£ 2800SF RESIjD�EN.CE+�+��y-��t p *�tx*+r*�t�r�r**�t�*�r+r*+��r�r**�t*�r**�r*+r�t*�tx**�r�t*Q�t*�t�***�***x*���r**�Vf�� LJC I CV��I Z O N S N G R E U I R E M E N T S S E T B A C K S ����� ------------ MAIN BUILDING ---------- ------=-- ACCESSORY BU �--------- FRNT: FT IN AEAR; FT IN FRNT; FT IN REAR; FT ' IN LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN PARKING REQ; PROV; PARCEL: 41218115 ZNE; . REF NO; PLANNING NOTES> ;,t • � , . � it it if iF if iE jf jE 1f� �E iE if if iE iE 1E iE i4 if iE iE iE iE it it iE iF iE iE 1E �f it �IE iE ik iE iE ff iM1 if iE �f iE iE if af iE iE iF jE 1E if �E iE if iE iF iE �F if i4 if jf �f 3E it if jE if�iE iE �Yr * 1E iF 3f ik iF df 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` iT S ' ZONING APPROVEP BY DATE; �t. BUILDING APPROC'ED BY ;" DATE: � APPLICATION ISSUED BY; DATE: ******�*,�����*�����*�� *�***�*,�** ��9 `�'1�� iE iE �E if if if 1E iE iE iE 1E ik ik if iE iE ff iE iE iE it iE 1E it if if iE if iE 1E iE iE iF-IE if if fE �F at 1E iE i! 1! iE iE iE if if iF k �f if iE iF it if 3E iE iE iE �)E iE if iE iElF iF if # iE if iE jE %�E iE iE fF iF LEGALIZATION:N : F E E' S U M M A R Y ��� STRUCTIIRAL SEGMENT:Y BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 63,00 ^ .50 ' PLAN `•M SMIP/NON—RES ISSUE FEE t'�� ' P. BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL �, PAID DUE TOTALS----> 63.50 0,00 0,00 63.50 `•', 63.50 ,00 p'+ REVENUE DIVISION TOTALS--> COLLECTED: 63.50 OVER'/SAORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZP/T,OT'� GRADING PLAN—CHECK 63.00 ���;�50 i l.-. if 1k 1f j! iE ik iElE if if iF ik Ik k iF iF 1f if �!f if iF iF �Elf �Elf if iE if # k!! iE !E!F 1f iF?E!! ik iE iE i! 1E if if if ff iE 1f iE k 1E ik fk iE iF fE if k it 1f #f ?E iE iE 1E iE iElf !f �F if if.if �E iF it iE I N D I V I D U A L F E E B R E A K D• O%W N � TYPE QTY D E S C R I P T I O N UNIT�COST TOTAL COST SFR 4000 REROOF BY VALUE RESIDENTIAL NOZONE '�,1A�00 4,000.00 END OF FEES +�:�' / � �J1 OOl.i�i&3-00155134 TO T 6s.50 6ATE: 02/09/94 TItfE: 11:58 i ' � `� V � ` . CONSTRUGTION AND PLANNING .. - . POOL & SPA � APPROVALS Permit# � -�ate Inspector AppqOVALS Permit# Date 16spector �� - 1. Temporary Electrical Service'or Pole , �: � 52. Pool & Equipment Location �� 2 Soil Pipe-Undrgrnd. �, ^Y' . ,,, - 53. _Steel fleinfoccement � �� 3:'Electrical Cond'uit_Utility-URdrgrnd.�' � 2' � 54. Forms "f/ � 4. Electrical Condui,-Undrgrrid. � �� - = 55. Electrical Bonciing �. 5. Ste=_! ReinfOrcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. . � 57. APPROVAL TO COVER�GUNITE '�J. Footfngs ' � 58. Electr.cat Conduit-Undrgrnd. �_ $. �Foundation . /%,f ��� 59. Gas Pipe. � Undrgmd., Test ���� 9. Wacer Pipe-Undrgrnd. V.i}� ���` � 60. Backvrash Lines, P�Trap, � Undryrnd. i � �7 70. Structura! Floor System _ 67. APPROVAI TO DGCK � 11. Property Sewer Line & HqLse,Connectio� X� 62. Backwash & Receptor-Finai (.rJ 12. Sewer Cap ' , �� ' , � 63. Heafer & Veni-Final < � 73, Roof Drein> ' '�� %j� _ � 64. �Plumbing System � Final �� 14, flough Plumbing j � 65. Electrical�Finai � 15. Rough Electricai�Conduit � 66. Solar SYstem-Final `16. Rough EleUric Wiring - . 67. Fencing & Access Approval 17. Rough Wirin9 S+gn _ 68. APPROVEO FOR PLASTERING . 78. RoughElectricai-TBar.Ceiling 69.�POOL/SPASYSTEP;15FINAl 79. Rough Heating�& Air Conditioning � '- ' "FIR£ DEPT. REQUIREMENT' � � - . � 20. Rough Factory Fireplace ' . '' qppROVALS� � Permit # � 21. DuctS, in Structure �.. . : . 70. Underground�Hydro 22. Ducts, Ventitating . . .7}, product Piping O Gas D Oi1 . 23. Gas Pipe_Rough & Test � -72. Underground Flush � 24. Roof Framing _ � r� ' . � 73. Underyrnd�•:StoraycTank �Gas �'Oil 25. Roof Sheathing � � 74. Overhead Hydro 26. �T-8ar, Ce�ling (Structural) & �h4onocoat _ 75. �Dry Chemicai -' . 27. Frame and F4ashing . -� �� 76. Dry Standpipe _.� � 28. Lathing & Siding ' . • • � 77.: FIXED SYSTEM FINAL • 29. Insulation � � � ��. . � ' 78. FIRE PREV. FINAL � 30. Drywall Nailing ' � � HEALTN DEPT. REQUtREMEN7 _ �31. Ptaeter Brown Coat . � �9. FINAL INSPECTION - 32. Elzctricai�Power Meter-r�nal �� ' 80. FOOD CERTIFICATE ISSUED 33. Pinai Electric . � Notes: -� :: ; ,;. 34.,Final Heating & Air Conditioning _ � . ' n 35. Final Gas Pipe�Test ' - ,', . 36. Hood or Canopy . . ' � - . 37. `Flnai Factory Firepiace " . � `t,� , - ��, 38. Final Piumbing . � , � ' � . 39. WateP Service-Final , ' � �' 40. Gas Service•Pinal � . � . ,� - - "41. Solar pomestio-Final � ' _ � . �. - _: r;n -. ¢ 42. Backflow�Preventer. � 2_.iY�v_ �„ - ��, =�m o• _43. 8ackflow Irrigation ;ij ' � � ��.,;,�� � �� ° �rr.'>�. ; 44`. landscape irrigatiort�jjstem� . - - � - ., r . . . � � 'i ?: N� 45. Sound Rttenuation���- �' � .. . �`�� i . P.} � 46; Nandicap Regulatio�(s}�i ,,..�-� - : � . "*' � ms ' 47�. �iNAL STRUCTURE`& �S,LDtNG z �5_qy &wk ', d-., 48. FINALPLANNING�,,,; � ' ' � '- �N � 49�. Electric Release to �sbr`� i 2, � : � � � 50: Gas Release to Sout e,�,n Gatifornia.Gas Co '��.. . - _ �� " � ' S1: CERTIFICATE OF �CUPANCY ^' u • .�., W NO. ��':fld[C �M'� OWNER �g�N _ DATE 1/12�79 JOB ADDRESS AA� Dehlia Ave. • BUILDING PERMIT N0. �San� GAS WATER LINEILYNOUSE CON. UNDERGROUND � POWER ROUGH WIRING TRENCHES FORMS � FLOOR SVSTEM SHEATHING FRAME ANO FLAS SUBCONTRACTOR Z . d U Z Za O v~i am J � J V1 Q W ¢1 J J m Q U � Za w¢ aw wZ J Q m Z J � W w 0 ZH W � � � � z Q U J a a a 0 H � z O F- U � � H N z � 359G� COSTA MESA BUILDING-SAFETY DEPARTMENT 401CRP•o• Box i2oa COSTA MESA, CALIFORNIA 92626 For Applicant to Fi!l in Completely BUIIOING ADDRESS Dahlia Avenue OWNEF Lanvin Southern California, In MAIL ..,,�� .. . „ � � CITV BRANCM � ADDRESu F ARCHITECT . nooaess 9100 Wilshire Blvd. Bev. Hills CONTRACTOR Larwin Southern California, Inc. ADORESS 162 55 Ventura Boulevard cirv Encino, California No.`'986-8890 L C No. � q� 31 � LICyNO. B�� SIZE NO.OF BLIX'aS. OFlOT 7S .. 1ll1 INOWONLOT O EXISTING BLOG. SIZE OF NO. OF NEWBIOC�, 1]84 qOOMS EXTERIOR WALL :�OOF COVERING SFlJCCO COVERIN(� USE OF QUILDING AND WORK TO BE PER Construct SinQle Familv Residence I hereby acknowletlBe chat I have reatl thi5 uPplicntion antl state that the Bbove information is cOrrett antl agr¢a [o comply with all laws regulating building construction, antl I shall not employ any person in violution of t�e workmnn's compansation Inws ot No Stace of Califomia. I hereby Certi(y that I em properly licensetl as a controcior untler tho Statc of Calitornia Business and Professions Cotle, Oivisicn 3, Chepter 9, antl thet such licenses are in full force antl affect, or 1 am exempt trom the provisions of the Stete of California Businass antl Prote;sions /Cod�e, Division 3, Chaptar 9. � SiOnatureot// /�/`/.�j'e/ D. Downs Pe�mittee C/ �����r- Authorizatl Agent Y BUILDING � A�ORESS TRACT OWNER FIRE PA1❑ in,� a_;�-73<<��,OOi �as� *=:�142.G8 ON FOR BUILDING PERMIT DATE CEIVED OAT ISSUED ��a-7, %� FEF�1� � bi f 3 AuuA �c � LOT BLOCK P I,U I,N S. C i �UC A-R-G—�� `�$2 aa°" � TVPE� GROUP �Ii..0 en .,,.r� "7—i%—%7 ZONE� NO.OF PLANS VARDS APPROV ED MAIN BUILOING L. SIOE r REAR t DISTANCE BET. MAIN BLOGS. V AR. aV+ C.V.P. # APPROVED I. i FOR USE OF NEW �j//(J F<F� BUILDING ;r� �/ d.�sr � t���.. � YARDS APPROVED ACCESSORV BUILDING FT. BET. MAIN & ACCE.'U^. BLOGS. DATE A—PPRO�VED — //�f1C� L— IJ v iAX / / m SQ. FT. �/� (O� � 0 THE AMOUNT SHOWN UNDER VAIUATION IS FOR � THE PURPp$E OF ESTABLISHING A PERMIT FEE ONLV: m ¢ VALUATION p{� � PERMIT FEE S �i � b'9 m $ p� ��� PLAN CHECK $ E / � O ! LL TOTAL FEE $