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Home My WebLink About204 DARTMOUTH PL - Building Permits- '78017 COSTA MESA BUILDING DEPARTMENT P. O. BOX 317 COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN BUILD ULDINc!W4 Dartmouth Place B FEE RECEIVED FINANCE DEPT. CITY OF COSTA DESA APPLICATION FOR PERMIT BUILDING COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY ' RECEIPT NO. OWNER YaIA Propertipq.• IJ�A MAIL . RECEIVED BY DATE RECEIVED DATE ISSUED ADDRES9 E. 17th St. �L7 -elf n . TEL Li. 8-1159 BUILDING CITY' Costa Mesa - NO. ADDRESS ARCHITECT Carlson LIC. OR ENGINEER ddlebrook NO. COSTA MESA. CALIFORNIA n� ADDRESS Grove FIRE ZONE }G�arden� ITV LIC. L1kQ Uf. Golegrov�, a', ZONE NO. OF P,LANB TYPE GROUP U'A'1+1� CONTRACTOR OLS; 419 E. 17th St. TN 4* 8-1159 BYPROVED ADDRESS DATE LEGAL Lor CORRECTIONS DESCRIPTION O. 2 955 A.P. NO. SIZEry �1 NO. OF BLDGB. OF LOT !O $ 110 NOW ory LOT none USE OF EXISTING BLDG. SETBACK LINE FROM CENTER OF BTREET' REAR YARD 401 SIDE YARD RIG451 LEFT 51 DEYPSCRIPTION OF WORK NEW A ALTERATION ADDITION REPAIR MOVING DEMOLISH BUILDING 11VLL. NO.OF L SIZE 1365 s A ROOMS6 STORIES EXTERICOVERING OWALL I ROOF Comp. .�itIIoOo COVERING - USE OF NEW Single family residence BUILDING with attached garage. Plan 110B 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE �RRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND {E LAWS REGULATING BUILDING CONSTRUC- VALUATION TION. ^ /�(� PERMIT FEE S 32*00 SIGNATURE OF PERMITTEE 13,919.00 PLAN CHECK s 10.00 S }� /� AUTHORIZED AGENTDike & ColeInc* TOTAL FEE S 48.00 grove, 'mr, r 43817 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 FOWNERPaul t to Fill in Complete) Use Ink Only 4 Dartmouth, osta Mes; l Eklof DartmouthTO.'557_4, Mesa TEL / BRANCH ARCHITECT T L - OR ENGINEER Wayne Howard In � ' 1-6 1 ADDRESS 1.116 N.Harbor Blvd. R f.� FOR STRUCTURAL PERMIT A.P. NO. Iyl ySJ PERMIT NO. BUILDING n �/ �J ADDRESS .GGlJ/7� /Q �/i'f �J (/%/'J / p Imo, TRACy� % , LOT /O BLOCK OWNER PRT✓t. A KLOF FIRE ZONE APPROVED DATE 7 LQ ADDRESS 111b N.t1arDOr biva• r7 CITY Santa Ana No4j 31-6 / 18 ZONE // NO. OF P1/ PLANS 2 USE OF NEW BUILDING YARDS APPROVED ACCESSORY BUILDING .Fi STATECITY r7''1144 LIC. NO. 208220 B-1 LIC. No.00'7? YARDS APPROVED MAIN BUILDING fsi SIZE NO. OF BLDGS. (FROM C/L STREET) 96 OF LOT NOW ON LOT FRONT 19 r y/p'W.b o FT. Q USE OF / Single Family .N. EXISTING BLDG. SI T . FT l/] FSeparate permits are required for r L. SIDE) Tb L FT. electric, plumbing and heating work. nn�N r 4 A REA R/. / YT. FT. USE OF BUILDING AND WORK TO B€ PERFORMED DISTANCE BET. BET. MAIN & aMaster Bedroom Addition MAIN BLDGS. ACCESS. SLOGS. VAR.+ DATE QC.U.P.# APPROVED > APPROVE iBY 11ATPas .a W 0 I hereby acknowledge that I have read this application and state - n n 1:9 that the above Information is correct and agree to comply with y� a all laws regulating building construction, and I shall not employ z any person In violation of the workman's compensation laws of m the State of California. _ ' 3 1 hereby certify that I am properly licensed as a contractor under SD. FT. of the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR la Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ a and Professions Code, Division 3, Chapter 9. -. PLAN CHECK $ u. Signature of � $ u.� Perms � � TAX $ � U 'Au Agent TOTALPAID' E �I '- 2449 !' COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 9I7 COSTA MESA, CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT COSTA MESA, CALIFORNIA Y -e D R 9 e— _ c0 IN SETBACK LINO PROM TEL. NO. TEL. NO. /v 114i4m 1411*] lk WE73Y 19I J-4 EXTERIOR WALL (ROOF - COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED t / cl 1 HEREBY ACKNOWLE THAT 1 HAVE READ THIS APPLICATI N AND STATE. THAT THE AB VE'18 CORRECT AND AGq EE'TO co PLY WITH ALL CITY GROIN NCBS AND STATE LAWS REGULATING /BUILDING CONSTCTIOI(. // SIGNATURE OF�,/wT\I(////W��\J��'j�/��/ PERMITTER AUTHORIZED AGENT CITY dE CuS�A MESA JUL 3 0 1965 RECEIPT NO. PERMIT NO. RECEI DAT96RECEftEO DATE 18UE 35 BUILDING ADDRESS nC© FIRE ZONE ROUP APPROVED BY DATE ZONING ZO NO. OF ^ I USE OF NE PLANS 'hill'AUILDING LEGAL U \ / OSSCRIPTION' d -L A. P. NO. Q v NOTE: NO SAVE OVERHANG SHALL BE LESS THAN 90'.TO SIDE B REAR P. L EAVES ALLOWED (U.S.C.REOUIREMENT) YARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUILDING (FROM C/L STREET) FRONT- FT. FT. R. SIDE FT. FT. L. SIDE PT. 1 1 FT. REAR FT. FT. DISTANCE BET. BET. MAIN Q MAIN BLD S. ACCESS. BLDGS. VAR.# DATE C. U. P. APPROVED APPROVED q / / .lo-/� 1- BY _WlE ✓ C JJJ r Sq. FT. THE AMOUNT SHOWN UNDER VALUATION 1E FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. VALUATION 00 PERMIT FEE $ — O. P�AN CHECK TOTAL FEE $ / T°% (714) 754-5273 • Fax (714) 754-4856 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT .lob Address: 204 DARTMOUTH PL Suite No Vicinity: Parcel Nunmber: 14145506 Applicant: EKLOF, PAUL C Address: PLUMBING PERMIT Phone: Zip: - Phone: Zip: 92626 P98-00323 PERMIT NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 05/01/1998 Issued: 05/05/1998 Phone't714 8951246 :IZipj 92841-- - > - '-License: 707775 1 Phone: Zip: License: • i SCOPE OF PERMIT INSTALL DISHWASHER.' - - iUMMARYi / AMT Owner: EKLOF„PAUL C. Address 204 DARTMOUTH PIL - COSTA MESA, CA Contractor:,,,,NOCK PLUMBING Address ' 11612 KNOTT ST - GARDEN GROVE, CA 0 Clarifier System Arch'/ Eng 0 Address: - PLUMBING PERMIT Phone: Zip: - Phone: Zip: 92626 P98-00323 PERMIT NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 05/01/1998 Issued: 05/05/1998 Phone't714 8951246 :IZipj 92841-- - > - '-License: 707775 1 Phone: Zip: License: • i SCOPE OF PERMIT INSTALL DISHWASHER.' - - iUMMARYi / AMT QTY, ISSUE FEE ' `$22.00 _QTY -0 Backflow irrigation $0.00 0 Backflow Preventer $0.00 0 Bathtub $0.00 0 Clarifier System $0.00 0 Connect(Ice,Soda,etc) ,$0.00 0 Dental Units $0.00 0 Dishwasher $8.75 1 Drain, Floor $0.00 0 Drain, Rainwater $0.00 0 Drain, Roof $0.00 0 - Drinking Fountain $0.00 0 Expansion Tank $0.00 0 Gas Earthquake Valve $0.00 0 Gas (1-4 outlets) $0.00 0 - Gas (Over 4 outlets) $0.00 0 Gas Repipe $0.00 0 Gas Service $0.00 0 Interceptors (Grease, Oil) $0.00 0 Interceptors (Sand Auto ) $0.00 0 PLUMBING PERMIT Phone: Zip: - Phone: Zip: 92626 P98-00323 PERMIT NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 05/01/1998 Issued: 05/05/1998 Phone't714 8951246 :IZipj 92841-- - > - '-License: 707775 1 Phone: Zip: License: • i SCOPE OF PERMIT INSTALL DISHWASHER.' - - iUMMARYi / COMMENTS / SPECIAL CONDITIONS EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with'all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754.5626 AMT/ Laundry Tub / Washer =$0.00 ` _QTY -0 Landscape Irrigation $0.00 0 P -Trap $0.00 0 Pressure Regulator -` • $0:00 0 Process Piping�(per 10 ft), - $0.00 0 Receptors ,$0.00" $0.00 0 ' Septic Tank ' � - ''. ," ' :..$0.00`, 0' Sewer Cap for Demo " $0.00 0 - -'Sewer Connect , $0.00 ' 0' Sewer Private Line - $0.00. ; 0 Shower' $0.00 0 Sink, bar _ $0.00 0 Sink, commercial $0.00 0 Sink, Floor - $0.00 0 Sink, kitchen $0.00 0 Sink, service/mop $0.00' 0 Spa (private) $0.00- , 0 ' Spa (public) - $0.00 0 COMMENTS / SPECIAL CONDITIONS EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with'all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754.5626 " AMT,' QTY Sump Pump',, : ' $0.00 0 Swimming Pool ! $0.00 0 _ Trap Primer, - $0.00 0 Urinal:- %� $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 -- Wash Basin ". $0.00 0 Wash Basin Set $0.00 0 _ Waste and Vent System $0.00 0 Water Closet (Toilet) $0.00 0 Water Heater/ vent $0.00 0 - Water Piping (Inst or Rep.) $0.00 0 Water Re -pipe $0.00 0 Water Service $0.00 0 Water Softener $0.00 0 OTHER $0.00 VIOLATION $0.00 PLAN CHECK $0.00 REINSPECTION $0.00 0 TOTAL CALCULATED FEES: $30.75 COMMENTS / SPECIAL CONDITIONS EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with'all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754.5626 DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a cedi irate of consent to sell -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carder and policy number are: Cartier:Policy Number: (This section need not be completed if the permit is valued at one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 370000 of the Labor Code, I shall forthwith cmply with Applicant Signature:ese—prov1 � Date: WARNING: FAILURE TO SECURE WORKERS COMP TION COVERAGCE IS UN --LAWFUL AND SWILL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($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 affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cede, and my license is In full force and effect. Lic. tr _ Class W Contractors Signature: _ _ — Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lander's Address: Signature: V Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as Owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as Owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a coniraclor(s) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, Le. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby candy that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ........................................................... ........................................................................ .. .............................................................................................................................................. . 2 Does or will the applicant or present art future builtling occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ............................ t'h'..--.-.-....-..-.-..... pre, -a n"..'r.fut'u.r'...-......-.-.-.'...u'..'n.t-n.e-e-..-...-.r'e'p.-.-.-...-...-...-.-........-.-.....................................enti.......rogr-..-....-......utel.......................aterials)? 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Celifomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department, -------------------------------------------------- -- ------------------------------------------------------ -- -- ----------------------------------------- -- -- -- ------------------------------------------------------------------------ ----------------------------------------------- 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No .................................................................................................................................................................................................................................................................................... 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this appplication a-Eemit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes ONO (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ----------------------------------------------------------------------------------- --------- --------------- -- -- ------------------------------------------------- ------------------------------------------------------------ -- -------------------------------------------------- ---- 6 Will any pad of the facility to be constructed under this permit be within 1000 feel from the outer boundaries of a school? ❑ Yes ❑ No (If -yes-, the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). .................................................................................................................................................................................................................................................................................... 7 If a formlt from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which is the subject of this appl cation, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑ No ......................................................................... .. .......................................................................................................................... ............................................................................... 8 (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to c;Apfy with.all sfal%llews."and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspections pu agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. 41 'Signature Ot " Owners) And/Or Authorized Applicant Date ' QQOE L INSPECTION TYPE JIM R1ITTIALj CODE INSPECTION TYPE QS¢ NQIDALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing y _rPaote 200 Flnal Re -Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 244646 PROJECT ADDRESS: 204 DARTMOUTH PL OWNER'S NAME: EKLOF PAUL C ADDRESS: 204 DARTMOUTH PL COSTA MESA,CA 92626 I ARCH/ENGINEER: ADDRESS: REG.lij UNIT: UNIT: PERMITTEE: MESA ROOFING CORPORATION (714)548-3012 ADDRESS: 843 W . 17TH ST COSTA MESA. CA 92627 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. ., CITY LIC.: 0356881 STATE u0.: 56415 Date: Signature:��— WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance' or a certified copthereof (Section 3800, Lab, C). POLICYNO.: WP9150002062 EXP.oATE: 07/01/92 COMPANY: FREMONT COMP ❑ Carbide copy is hereby furnished LX Certified copy isfiled with Bur ing Division. Date8" q11 Applicant: 2 - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred (SlOO pr less). I terbfy that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: It, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: ' OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any,slruclure. prior to as issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' Slate License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as, their sole compensation, will do the work,and the .E1 structure is not intended or offered for sale (Section 7044, Business and Professional Cotle: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion. the owner will have the burden of proving he/she did not build or improve for the purpose of sale) I,as owner of the propertyr am exclusively contracting with licensed contractors to construct the project (Section 7044, Business • ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractogs) license pursuant to the Contractors' State License Law(. I'am aware that proof of Iheir Worker s Compensation insurance should be provided to me. ❑ I am exempt under Section: B, A. P. C. for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of. California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future budding occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or Modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. i Date'. Applicant: I hereby certify that Ihave read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and her ativesof ity to enter upon the above-mentioned property for inspeclion purposes. ' Date -C7 rJ Signature:. Driver's License or Social Security n: 1641-46 Whid—Buddmg: Green—Code Enforcement; Canary—Applicant: Pick—Revenue; Goldenrod—Assessor CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 05432 PERMIT NO: B 054323 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: 5-N r PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION ; T/O.RE-ROOF W/30 YR FIBERGLASS SHINGLES ,SQ FT: 4,790 CLAIM VALUE: 4,790.00 CALC-VALUE':. 4,790.00 GROUP OCC: R-3 /M-1 COMMENTS: SMOKE DETECTOR(S) REgUIRED IN HOME.' Z O N I N G R E Q U I R E M E N T � ETECTORI S E T B A C K S. pp ------------ MAIN BUILDING ---------- --------- ACCESSORY B(3FQJ1_R DL--- FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT FT IN LEFT: FT IN RGHT: FT IN PARKING RE • PROV: PARCEL: 14145506 ZNE: REF.NO: PLANNING N TES> > kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk3F,kkkkkkkkkk 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: S r1 kkkkkkkkkkkkkkkkkkkk kk IF1F'�F'iFkkkkkkk kkk kk kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk ktkkkkkkkkkkkkkkkkkkkkkBE,jEhlEkkkkkkkkkk LEGALIZATION:N F E E S U M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 72.00 ;50 PLAN SMIP/NON-RES ISSUE FEE „ ^ BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS----> 72.50 0,00 (x; 0,00 72.50 72,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 72.50 OVER/SHORT:00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 72.00 ,50 kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkitkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk - 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 4790 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 4,790,00 ENDL OF FEES OCT - 8 1991 >< CITY OF COSTA MESA CONSTRUCTION AND PLANNING POU, a SPA APPROVALS Permit # - Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Servi4c'e(or PolIe '' 52. Pool & Equipment Location .r1 2. Soil Pipe-Undrgrnd. rc :J m .1 t"( 53.'Steel Reinforcement 3l�EFctrical Cond`it-Utility-Undrgrnd,.D i� 54. Forms i1 ' <.`4irflectrical Cond iu tt UOdrgrnd. 55. Electrical Bonding _ D5.uSieel Reinforcemr 56. Rough Plumbing & Pressure Test > •�'.6;�Electrical UFE,R.Gid.-u - 57. APPROVAL TO COVER-GUNITE x I'; 7.cF60tings 58. Electrical Conduit-Undrgrnd. r 8.;-FoundationCom, y1 ? 59. Gas Pipe, O Undrgrnd., Test! cr 9. Water Pipe-Undrgrnd, 60. Backwash Lines, P -Trap, D-Undrgrnd. 10. Structural Floo1System y�i� i /1•,i 61. APPROVAL_TO DECK 11. Property Sewer -Line-& Hof e Connection �; 62. Backwash & Receptor -Final itr (j 12. Seuwer Cap 'S x ti % 63. Heater-& Vent -Final 1! o, 13. Roof Drains 64. Plumbing System ;Final 14. Rough Plumbin �' ),� f 65. Electrical -Final rSi/j; 15. Rough Electrical -Conduit 66. Solar System -Final 1�! 16. Rough Electrir_Wiring ( 67. Fencing & Access Approval j) 17. Rough Wiring Sign i 68. APPROVED FOR PLASTERING 16. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL f 19. Rough Heating & Air Conditioning - - FIRE DEPT. REQUIREMENT APPROVALSi-DC 'mit # 20;YRough Gctor-y fireplace i tr;:r, � C �:� - _ irlStrctE?' :-• �- Ch-r:c nrgronHydro .n �21ibu�, (`r.� V 3. 22._Dutts, Ventijatir g.x _ t -71. Prod uctrP.ip ing O'G_as O!OiI 23.CGai-Pipe'TRough &'Test `; T ^' ' -72, Undergiound Flush:._ X " - I (r, 5 .1 01 T < O 2 24:1Roq`,f Framing. Zr ( .:L- 'S> J :: 573wUndergrndx Storage Tank:0 Gas OOiI �;-. 25. Roof Sheathing n s r In 'o^ i? t ;.' 574!?Overhead'Hydro`:�`C' ax-, •,r ,� ' M :•. y to Un -126.;?-Ba 7 ,; fi I-: uuc 75•?., Dv_n, y Chemical ^ 27:•+Fra me and Flashing * �' `' 76 -Diy Stanii`ipe %� sT•' "_28 -Lathing.& Siding�;x ;�; •-_6:J� u; :E 5; ••r +: 77::FIXED SVS_TEMI FINAL: _ :• >29. Insulation "' '� I 7k 78� FIRE PREY. FINAL k S 7 _ z `130. Dr wall6ilp (J' L�' V . , 9 --m x `� �;;`�:': fi �� HEALTH,DEP_1 REQUIREMENT _ 31. Plaster BsowACo£ix ! i .r ; IN$PECTIgN, c ^ r r79yFINAL 32.-ElectricaEPoLr,1.91t;Final( p; I _r r,80,:FOOD CERTIFi.G TE ISSUED _ 33inal Electric 'r'- ' "'' .! %".i ' '}Nofes: = ? u Y C TY :21 rig {l, :1 _ _ rj _ �: Ne ��con He ting:& Air;Con14!�iticJn�g -I �`,� r ,� ,,341-FirZI s •C _35uFinaI Gas Pipe-Titvl •'>? I -Is s IV 3Ho�B or Canopy (j::. �l r;_; +Z6f' w 7 _ I tr'-t a ,^1 Y %I.: ;r: �•, ;c .y rr ~i�? i-37:=Final Factory Fireplace• i�' �+ m r tr =, e -I r, C38. Final Plumbing r I �` ' ' t. ;;39. Wafer Service-Finatr ylr :?. C' :�+_ri +' t� O I, fi. Gas Serv`JCe-Pinal l7. t„140. :r. tT•r, u'b' =, Qcn r+_:pi t X41. Solar DoSnestic-FiQ_zS -i7" ' •• •k cr,i I x �?.� .-� :11 n v z f-'42:-%ackflow" �j ; .Preventea o. u J 43. Backflow Irrigation 19s.S ?44. Landscape Irri atio 5 ste " y,+ L7 A g fi lJ a 45.und Attenuation Yi- sSo x _ -_A s ' ? 46=ap' HandicRegulation' bl ^ " ~ ! t r ... , v �G ,`} 47 _FINAL STRUCTUAE.& BUILDING 6 { i Wil.' -tj;:,•� t"j 6 48S5I14AL PLANNING'.�,' _j f LTI --49._-Electric elease to:Edison' ' I-4`. Y. s; [ 'V T _ - 450. Release io Southern California Gas Co _Gas ''51. CERTIFICATEOF,OCCUPANCY^- No. 4 - _ CITY OF COSTA MESA BUILDING DIVISION ROOF COVERING CERTIFICATION Permit No. Zs /i2 2 3 Property Address Z O 4i I)A RT Mou�H Pbec4r Owner MeQ 4t&XS EkLa-)C- Contractor nlzFneq Roo E6=✓ 6 cog i State Contractor License Number J t Y/.S/ Classification I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the above address in conformance with Chapter 32, and Section 1704 of the latest adopted edition of the Uniform Building Code, as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the manufacturer. ❑ I further certify that I am the owner of the property. (Owner -Builder permittee only). V I further certify that I am: ❑ Owner of sole proprietorship company ❑ Full partner of the company ❑ Limited partner of the company XOfficer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shall be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. Received by Building Division By: 099048 WhiWEluilding Div.; Canary-Contreaa; Pink -Owner company or corporateName RA/3 Address m PROJECT ADDRESS: 204 DARTMOUTH 'PL UNIT: OWNER'S NAME: EKLOF, PAUL C ADDRESS: 204 DARTMOUTH PL COSTA MESA,CA 92626 ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: PAUL C. EKLOF (714)545-9705 ADDRESS: 204 DARTMOUTH PL COSTA MESA CA 92626 LICENSED CONTRACTOR DECLARATION: I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cotle, and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: EXP: Date'. Signawre'. WORKERS' COMPENSATION DECLARATION: 1 hereby affirm that 1 have a certificate of consent to selfinswe or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C). POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: ApplicOnt EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is lot one hundred ($100) or less). I certify that in the performance of the work for which this permit �}55s ued, I shall not employ any person in any manner s0 as to become sublecl to the Workers' Cam ensation Laws of California SignaWre: Date' �• NOTICE: If, after making this declaration, you should become subject to the Workers Compensation provis ns of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance Of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve. demolish, or repair any structure. prior to Its issuance. also requires the applicant for such permit to file a signed statement trial he/she Is licensed pursuant to the provisions of the Contracturs' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for sale. If,however the building or improvement is sold within one year of completion. the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code'. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a Contractors) license pursuant to the Contractors' State License Law). I am aware that proof Of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. & P. C. for this reason: p Date' ( S 1 S Owner'. I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 255)3, and 25534 and that I or any future building occupant wlll/ III not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the it rainy Management District. Residential construction applications are exempt from these provisions. Date, Applicant: I hereby certify that have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above mentioned Property Im inspection purposes. \�\3yE`^I Da� SignaWre: Driver's License or Social Security a: 1641-46 White—Building; Green—Cotle Enforcement, Canary—Appllcanl; Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 068106 PERMIT NO: P 068106 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH JOB DESCRIPTION : INSTALL A NEW INSTANTANEOUS WATER HEATER SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: # ############################################################################### Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT: FT IN RGHT; FT IN LEFT. FT IN RGHT: FT IN PARKING REQ; PROVII PARCEL: 14145506 ZNE: REF NO: PLANNING NOTES> 27.00 > 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: /5 DATE; LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N V BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/AES GRADING PERMIT 7.00 253 SMIP/NON—RES PLAN ISSUE FEE 20.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 7.00 20,00 0.00 27.00 27.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 27.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 27.00 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 PLU 1 WATER HEATER AND/OR VENT 7,00 7,00 END OF FEES I� 01 0016<172-00164172 TSS T 27,00 DATE: 07/16/94 TIME: 11:31 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL " SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrnd. '• 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4, Electrical Conduit-Undrgrnd. 55, Electrical Bonding -- 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58, Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, O Undrgrnd., 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 Drains 64. Plumbing System - Final 14. Rough Plumbing 1 65. Electrical -Final 15. Rough Electrical -Conduit _ 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69, POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑Gas 000 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76, Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation _ 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning S 35. Final Gas Pipe -Test 36. Hood or Canopy - ;• ,.'• 37. Final Factory Fireplace - 38. Final Plumbing 39. Water Service -Final 40, Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43- Backflow Irrigation 44. Landscape Irrigation System.-. -, 45. Sound Attenuation ' 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 204 DARTMOUTH ' P L UNIT: ITWNEFVS NAME: EKLOF PAUL C ADDRESS: 204 DARTMOUTH PL COSTA MESA,CA 92626 545-9705 ARCHIENGINEER: ACTEC ENGINEERING REG.NO.: C17003 ADDRESS: 1660 N MAIN ST UNIT: ORANGE CA 92667 PERMITTEE: THOMAS ELECTRIC SIZRJIC.E (714)546-9303 ADDRESS: 2361 FORDHAM DRIVE COSTA MESA CA 92626 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.:�,0(244011 SSTATELIC. :401360 CLASS: C-1 Date: —/ V—_q Signature: _ WORKERS' COMPENSATION 11ECLARATION: I hereby affirm that] have aceNficate of consent Io selt-insure ora certificate of Workers' Compensation Insurance. or a certified copy thereof (Section 3800, Lab. C). POLICY NO.: EXP. DATE: COMPANY: ❑ Carried copy is hereby furnished. ❑ Certified copy is filed with the pity Building Division. Date'. Applicant'. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred j$100) or less). I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner So as to become ancient Ip the,�W/orkers' Compenss' ttoo Laws of California. �^zsy�'p-- Dater(_�..j� Signature: Workers' NOTICE: N. alter making anis declaration, you mould become ancient to the Workers' ompensation provisions of the labor Cade. you must fonhwilh comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: E 066812 PLAN CHECK NO: N CONSTRUCTION TYPE: PERMIT TYPE: ELE JOB DESCRIPTION : 394SF 2ND FL ADDITION, 113SF DECK CLAIM VALUE: CALC—VALUE: PERM NO: E 066812 GOVT: N SUPP: N PURPOSE: ADD SQ FT: GROUP OCC: R-3 / COMMENTS: ADD HOBBY ROOM & DECK OVER EXISTING GARAGE, RE:#B66334 Z O N I N G S E T B A C K S R E Q U I R E M E N T S ` ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RIGHT: FT IN PARKING RE&p PROV: PARCEL; 14145506 ZNE: REF NO: PLANNING NOTES> > !f iE iE lE 1E 1E 1E iF iE 1E iE 1E iE 1E if * iE iE lE lE 1E 1E 1E of iF it iF iE iE iE iE 1E 1E iF a( -!E iE iE iE iF iE fE lE lE iE BF 1E Sf * 1E iE ff iE fE iE fE aE 1E iE ah ae ie 1E fE 1E fE ff ie ie 1E iE 1E iE iE 1E it iE �E iE 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 BUILDING APPROVED BY : APPLICATION ISSUED BY: *eE eE iE**iF fElf ii if iE♦E******eE iE iE ie ieiE *iE Mil lE eE el ft iEM LEGALIZATION:N FIE E, DATE: DATE: TE 1E iE iE iE lE lE 1E eE Bf fE BE iE eE Bf eE iE if iE if 1E 4 ie fE fE if if iE lE 3E 1E 1E iE i! ie Bt * fe * iE k 1F iF iE fE S U M M A R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: Ihereby affirm that l am exempt from the Contractors' State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031,5 Business and Professional Cotle'. Any city of county which requires a permit to construct, alter, improve, demolish, or PERMIT 4 0 ..2 5 repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed ^:'S 0 % iF iE iE ik if it SMIP / NON—RES 1E iE iF if if ie it 1E eE et ie iE 1E iE iE iE iE iE 1E ie 1F tf iE pursuant to the provisions of the ContractorsState License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business PLAN " I N D I V I D U A li. F E E and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by five hundred dollars ISSUE FE E 15.;00 TYPE QTY D E S C R I P T I O N any applicant for a permit subjects the applicant to a civil penalty of not more than ($500). BUILDING—DIV—> PERMIT ISSUE PLAN.—� CHECK TOTAL PAID DUE L as owner of the properly or my empIoyees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Saction 7144, Business and Professional Code: The Contractors' State License Law TOTALS ---- > 40.25 1 5.00_ 0 , 00 ' 55.25 55.25 .00 does not apply to an owner of a properly who builds or improves thereon, and who does such work himself/herself or through" ELE 9 RECEPT/OUTLET 1 ST 20 his or her own employees. provided that such improvements are not intended or offered for sale. If, however the building or REVENUE DIVISION TOTALS--> COLLECTED,. 55.25 OVER/SHORT; 9 00 improvement is sold within one year of Completion, the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CBE for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. for this reason: Date'. Owner: I do hereby cendy that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/Will not (circle one) need to comply with said state codes and the requirementsfor a permit for construction or motlihcation from the Au uality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and stale laws relating to building construction and hereby aut prize representatives of this city to enter upon the above mentioned property for inspection purposes. Dale5�=l �� V Signature: �3 � -- r 7 j Driver's License or Social Security a: 1641-46 Whh0—Bmldmg: Green—Cotle Enlorcernent: Canary—Apichcam: Pink—Revenue; Goldenrod—Assessor END OF FEES f :Y 01 00158922-00158922 T 0 T 55.25 DATE_ 04/14/94 TIME: 09:55 55,25 ; CK iF iE iE ik if it ie if 1e iE iE * 1E iE 1E iE iF if if ie it 1E eE et ie iE 1E iE iE iE iE iE 1E ie 1F tf iE ie * ie iE iF iE %it at iE rt it * r * iE * iE * * iE iE iE BE 1E iF if iE it iE iE * iE iE if iE iE iE iE iE iE aE I N D I V I D U A li. F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 11 FIXTURES, LIGHTING• 1 ST 20 EA. .75 8.25 ELE 9 RECEPT/OUTLET 1 ST 20 EA. .75 6,75 ELE 9 RECEPT/SWITCH 1 ST 20 EA. .75 6.75 ELE 1 SERVICES BELOW 600-V & BELOW 201 AMP 18.50 18.50 END OF FEES f :Y 01 00158922-00158922 T 0 T 55.25 DATE_ 04/14/94 TIME: 09:55 s ONSTR UCTION AND PLANNING PROVALS Permit # Date Inspector POOL & SPA APPROVALS Permitemporary Date Inspector Electrical Service,& Pole F 52. Pool & Equipment Locationoil Pipe-Undrgrnd. 53. Steel Reinforcement i 3. Elecfrital Conduit Utility-Undfgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5: Steel RePnforcemeiit 56. Rough Plumbing & Pressure Test 6:;Electricai•UFE-R'Gtnd. _ 57. APPROVAL TO COVER-GUNITE , 7. Footings: -�< i =. 58. Electrical Conduit-Undrgrnd. .' 8, -Foundation - �; I 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines. ?-Trap, 0 Undrgrnd. '• 10. Structural Floor System 1 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap r , 63. Heater &Vent -Final 13. Roof Drains, J / • 64• Plumbing System - Final • 14. Rough Plumbing 65, Electrical -Final I 15. Rough Electrical -Conduit o Solar System -Final 16. Rough Electric Wiring J:� ��/ ( n,. Fencing & Access Approval l 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18, Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT rAPPROVALS - _Permit # _ 20.rRough Factory Fireplace 211 :Dugjs, in.Stf acture; &nderground Hydro } r 22 _Ducts, Ventilating j-_ _ - '71. Product Piping 0Gas 0Oil 23: Gas Pipe -Rough &'Test '72. Underground Flush' 24n -Roof rriaming - ••i-_. 73.=Undergrnd. Storage'Tank I- C1Oil 25. Roof Sheathing - - -. "74: Overhead Hydro- 26.'T.Bar Ceiling (Structural) &:Monocoat 75: -Dry Chemical' - 27. Frame and Flashing 76. Dry Standpipe " 28: Lathing & Siding a 77.' FIXED SYSTEM FINAL' 29. Insulation- • " 7$: FIRE PREV. FINAL ,$0. Drywall Nailing h HEALTH�DEPT•. REQUIREMENT: 31. Plaster Brown Coat' _ i < �' FINAL INSPECTION' ' '32. Electrical Power Meter:Final T�y� 4�t 7 n K ' sn FOOD CERTIFICATE ISSUED' •- - 33. Final Electric 34. Final Heating:& Air Conditioning •-. 7 '• Notes: zi C, ' 35. *F ina I Ga4 Pi pe -Test ' 36. Hood or Canopy37. Final Factory Fireplace. _ 38. Final Plumbing 1- 39. Water Service -Final- r 40. Gas Service -Final.;, 41. Solar Domestic -Final . 42, tackflow Preventer "' ',• ,• 43. Backflow Irrigation- i ' 44. Landscape irrigation System-,:. 45. _'Sound Atte6uation +-- - - - - - 46. Handicap Regulations _ •: - ' 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING _ 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 204 DARTMOUTH'PL L /'� UNIT: OWNER'S NAME: EKLOF, PAUL C lJ ADDRESS: 204 DARTMOUTH PL COSTA MESA,CA 92626 545-9705 ARCHIENGINEER: ACTEC ENGINEERING REG.NO.: C17003 ADDRESS: 1660 N MAIN ST UNIT: ORANGE CA 92667 PERMITTEE: CHRISTOPHER CONSTRUCTION (714)498-1417 ADDRESS: 2932 HIERRO SAN CLAMENTE CA 92672 1ENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section DO) of Division 3 of the Business and Professions Code. and my license is in full force and effect. fix rir�859 sort nc.406707 �is B of consent to self -insure or a candidate of Workers' Compensation Insurance. or a cendied'copy thereat (Section 3800. Lab, C), POLICY NO.: EXP. DATE: ,COMPANY: n Certillfjil is hereby fdrished. El Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENS'ATIOWDECLARA11OW—Rhis section need not be completed if the permit is for one hundred (3100) or less). I codify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date'. Signature: NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must fanhwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ, C) LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the fallowing reason (Section 7031 5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/She is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500, I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not Intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a comedy who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for sale. IL however the building or improvement is sold within one year of completion. the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I. as owner o1 the property. am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' Slate License Law),I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. S P. C. lot this reason: Date: Owner: I do hereby teary that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements tar a permit for construction of modification from the Air Quality Management District. Residential construction applications are exempt from these provisions. Date: Applicant I hereby Certify that have read this application and state that the above information is correct, I agree to comply with all city and county a d nd state laws relating to building construction and hereby authorize representatives of this city to enter upon the above mentioned pra,P ny for nspectjon pure es. ��ate 4L Signal e�� mer' License or Social security a: 164146 While—Building: Green—Code Enforcement Canary—Appbcanh Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT r x v: M 06/ PERMIT NO: M 067202 PLAN CHECK NO: N L,u : N sur : N CONSTRUCTION.TYPE: PERMIT TYPE: MEC PURPOSE: ADD JOB DESCRIPTION 394SF 2ND FL ADDITION, 113SF DECK SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: REF: B-66334 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 14145506 ZNE: REF NO: PLANNING NOTES> > D E V E L O P M E N T S E R�CF I C E SSv 1/ R E Q U I R E M E N T S ;ZONING APPROVED BY ' DATE: BUILDING APPROVED BY : DATE: c� APPLICATION ISSUED BY: DATE: LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 9.00 PLAN 2;52 SMIP/NON—RES ' ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK _ TOTAL PAID DUE TOTALS ---- > 9.00 15.00 0.00 24,00 24.00 .00 REVENUE DIVISION TOTALS--> COLLECTED:. '_24,00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 24.00. . t I N D I V I D U A L ;:F..E.E _P -'.R EAKD OWN TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST MEC 1 INST/RELOC RECESSED WALL HEATER 9.00 9,00 END OF FEES 01 00160660-00160660 TOT 24.00 J DATE: 05/17/94 TIRE: 11:59 CONSTRUCTION AND PLANNING APPROVALS Permit # pate Inspector PO,_ & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or.Pole 52. Pool & Equipment Location i 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' 4. Electrical Conduit-Undrgrnd.,;, 55. Electrical Bonding 5. Steel Reinforcement '- 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. r� 57. APPROVAL TO COVER-GUNiTE 7, Footings .' 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, C Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, C Undrgrnd. 1 ------------- 10. Structural Floor System - 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing i 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68, APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning 1Z i- FIRE DEPT. REQUIREMENT APPROVALS Permit # i 20. Rough Factory Fireplace 21. Ducts, in Structure 70, Underground Hydro 22. Ducts, Ventilating 71. Product Piping u Gas C Oil 23. Gas Pipe-Rough & Test 24. Roof Framing 72. Underground Flush 73. Undergrnd. Storage Tank C Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro , 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 28. Lathing & Siding 76. Dry Standpipe - 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing _ a HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric 34. Final Heating &Air Conditioning 35. Final Gas Pipe-Test13 6Ts��'`iJ' Notes: 1 T '7 C r 2i-I�ZC-Z jG �'o-L_ Lry.0 'fit KtS 36. Hood or Canopy `, 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer - I 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46., Handicap Regulations -� 47, FINAL STRUCTURE & BUILDING n ; 48. FINAL PLANNING 49. Electric Release to Edison -- 50. Gas Release to Southern California Gas Co �. 51. CERTIFICATE OF OCCUPANCY No. Date 4j PROJECT ADDRESS: 204 DARTMOUTH PL � � � UNIT: OWNER'S NAME: EKLOF PAUL C ADDRESS 204 DARTMOUTH PL COSTA MESA,CA 92626 545-9705 ARCH/ENGINEER: ACTEC ENGINEERING REG.NO.: CS��O3 ADDRESS: 1660 N MAIN ST " PERMITTEE: ORANGE CA 92667 ADDRESS: RICK BENZINGER/TRUE VALUE (714)545-2212 843 MAGELLAN C.M. CA 92626 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade. and my license is in full force and effect. Dteuc �S 86� d� "I BTATELIC.:6360Q�That d/DjSB`^C3 Date: _ '• Signature: .('�'-��WORKERS' COMPENSATION DECLARATION: I hereby at firhave a certificate of consent I ore or a certificate of Workers' Compensation Insurance, or a certified copy thereat (Section 3800. Lab. C). POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby famished. ❑ Certified copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed it the permit is tar one hundred ($100) or less). I certify that in the performance of the work tar which this permit is issued. I Shall not employ any person io any manner so as to become subject to ty VJapkersCompensation Laws of California �7 Date: C Signature: NOTIC : It. after making this tleclaralion, you should ecome subject to the Workers' Cn n provisions of the Labor Code. you must farthwith comply with such provisions or this permit shall be deemed r ked: CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a Construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Cade: Any city of county which requires a permit to construct, alter, improve, demolish. or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/She is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). El structure as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale(Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvemems are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I,as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ antl Professions Code: The Contractors' State License Law does not apply to an owner of prof who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section. B. & P. C. for this reason. Date'. Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code 25534 and that I or any future building occupant will/will not (circle One) need to comply with said state codes permit for construction or modification tram the Air Quality Management District. Residential construction a these provisions. Sections 255DI 25533, antl and the requirements for a pplications are exempt from Date: Applicant: I hereby certify that I have read this application and state that the apove information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction 5k,ereby authorize representatives of this city to enter upon the above-mentioned property for ms ection purposes. Dale'. V ( Signatur Driver's License of Social Security x: 1641-46 White—Building; Green—Code Enforcement: Canary—ApplicanC Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: P 066678 PLAN CHECK NO: N CONSTRUCTION TYPE: PERMIT TYPE: PLU JOB DESCRIPTION : 394SF 2ND FL ADDITION, 113SF DECK CLAIM VALUE: CALC—VALUE: PERM NO: P 06667 GOVT: N SUPP: N PURPOSE: ADD SQ FT: GROUP OCC: R-3 / COMMENTS: ADD HOBBY ROOM 6 DECK OVER EXISTING GARAGE, RE:#B66334 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ; PROV: PARCEL: 14145506 ZNE: REF NO: PLANNING NOTES> > iE 1E iE iE iF if BF iE iE iE iE iE 1E 418 i! fE if * iE 1E iE iE ii iE iE iE is iE iE 1i iE iE 1E * 1E iE iF iE iE iE iE iE iE iF it lE M RHE iE * iE 4 iE iE iE iE iE iE iF iE iE iE iE *!t iE iE it iE of RE * i6 ie ie 1E iE 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 n ZONING APPROVED BY DATE; BUILDING APPROVED BY ; DATE: APPLICATION ISSUED BY: DATE: cl� iE iE 1E iF iE * iE * 1E iE iE iE * 1f * * iF iF 1E 1E lF fE iE iE iF iE iE iE iF iE i(• iE iE eE iE iE iF iF iE iE if eE 1E iE iE iE iE * iE fE iF iP 1F it ■ ie aE 3E iE 9E aE iE iE iE it eE iE * iE 9E iF iF iF iE iE * aE iE iE LEGALIZATION:N F E E S'U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC- MECHANIC FIRE SMIP/RES GRADING PERMIT 26.00 H% SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> TOTALS ---- > 20.00 PERMIT ISSUE 26.00 20,00 h PLAN—CHECK 0.00 TOTAL PAID DUE 46.00 46,00 .00 REVENUE DIVISION TOTALS--> COLLECTED:, 46,00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 46,00_ lF iE 1E iE iP fE lE fflE1E*1Elf 7E 1f**184*1F 1f ff 1E iB 1f 1E 1f 1E 1f 1E 1E 1E 1F if 1E 1E 7E 1k fE*!f iP iE iE 1E lE ik iF iE iE*kkiElE1ElE 1E 1E 1E lei(-iE iF iF iP Bk iE 761f it it iEiE lE iE iE I N D I V I D U A L F S 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 PLU 1 SHOWER y':% 7,00 7.00 PLU 1 WASH BASIN :', 7,00 7,00 PLU 1 WATER CLOSET (TOILET) 7,00 7,00 PLU 1 GAS PIPING SYS OF s 1 TO 4 OUTLETS 5.00 5,00 END OF,FEES 01 00158388-00158388 TO T 46,00 /: DATE: 04/05/94 TIME: 15:27 u CONSTRUCTION AND PLANNING POOL & SPA - , APPROVALS Permit# Date Inspector .APPROVALS Permit Date Inspector j 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3iwEtectrical,Conduit U_ulity-Undrgrnd. 54. Forms lectrita.l-Cohduit..11ndrgrnd. 55. Electrical Bonding -5; St -eel Relriforcetiieirit 56. Rough Plumbing & Pressure Test 6 -.El' triciiI`6FER-Grnd. 57. APPROVAL TO COVER-GUNITE 58. Electrical Conduit-Undrgrnd. - -_ -8. foundat"06- .' 59. Gas Pipe, 0 Undrgrnd., Test '' I 9.Water Pi Pe-Undo9rnd. 60. Backwash Lines, P Trap, 0 Undrgrnd, 10. Structural Floor System 61. APPROVAL TO DECK - i t. Praperty Sewer. Line-& House Connection 62. Backwash &Receptor -Final j 12. Sewer Cap _ _ 63. Heater & Vent -Final - - 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 2 _G �- �( 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough electricaPT Bar Ceiling 69, POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT _T 'APPROVALS; Sermit :yet 20. rRough Factory Fitepiace 2L'Ducis,in-Structure',t" rn ' 70. Undeig'ro}rcl-.�lyciro r 22. Ducts, Ventilating- r I _ - ' + t•71. Prod uct:�sRing 0'GL� El Oil i 21. as�Pipe-Rough&'T'est 32. Undergrond'Flushv 24.:Roof;Framing =j, _ t W3.uUndergrnd?Storagesank 0Gas 001-11' 25. Roof,; Sheathing 25. -74. Overhead P{ydro-'' 26. T -Bary Ceiling (Structural) & Monocoat r -; �_; r - 75.CDry Chemical '-I •-+ :' :�� =iw 27. Frame and Bashing* Y 76. Dry Stand"', _ r t .28. Lathing Siding 77. --FIXED SYSTEM-r"ALx _ ••• y 29. InsulatioFi 78. LF.I,RE PR _,EV. -30. Drywall Nailing r z 'r HEALTH,OEPTiREDLi4REMENT' PBCa 1. Plaster Brown ot' I y ' .z 7,9tFtNAL t '.ECTIOT C fu :3 r-. '• r .Kl --N 32. •Electrical'Powgr Meter -Final e - 5 ;80.:50OD CERTIFICATE ISSUED 3._ 33.'Final'Elestric , ='-. �: h 'Notes: !_�'I 5.'�d-?iG�; Y>-•�;:�•-_i 1 34. Fin EHeatng & iAir Conditioning = _ - i j: r " 35.'Final-GasPipeTest .. _ 36. ' ioocVor Canopy zI ` < `•ice _ _ _ 37. Einaf.Factory Fireplace, 1 •K s Y I 38. Flna7•Pluirtbing r. T. •• - _ %�, = H_ - "• 39. Water SeNice-Finall- - r* .' %?7 + c: i'7 90. Gas Service -Final _r . t e �r. :a• - .n 41. Solar Domestic -Final- i+ 42. Backflow Preventer?; o. I 43, Backflow Irrigation x 0:- 44. Landscape Irrigation System - rev W 45. Sound Attenuation' 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 46. FINAL PLANNING' 49. Electric Release to Edison '• - r,; - 50. Gas Release to Southern California Gas Co 71 x 5.1. CERTIFICATE OF OCCUPANCY' - No. Date PROJECT ADDRESS: 204 DARTMOUTH PL UNIT: 16� OWNER'S NAME: EKLOF, PAUL C ADDRESS: 204 DARTMOUTH PL 10 COSTA MESA,CA 92626 ARCM/ENGINEER: 545-9705 ACTEC ENGINEERING eEc.No.: 0171103 ADDRESS: 1660 N MAIN ST uN1T: ORANGE CA 92667 PERMITTEE: SHARON EKLOF (714)545-9705 ADDRESS: 204 DARMOUTH PL C,M, CA 92626 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in lull farce and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature - WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance. or a certified copy thereof (Section 3800. Lab. CI, POLICY NO.: EAP. DATE: COMPANY: ❑ Certified Copy is hereby furnished. ❑ Codified copy is filed with the city Building Division. f ' Date: Applicants I cenly ION FROMthe WORKERS' COMPENSATION DECLARATION_, mit(This section needfim be completed if the permit n for one hundred so as to a lose subject that in the performance of the work sm which this permit is issued, shall not employ any person in any manner so as to become subletl to me WorkersCompensation Laws of California. Date'. •0 1 � L) Signature: ^^ NOTICE: If, after making this declaration. you should'become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affi sal there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C)., f LENDER: •' ' ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Corte'. Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a Tragedy who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for safeif, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business M and Professions Corte: The Contractors' Stale License Law does not apply 10 an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. for this reason' Cale: TG� 1 L—A Owner. �• � I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that 1 or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Ouality Management Distrlat. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned .�nerlV for infs�pe tiopn pmppse5. (J I S, poll flurried or Social Security a. White—Building: Green—Code Enforcement: Canary—Applicant Pink—Revenue: Goldenrod—Auessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 066334 PERMIT NO: B 066334 PLAN CHECK NO: 04572-93 L GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: SIR PURPOSE: ADD JOB DESCRIPTION : 394SF 2ND FL ADDITION, 113SF DECK SQ FT: 1 507 CLAIM VALUE: 25,000.00 CALL—VALUE: 30,828.40 GROUP OCC: R-3 / COMMENTS: ADD HOBBY ROOM & DECK OVER EXISTING GARAGE Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: 23 FT 6 IN REAR: 3 FT IN FRNT- FT IN REAR: FT IN LEFT: 5 FT 7 IN RGHT: 45 FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 14145506 ZNE: R1 REF NO: PLANNING NOTES> ADD 2ND FLR,(HOBBY ROOM AND BATH) ABOVE EXISTING GARAGE. FT >'DECK MAINTAINS'20' STBK; DECK AT SIDE ALSO STBK PER CODE. iF if eE * iE if iE fE 3e jF i! iE jE eE if 9E iF ie iE 1E iF iF ep ee # if {r: iF of aF iE ff * iE iE ae #E if ik if iE iE iE if ae if * iFiE eE of aE if fE iF iE ¢E fF * aE * 1E ie � * ie iF if"f�.AE ae of * iE?f * iF if D E V E L O P M -E NT 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-, ��r'c, DATE: iLx-�-it iE jc iF *iP?F ih it *rt: #�rE �E �P Tc �-iEjc is�r�*�P3FTF7f3F iF3f 3��E �E3F iF �-at iE x 3f �+�iE aE +F?r 7F.?�� iE#'-iE 9F MBF iE 1E aE iF 9f+F 9E 1Elf+F if BE iE eF iE ie#7F TF iG iP ak#F:E iE if iE iE?E?E*i'jE iE')E iE if Bf jF ie a(iE jF eE 4E Maf-9f iF iE*iE iF*iE iF if iE iE 9E 9e aF iF jk iE dF iE iF it iE ie iE LEGALIZATION:N F E E S U M M A R Yf({1 STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC('/,'FSRE SMIP/RES GRADINGPERMIT 291,00 %.:/ 3.08 PLAN 189,15 SMIP/NON—RES ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL ' PAID DUE TOTALS ---- > 294.08 0.00 189.15 48,3:23 483.23 ,00 REVENUE DIVISION TOTALS--> COLLECTED:f 294:ij OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC i"FIRE SMIP/TOT GRADING PLAN—CHECK 291.00 ': 3:08 iE iE eE if !e 1E iF lE if yE iF lC ae iE 3f iE iE iE iE if iF ie iF if iE iE 9E iE iF iE iF TE 1E 1E if #'- iE ie if iE * #'yE iE fE jF if aE j' iE jf iE ie If * iE Bf iE * iE iE eE iF iE iE of iE ie iE * aE if if iE ih aE iF iE % I N D I V I D U A 1",'F'E:E H.R E A K D O W N TYPETY D E S C R I P T I d� N Q e UNL'T COST TOTAL COST SFR 394 DWE—TYPE V—WOOD FRAME —GOOD; 74.00 29,156.00 SFR 113 RES—BALCONY, EXTERIOR STAIRWAY', SEND OF FEES, "14,80 1,572.40 .I A f /! 01 00156821-00156822 Tl 294.03 DATE: 03/03/94 TIME: 12:01 CeNSTF�JCTION AND PLANNING APPROVALS Permit # Date POOL & SPA Inspector APPROVALS Permit # I . Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement _ 1 Electrical Conduit Utility-Undrgrnd. 54- Forms " 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5, Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 7. Footings 3�L/A/ 57. APPROVAL TO COVER-GUNITE 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 3 -�( 61. APPROVAL TO DECK ll. Property Sewer Line & House Connection 62. Backwash & Receptor -Final _ 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65- Electrical -Final i 15. Rough Electrical -Conduit 66: Solar System -Final _ - 16. Rough Electric Wiring 67. Fencing & Access Approval _ : 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING— 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas 0 Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24, Roof Framing 25. Roof SheathingI/ S7 71 Undergrnd, Storage Tank ❑ Gas ❑ Oil 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing &Siding 4,477. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing Ci"ZL(-ct ge✓'K HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coate 32, Electrical Power Meter -Final 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED 33. Final Electric 34. Final Heating & Air Conditioning Notes: A.I.�ys/ 35. Final Gas Pipe -Test Y L8 -9q 69 SA+ -ems-- ��r t4,-- 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final f 42. Backflow Preventer 4' 43. Backflow Irrigation �/• -, 44. Landscape Irrigation System 45, Sound Attenuation 46. Handicap Regulations 47- FINAL STRUCTURE & BUILDING / '•�� t% 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date , CITY OF COSTA MESA BUILDING DIVISION -OWNER-BUILDER VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of, an owner -builder verification. Attention Property Owner: An 'owner -builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the pro- posed property improvement. ❑ Yes 1� No 2. Ihav have not) signed an application for a building permit for the pro osed work. 3. 1 have contracted with the following person (firmly to provide the proposed construction: Name GtiY \y—��•,MY��+^vuCTlil-. Address �, City Phone ( ) Contractor's Lic. No. 4. 1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name Address City Phone ( ) Contractor's Lic. No. 5. 1 will provide some of the work but I have contracted (hired) the following persons to pro- vide the work indicated: Name Address Phone Type of Work I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State of California Health and Safety Code and have completed the above information to the best of my per- sonal knowled ompli lance with this �Stale /law. Signed: - :1 r E�/. /iId— Date: Name: (Printed or Typed) C.D.L. # or S.S. # 754-5273 INN CITY OF COSTA MESA BUILDING DIVISION CERTIFICATION OF SKYLIGHT INSTALLATION Propert, Owner Contractor Fl.A-�q2 State Contractor License Number Permit No. Z— (rCn3� Classification hI �h�ereby certify that I have installed, or caused to be installed, an approved listed skylight I.C.B.O. # '--) on the roof of above subject address. That I have re -fabricated the roof to the standards of the industry and in accordance with Chapter 32, 34, 52 Appendix 32, and Section 1704 of the latest adopted edition of the Uniform Building Code as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of thenufacturer. The integrity of the area worked on is as good or better than the rest of the existing roof. I further certify that I am the owner of the property. (Owner -Builder permittee only). ❑ Ifurthe ertify that I am: Owner of sole proprietorship company ❑ Full partner of the company ❑ Limited partner of the company ❑ Officer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shall be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. Received by Building Division By: 0 14 1/ V. Initial Date 102946 While City; Canary Owner. Pink Contractor Company or Corporate Name Address �= -Q -7 y Signature Date Printed or typed name Insulation Certificate Number and Street c7,c-, Z& County ROOF Material City of Costa Mesa California 92628.1200 P.O.Box 1200 Permit Number Yom-/— Subdivision Description of Installation Thickness (inches) EXTERIOR WA Material —5- Thickness (inches):" CEILING Batt or Blanket Type—�6- Thickness (inches) Loose Fill Type Contractor's minimum Installed weight/ft2 Ib. City Lot Number Brand Name�� L Thermal Resistance (R -Value) Brand Name t ' ^(`1V[LU-- Thermal Resistance (R -Value) Brand Name Thermal Resistance (R-Value)—t`-3D Brand Name Minimum thickness inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R -Value) RAISED FLOOR Material �%— Thickness (inches) SLAB FLOOR Material Thickness (inches) Width (inches) FOUNDATION WALL Material Thickness (inches) Brand Name Thermal Resistance (R -Value) Brand Name Thermal Resistance (R -Value) Brand Name Thermal Resistance (R -Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the Califorr i dminstrative Code. G GeneI ntractor (Builder) �wlti Signature and Title Sub -Contractor (Insulation Installer) Signature and Title 1907-46 License Number —7 �— e Date License'Number Date iL\ Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITE'_ OF COSTA MESA - - PERMIT IN - - - - T ACT O. -- - LOT NO: - -BLDG. NO. • - - - - " •- - - " 6(157 - 5/87'/62 --` ' 7.00- CONSTRUCTION PERMIT - ,j ZZ= ( .Z� �, -y�• TYPE OF CONSTRUCTION""• i1 -HADD-' �) _ .. -; , . `-° I _ i•`-4; . 1. }p •� 'rl NI; . Project Address - _ .: $ :Owner -'' - 'Phone '� �]p -y _ ❑ NEW ❑ ALTERATION - .REPAIR ❑CONVERSION ❑DEMOLISH_ , ❑ IFI ER = -- - -_- - - -•- .'-- ^- - -. -ZONING REGULATIONS'•, _ .Address _ t ,-} .- _ �rr_"'•� -„_ (.Arch/Eng. - -'• - - t - -- License NO.. _ - - DESCSC RIPTION OFWORK - -- _ A.P. ^•„� ^�' ':ZONE Address - +- - -I- •-- -- --_ ,-_ _ .— _ -_,_ ”- PLNGfREF. �P_.,--- ;Contractor-- - ,------�--- - Phone- TYPE OF PER :- '-' i� ”- -';- - "ie D TTpo •eUI LDIrvG y, , SETBACK LST. GRO PE RTV LINE( GRADING FOUNDATION XSTRUCTURAL•-, - ySIDE-YARD-- t- p- - LS Address--.-- -. - ----' -- - - - '�LICENSED CONTRACTOR DECLARATION- -- + •y _ ❑ TENANT.❑ ELECTRICAL' OPLUMBING ❑MECHANICA IEEDE VA ,I hereby affirm that I am licensed under provisions bf-Charter 9 (com- i- - s- - RIGHT f Y mencing. wlth._section-7000). of 0Division 3. of the. Business .and' 7 O'CiTHER'' • ' .- I ,Profession s Code :and my license is in full force and effect. ,, - - ."REAR YARD (TO P/L) + 1 ''- - License Class' "' - -License'No - PROJECT D`p SCRIPTION - ` �-I -PKG: SPACER EO:'--"-'--- _ .,: +lt�.. (Date" r [00 9Q'FT }� ,PROVIDED -_'_'__-S19natUre-.,. _...__' - ,:._ - _.,.—+-I--' .._ 3 c' _ ,-STREET WIDTH-. _ _ ...�; PARK FEE'$._ -'I ff ORKERS ,COMP -E NSATION DECLARATION ret affirm that have a certificate of consent -to self Insure ora s Y OCCUPANCY CONSTRUCTION TYPE 06 f` - - - ONZONE - - - -•ZONING APPROVED BV 'DAT E + •• ,• �� 5 �T sz -a fiwt¢ of Compensation Insurance,.or-a.certifled.!copY _VA __ _ - ____ , _ _ -.- ' —_ _ ']SPECIAL -CONDITIONS: ^^9i (Section 3800, Lab. C.)- + . GRADINGIC U.,,V,DS. ACRES I O. __ L,-. _- -Company REMARKS:,�I,11 i I •' t' r LJ Certified copy Is hereby furnished.- _- ,'tti ❑ Certified copy Is filed with the city Building Division. _ _ _ _ __ _ - EXEMPTION -FROM WORKERS' -COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred -`-'� -_, _- _ - •• -�. . o :_ -..- � ._., _. (. - _..._. _. _ __ _ aiy-j„j3 _•� pP;l^,<' ($100) or'less)� 1 ... ,; 'I certify that In the performance of the work for which this permit Is issued ;-(-shaWhat 'employ'any'person-I n -an ymanner'so-as to become r PLUMBING- } t'PL'AN-CHECK -- - -' - •- iELECTRICAL "'• -”' 'PLAN CHECK' - - - subject to the Workers' Compefssato` Laws ot_ 1if or ni 1 >'.- _ _BATHTUBS' ___ _._ 'SHOWERS-- _ .i _ r G"— AZc �(=Sn,-,�- -�_p) Date ��- (gnat urea J4A NOTICE: If after making this declaration, you should becom subject , -,T;OILETS,.a, ,^,URINALS^^ -'- -- •-�---- ^� -"GENERATOR-- -- 0 1 KW 1 30 KW _ to the Workers' Compensation provisions of the Labor Code, you must' - TRANSFORMER a .. , •... , .I (I •,C forthwith comply with such provisions or -this permit shall be tleemetl LAVATORIES -DOUBL-E-LAVS- 4APPLIANCE-' --10-50 KW- --_ - -- •revoked_ ] i '- '" -- CONSTRUCTION LENDING AGENCY ' ' KIT:$INKS -DISHWASHERS _KW_50 :;MOTORS - 0-1-HP I hereby affirm that there is a construction lending agency for the Per. SERVICE SINKS .,,.SUMPS"' -- '- -t:r n„ - _., .j(INC:SOLAR)_-10-50-HP 50 -+.HP_ _ formance of the work for which this permit is issued (Section 3097 7, - -F L'00 R'SINKS' -' •-"FL'OOR-DRAI NS 1' - 9 `FIXTURES - OUTLETS -SWITCHES---• • — - ,.Civ. -CJ. ---- ---- - .-.,---.-------- _, ._ _____ .. 'Lender's Name Lentler's Atldrels' - — - -'DRINKING'FOUNTAINS --ii -^' ^+--'-- - - - ''GAS TUBE SIGNS-- -. --- - - - - - - - - OWNER -BUILDER DECLARATION "INTERCEPTORS--'.'--CL"ARIFIERS-"'-""' --,POL-ELIGHTS-----•-- -- --- -- - -- I hereby affirm [hat am exempt fro m.t he Contractor's License Law for the . -following,, eason_(Sect ion.7031.5. Business. and -Professions Code:. Any city or county which requires a permit t0 construct, alter, - SWIMMING POOL ---P TRAP----- -- .. .--- - - POL'ES - - � �-- `METERED-' SUB -WATER SERVICE" -^'-ALT - - ---- - <PANELS --'-----MAIM - SUB--- -- - - improve, demolish or-repair-anY-structure,-prior to.its issuance, also re- -^ ires the ap,liczmt for such permit to file a signed statement that he -GAS SERVICE- -"OUTLETS' -"" - - 1 -..._.L:- -"""'- - ',SERVICE-- -erred-pursuant to the pr 0 vi si o ns of.the-Contractor--•s.Lice rise Law. pt. iess 9 (commencing with Section 7000) of Division 3 of the is exempt therefrom and the (for rid Pllegedio ns. Cotle)n. - WqT ER -HEATERS'+ - -BTU OUTPUT--------: - - ----------- - '• " "- =-- -- Any .: for the alleged exemption. Any violation Of Section 7031.5 by - SEWER 'CONNECTIONS�- �;• --^--- -------- - - --- y.notapplicantthan fi.permit-snblellars (e_appllcdnt to_a civil penalty not more than five hundred dollars ($500) as owner`Of-the'Property!' T•""'^^' '� '^^ ^•' -"SOLAR•TANK'�--^-- COLLECTORS--- - ---------•--- - --- -_ t - - will tlo the work, and the structure is not intended or or'o er ae.(Section 7044,'Buslness and"PrOfessons Cotle'The''SOLAR'PIPING SVS.--"(`ISSUE-FEE-- - SSUE FEE' --- --- - " -- -- - Contractor's License Law does not apply to an owner of a property who`builds'or'improves thereon, antl.who- does such'work'himself or -"ISSUEFEE-_-'---"-j-----"-`-"`�"-'---' - --DATES2)• 'APPLICATION APPROVEDtt' through his own employees, provided that such improvements are not "MECHANICAL PLAN CH ECIC 1'- SUMMARY OF_FEES_ p I'Q.� intended' or'offered'for sate. -If; however; the building-or'lmprovement' Is sold within one year of completion, the owner will have the burden of 'proving he 'ditl"not'builtl"or improve -for -the purpose of sale): HEATING SVST EM 0-100,000 BTU i :BUILD( G • ! �„�$; ❑ .I, _as .owner--oL the property, am exclusively -contracting, with, licensed contractors to construct the project (Section 7044, Business -q ND DUCTING - -- - - 1- -^- ---- --- 100,000+gTU --- $ ,00. 1•SMIp,r -- -'1 ` 'PLAN CHECK $ {p.� PERMIT.p,CCw and -Professions Code: The,Cootractor's License. Law. does.not.a pply_t0. -r + ISSUANCE_.$• an owner of buildsnd who oto. cwhoontractor(s) nlecesneda t from.such_propropertje RATION BTU (PLUMBING $ :CGRAOING_••$.ar°' acts ts, with. pursuant the Contractor's License Law). -0-100,000 SYSTEM- - 100,000+ BTU -' - - _ _ _ _ _ - - _i PLAN CHECK $. - �` ;p 0:1 am exempt under Section- ` - -- -- Br& P: C: forthis ---- ..-- - ---- -- --� BOILERS BTU - -" ' • - .._ . _ _ _ .5,' ELECTRICAL $� " reason _ __ -_ _ _. _. SYSTEM REPAIR, ALTERATION r _ _ tt^ MICR OFIL7A's �^ -'- 'PL -AN CHECK-$ - - - - --- -- MECHANICAL-,$ -� _ - 'TOTALI�FEE $ "� _ -fit' - - - ' Date Owner I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE J • I : • i .VAN information is"correct..-l-agree-to-comply-with all-city'and-count to 1 PLAN CHECK- -Oi,�h; EPC '-t -: rites and state laws relating construction, and hereby authorize -this -city -enter -upon -the II - _ _ L ( ' a ) { '' r representatives of to above- mentioned representatives property nspection rp -- - --- / C Signatu _ [� _. _ _ ---Date J _'Z-) ZC. --.__ - - - )) .._ _- _. FINAL FEE $ Drivers' License.." -. -. _.. _ _ _ _ _ -ISSUE FEE _ ..- _. 'i _.. --.._ __ _ ._ .- _ .__ .__ ..•.. CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TU AM C CONSTRUCTION AND PLANNI G APPROVALS Permit # Date Inspector POOL & SPA a - .= 'APPROVALS Permit # `•�•:,, Date Inspector 1. Temporary Electrical Service or Po_le-' 43. „Pool &Equipment Location' J-- 1. -2. ,Soil ipe.Undrgrn _;- -_ _ _ _ _ _ _ 44. Steel Reinforcement- 3.-_ElectricaLConduit.UtilityzUndrgrnL45. --- "'-- Forms _ - -- - - - 4.__Electrical"Conduit-Undrgrn-. _ _.. cr •'_ _._ '_ :, -_ ..' 46. Electrical Bonding- {. _ : tee ein orce- 47. Rough Plumbing& Pressure Test -• - --- - ••--- - - - --- - - _ -6. Electrical UFER Grn,•- _� "- �48. APPROVAL TO COVER-GUNITE- _7.. Footings , g, 49. Electrical Conduit-Undirrn', ''' "• "' i- B... Foundation_ _. _.' _. '. ' 50:, -Gas Pipe,-,DrUndr m, Test _ -9.--Water.P.ipe-Undrgrn__ . _ T' _' _'" -. 51.: _ Backwash Lines P-Trip,❑ndr rn • - " ' ' ' `._.10. _Structural Floor -.System. - » ' ;• .52. . - ___ � APPROVALTODECK - .-. _. .. ,_._...___ r. •__71. _Property Sewer Line.& House -Connection - .r - �--' '�s 53. � Backwash WRece tor-F.inal'.~' .. 12.- Street Sewer Connection' - --- - - - - 54: Heater & VenYFinal ,_.13. _ Rough Plumbing - 14. Rough Electric -Conduit f " - - - "' '56. Electrical -Final • -' ' • - - • ^ ' 15. Rough Electric -Wiring -"- - - - 57. _ Solar System -Final 16. 'Rough Heating & Air Co-nditioning- ' - - :, - - _ •-- Fencing.& Access Approval 17:- -Ducts,-in Structure-=, .APPROVED.FOR PLASTERING r• -. .' i '. -18. DuctsrVentilating- - ' --- - '- 19: Gas Pipe -Rough '& Test 20: Roof.Framing.. _- ---- " _ - -` .. 1_. -F- r -- _ - - -60. --- -POO L/SPA SYSTEMS FINAL - --. . + .. .. , , .i• , 21: Roof'Sh'eaTtiin 22:- Frame -and -Flashing -- - - - -- -- -- i -- _' - - =$VL - 'NOTES �, ., • , = •.� ,r .. aT " - -23: Insulation 24. Lathing& -Siding r,'"' } 25. DrywallNailin9 - - _"..'-- ...,. '. .i - - .. '�..: .. .. •,. _ .,r. ,.vc.. ' 26: Plaster-BrownCoat -- - - ,{• - - --- - - - - •' ' ,- 27: Electrical Power Meter -Final- - - -- - - - - r -- - ' - - _• • ,- '' !-28.- -•FinaliElectric-• 29: -Final;Heating &-Air Conditioning- - - - •t-- - -- - - -- - - 30S-Final'Gas-Pipe-Test -.- - - - - ---- -- - -- - - - - - - " • ' .31.1.._.FinayPlumbing'----_... ._ .. __................._._,_....,,.. ....._ 32!- Water Service -Finan -33. GasiService-Final- . - - - -- --- - :•� - • •� 1 34. Solar Domestic -Final "' "' _- _ _ _ _ _ _ `'' "-_.• -'� " 35. ' Landscape Sprinkling System 36. Sound Attenuation 37. Handicap, Regulations 38. FINAL STRUCTURE & BUILDING - 4 39. Special Requirements Completed 1 40. Electric. Release to Edison - 1 41. Gas Release to Southern California Gas Co.- ! 42. CERTIFICATE OF OCCUPANCY No• Date �" - I STRUCTURAL APPROVAL ONLY SEPARATE PERMITS ARE REQUIRED FOR El FGfR , !W , . Pf uilI . !,81NG, V-li Al, -01-AWf' AND c REFRIGERATION Ill Perm 'N THIS Ni-:: L Irt—I -4 [+ HE; —7-1 17 1 if i T7 7 -T-F M—L M-1-1 [7I Il I I I --l-LLL f I I if A J) LL I I I I if i I -M—1 I I i T- -1 -F —jT-FF1 T LL I I I T �T =-1, L I I I 1 4 I I I - JP 1 1 -a All LL --1 1 L -L L k4i i -j 11 14�1 I -H -1-7 i -T I it 77 1 1 !1 1 1 T IFF —1 7-7 1 I 7 —117-�-7- LI r L -71 —11 1 1 1 1 1 1 1 1 1 1 f I I I I I I I I I I I I -LIFFEB-EEH I I I I I I 1 1 1 1 l I I p I f 1 1!L' t I :1 11 :1 ?1 1 it 1—,"I Ll -LE I !-L-- -�-LILL L I LLE - Lj rIll. Ill lit 1 T- 1—T T 7_1 -7— _LL El I _I I I11 17 7 Fice•t ---L- -FT-7 `7 if 1: -77-- 1 II 1 It 71 1 1 : m,l fill I 1 11- ;1 If 11 It- i -L+ f- -L�--' Ll I it i I I fill F it I I It. 7 I'll lit; 1.1 7-1 i if 1 -1 +i lit lt 4 - I Ill`7 f :1 7 -r+ it 777 1[ 77 -i I If I L 1 11 I I If =1 -IT I I rrrF- Fil -T-I ;--,T-i I I I 1 11 1 it lit, I I . + I I I 1 I 'I r 11 p, __- - . "PRONVIED call CITY OF COSTA MESA FLAl DEPT. 5i TO of Inn. im arm DAM.4/4-7/dZ INVACM OF MANNING Pare PATIO COVER DETAIL -12/9/81 -NOT TO BE USED FOR SUN DECK, ETC. STATE --X ------ , SPACING SPA SIZE OVERHANG =-1 RAFTERS: ' Min. 114 .« CNGTH -.SLOPED FOR DRAIN I 3 z f 3/p x 5 Logs 32a/c Blocking �4' /c MAXIMUM Predrill Ledger Predrill Existing .....................'/43 Deep \ JOIST HANGER `-BEAM or other approved methods Oof support * tie. x ' STATE SIZE 3II6 % e -T -STRAP ALL LUMBER DOUGLAS FIR CONSTRUCTION GRADE FOR TABLE NO. 1 2 OR BETTER FOR TABLE NO. 2 POST -BEAM CONNECTION POST SHOW SIZE SHOW SPACING SHOW LOCATION ON REVERSE SIDE, - DROP PATIO FI -t— SLOPE TO DRAIN 2" max. @ door .�.:3 " THICK SLAB 5 PUDDLED SAND FILL• Remove Gass And Weeds Down To Natural Grade 12" CONCRETE MIX 1:3:4 MAXIMUM WATER CONTENT �_, � • •'+ _ 71 GALLONS PER SACK CEMENT. ked I—i2 Provide 26 Go G.I. Flashing At Wood Floor Const.- ithin 3" of Bottom, and ange or Weld Plate Screwed or Bolted to Frame. 12-46 (BU :0) rev. 12181 CONTINUOUS LEDGER TYPICAL JOIST ANCHOR NOTE: USE REVERSE SIDE FOR PLOT PLAN. NOTE: FOR PROPOSED OR FUTURE ROOM, OR WHERE PATIO WALLS ARE TO BE BUILT. USE NO.2 CHART ONLY. FOR PROPOSED OR FUTURE ROOM OR WHERE PATIO WALLS ARE TO BE BUILT SUBMIT COMPLETE HOUSE AND ADDITION PLANS FOR APPROVAL. COSTA ME":;A BUILDING DEPT. 77 FAIR DRIVE INSPECTIONS: 754-5627 RAFIER SIZE AND SPACIN No. 1 No. 2 UBC STD. TABLE UBCSTD.TABLE 25-21-J-6 25-21-R-1 For open egg crate alumi- For solid sheathing. num or plastic roof Shingles or built up covering. roofing. MAXIMUM SPAN SIZE SPACING MAXIMUM SPAN 17'2" 2" x 6" @ 12 o.c. 12'0" 15'7" 2" x 6" @ 16 o.c. 10'5" 13' 8" 2" x 6" @ 24 o.c. 8' 6" 10,111, 2" x 4" @ 12 o.c. - 9' .11 " 2" x 4" @ 16 o.c. - 8' 8" 2" x 4" @ 24 o.c. - NOTE: FOR PROPOSED OR FUTURE ROOM, OR WHERE PATIO WALLS ARE TO BE BUILT. USE NO.2 CHART ONLY. FOR PROPOSED OR FUTURE ROOM OR WHERE PATIO WALLS ARE TO BE BUILT SUBMIT COMPLETE HOUSE AND ADDITION PLANS FOR APPROVAL. COSTA ME":;A BUILDING DEPT. 77 FAIR DRIVE INSPECTIONS: 754-5627 4 fill in all heavy border CITY OF COSTA IM,.E$(A CONSTRUC1'IOJ�j•PERMIT( "` 1°"' VU ' Project Address a / (7/f2�-mOv ' 2 �! pplicant's Mailing Address 3t)yZ TYPE OF CONSTRUCTION LJ NEW Ll ADD ❑ ❑ all appropriate declarations. UNIT NO. ALTERATION LJ REPAIR �--(�� ^ Owner's Name n ShASrdwl Phone.�_L�'J Address /a/'1SQ ❑ 0N DEMOLISH OTHER CONVERS11- - - DESCRIPTION'_OF WORK/USE OF BLDG. A.P. E T B A C K $ Main Build Arch/Eng. License:No. Address TYPE OF PERMIT J ❑GRADING FOUNDATION L STRUCTURAL ❑ TENANT ❑ ELECTRICAL �P LUMBING ❑ MECHANICAL ❑ OTHER . - PROJECT DESCRIPTION SO. FT. OCCUPANCY - CONSTRUCTION TYPE - VALUATION $ Front Rear n 1 dAl h e Contractor's N plAr� n Q A�.L Cn'(2r� D ddress (mailing) - �� - Right Left City License No. I- ZONE LICENSED CONTRACTOR DECLARATION ' --:heieby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000): of Division 3 of the Business_ and Professions Code, and Remarks: 7031.5 by any applicant for a,permit subjects the applicant to a civil my license is in full force and effect. License Class - ense N $15 Issue Fee PERMIT 'late LIA 4 _ Signa toe 'O RKERS' COMPENSAT 19 CLARATION hereby affirm that I have ertificate of consent to self -insure or a certificate 'Bar Sink ' - of Workers' CompenSati Insurance, or a -certified copy t0ereof (Section Lab. C.) policy No -7 .L4_e'lc Company 21+%C - � Certified -copy is hereby furnished. I e Backflow Proyer"t er3800, Backflow Irrigation Bathtubs Certifietl copy is filed with the Ci B tlIng Dlvisigrw.u'O� Date _ � gi Applicant -- . t wo/ .s Clarifiers EXEMPTION FROM WORKERS' CANPENSATION DECLARATION (This section need not be Completed 1f the permit is for One hundred ($100) or less). : Dishwasher - - I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Drinking Fountains Workers' Compensation Laws of California. Floor Drains Date Signature NOTICE: If, after making this declaration, -you should become subject to the Floor Sinks Workers' Compensation provislons.of the Labor;Code, you must forthwith comply with such: provisions or this permit shall' be deemed revoked. Gas Service Outlets CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance - ".1 - Interceptors of the work for which this permit is issued (Section 30W)Civ. C.) Lender's Name J Kitchen Sink ~ ' Lender's Address -- t' OWNER BUILDER DECLARATION Ihereby affirm that I am exempt from the Contractor's License Law for the ' Lavatories f f following reason (Section 7031.5 Business and Professional Cotle:. Any city or P -Trap county which requires a permit to,construct, alter, improve, demolish or repair GRADING CU.YDS. ACRES plug. Ref. # •' - Planning Notes PLUMBING ' Service Sink - Sewei Cap ' I Sewer Connection - '- Solar Collectors - Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto -Wash CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assn _. --� ADD ld 11 ing: , ;I_ fAccesspr Parking F Automatic Washer Construction Pole Cooking Unit Dishwasher Dryers ❑Gas ❑ Fan F.A.U. Fixtures Z Device Boxes Outlets $ 3 FEES ELECTRICAL ' Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100 amps c Sub Panel Motors E10-1 HP,❑1'A-8 _Inc. Solar 09-15 HP 016 - Microwave Pole Light owacnes Garbage Disposal Generator 1:10-5 KW EI 5-15 KW Sign Trash Compactor Reinspection Fee - I $15 Issue Fee DEVELOPMENT SERVICESiREQUIREMENTS: f Zoning Approved By ' —Dal Building Approved By Dal Application Issued By- Dal N G R E Q M T S FEES $ 3 ' any structure,'prior to its issuance, also requires the applicant for such permit q file a signed statement that he/she is licensed pursuant to the provisions of fe Contractor's License Law (Chapter 9 (commencing with Section'7000) of Division 3 of the Business and Professions' Code) or that he/she iS•exempt' therefrom and thebasisfor the alleged exemption. Any violation of Section i- G u'v "`v' r Roof Drains ' , ' $ 7031.5 by any applicant for a,permit subjects the applicant to a civil f Reinspection Fee $15 Issue Fee PERMIT f5nalty of not more than five hundred dollars ($500). LJ I, as owner of, the property or my employees with wages as their sole PLUMBING compensation, will do the work, and the structure is not intended or offered for, sale (Section 7044, Business and, Professional Cotle:. The Contractor's License Law does not apply to an owner of a property who builds or improves MECHANICAL' - $' Boiler _ r 'Hood or Type I ❑ ' Canopy Type II ❑ ' ENERGY P.C. thereon, and who does Such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, thebuildingor improvement is sold within one yea, of com- pletion, the owner will have the burden of proving he/she did not build or im- ELECTRICAL Duct - Under Ground GRADING _ prove for the purpose of sale). PLAN CHECK •.50% Duct -Structural Refrigeration System $... ❑ I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does, not apply -to an owner of property who builds or improves thereon, and whocontractsfor Such projects with a con- ❑0-100000 BTU ❑100,000.8 Duct- Ventilating Exhaust System'❑ Multiple E)System"R _ epair/Alteration tractors) license pursuant to the contractor's License Law). I am aware that proof of their Worker's' Compensation insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Firepl/Fact. Bit. ICED # Fire Dampers f Date Owner Heating System & Ducting Registers - I hereby certify that I have read•this application and state that the above 110-100,000 BTU 0100,000 BT information -is correct. I agree to Comply with all city and county ordinances ' and state laws relati of to .building construe f antl hereby authorize repre- sentatives of this ty. to a Ler upon t love -mentioned propert o inspection pur pj Signet ure-� +• ` - Dale - - J� / Drivers' Li se or 55 - _- - - Reinspection Fee $15' - Issue Fee CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assn _. --� ADD ld 11 ing: , ;I_ fAccesspr Parking F Automatic Washer Construction Pole Cooking Unit Dishwasher Dryers ❑Gas ❑ Fan F.A.U. Fixtures Z Device Boxes Outlets $ 3 FEES ELECTRICAL ' Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100 amps c Sub Panel Motors E10-1 HP,❑1'A-8 _Inc. Solar 09-15 HP 016 - Microwave Pole Light owacnes Garbage Disposal Generator 1:10-5 KW EI 5-15 KW Sign Trash Compactor Reinspection Fee - I $15 Issue Fee DEVELOPMENT SERVICESiREQUIREMENTS: f Zoning Approved By ' —Dal Building Approved By Dal Application Issued By- Dal N G R E Q M T S FEES $ 3 ' SUMNIARYOFFEES; r BUILDING PERMIT $ -,SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE .. $' PLAN CHECK 25% $ ENERGY P.C. ELECTRICAL $ GRADING $ PLAN CHECK •.50% $ MICROFILM $... CONSTRUCTION AND PLANNING APPROVALS Permit # Date .- Inspector POOL & SPA APPROVALS Permit # Date Inspector . Temporary Electrical Service or. Pole 52. Pool & Equipment Location . Soil Pipe-Undrgrnd.'.. 53. Steel Reinforcement . Electrical Conduit Utility-Undrgrnd. 54. Forms . Electrical Conduit-Undrgrnd. 55.Electrical Bonding - 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit;Undrgrnd. 8. Foundation '59. Gas Pipe, 0-Undrgrnd., Test 9. Water Pipe-Undrgrnd. - - 60. Backwash Lines, P -Trap, 0 Undrgrnd. 0. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final ; 12. Sewer Cap 63. Heater & Vent -Final 13, Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final Rough Electric Wiring 67. Fencing & Access Approval - - Rough Wiring Sign 68. APPROVED FOR PLASTERING Rough Electrical -T Bar Ceiling U20: , . 69. POOL/SPA SYSTEMS FINAL Rough Heating &Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # _ ' Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating ! 71. Product Piping OGas 00il 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas 0 Oil 25. Roof Sheathing - 74. Overhead Hydro - 26. T -Bar Ceiling (Structural) & Monocoat -75. Dry Chemical 27. Frame and Flashing - 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL r - 29. Insulation - 78. FIRE PREY. FINAL ' 30. Drywall Nailing ' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat '. 79.: FINAL INSPECTION f 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED r 33. Final Electric Notes: •, t' 34. Final Heating & Air Conditioning 35. Final Gas'Pipe-Test e-0- 36. Hood or Canopy ' 37F Final Factory Fireplace ' 38'. Final Plumbing 39. Water Service -Final - 40. Gas Service -Final - 41. Solar Domestic -Final J - 42. Backflow Preventer �- 43.Backflow Irrigation 44. Landscape Irrigation System - :.45. Sound Attenuation `46. Handicap Regulations I ,47. FINAL STRUCTURE & BUILDING 48. 'Special Requirements Completed 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date V Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations CITY OF COSTA MESA NS RUCTI N PERMIT- PERMIT NO." / G V TRACT NO. LOT NO: UNIT NO. - BO I 1 "2/21 /85 - 5a oo 1 Project Address d..r' lFe ' _ J • TYPE OF CONSTRUCTION' NEW, ADD ALTERATION -REPAIR . f Applicant's Mailing Address -hone CONVERSION ❑DEMOLISH '❑ OTHER - A.P. # - Zone Owner's Name C- O - - - - - - 'DESCRIPTION OF WORK/USE OFBLDG, 'Address' - 7 S Main Building:• - Accessory Building: ` Arch - License No.' TYPE OF PERMIT GRADING [I]/Eng: FOUNDATION T SRUCTURAL 1 T Front r • ; - 'O l� TENANT ELECTRICAL UMBING ❑ MECHANICAL B - N pyo '•r Address. -❑ {j ��^p��.! Nam Phone o� _❑ • ❑'OTHER .' _ - A Rear - .. ! _ _ Contractor's - SQ'. C Right ; 1 N .G I n "Address PROJECT DESCRIPTION' FT. - - OCCUPANCY' K (mailing- i CON STRUCTION;YPE' "VALUATION $ I- S Left - City License No. ;30%'3 - r . ZONE GRADING CU. YDS. 'ACRES ,- Ping. Ref. # Parking. Req./Provided' R E� LICENSED CONTRACTOR DECLARATION 1 VT•� I, hereby affirm that I am licensed under provisions of Charter 9 (commencing 1 Remarks: 1 I Pa Oning Notes: I 1 1 fv1, with section 7000) Of Division 3 of the Business and Professions Code, and - 1 _ - T • my license is in II fo a nd effect. I i - �• , _ UI .nse Class —Lice e N.. Signature PLUMBING, - i FEESOate7,1�;�,_ WORKE_h_S_Sf COi1MPENSATION DECLARATION I I1 Bar Sink Showers - I - ELECTRICAL l FEES I 1 hereby affirm that I have a certificate of consent to self -insure or a certificate I i .of. Workers' Compensation-Insurance,,or- a_certified' copy thereof (Section,'. Backflow Preventer -- - -- Service Sink- - -- - -i - - - -- - Automatic Washer; - - - -Transformer ❑ 15-50 KW ' Late fr -P000y No.1C'CS-'u/Oi Company 2 �%L�/"�� I Backf low Irrigation I 1 Sewer Co P 1 Construction Pole,Sub. f I - i ❑ 50+KW kspwied copy is hereby furnished. i — er�t"fi$� cpp with the city Buil 'Sion i I Bathtutis ( _ Sewer Connection Cooking Unit Meter ❑up to 100 amps Date_( Applicant - �T ION FROM WORKERS' COMPENSATION DECLARATION ; Clarifiers 1 Solar C011ect0ls Dishwasher •ti Meter ❑over X100 amps _ (Th s (This section need not be cam plefetl if the permit is for one hundred retl ($100) or Dishwasher Solar Piping - ' Dryers ❑Gas DElectr is , Sub Panel - less). I certify that in th erfor f the work for which this permit is issued, I 1 , - shall not employ pe , y manner s s ecome subject to the Drinking Fountains I ' Solar Tank Fan �'/ Motors ❑Ql HP ❑1'/x-8 Workers', Compe s of. alifarnia., �� Date Signa ure Floor Drains 1 I Swimming Pool w/Spa F.A.U. Inc. Solar 09-15 HP Ell 6-15+ NOTICE: If, after making this declaration, you should become subject to the ' Workers' Compensation provisions OfJthe Labor Code, -you must .forthwith - Floor Sinks' -- - Urinal r 1 - - --i - - Fixtures- - Microwave - - comply with such provisions or this permit shall be, deemed revoked. - .._ _ CONSTRUCTION'LENDING' AGENCY' •: � Gas Service Outlets Water Closet ✓'. 1 - - - _ Device Boxes Pole Light I hereby affirm that there is a cons uction lending agency for the performance - •- �. of the ,work for. which/th is t is issued .(Section ,3097 Civ. C.) I Interce tors; - P Water, Heater i i Outlets f t Range L.entler's Name !moi _ 1 Lender's Addresi -- - - I I ; Kitchen Sink _ - Water Service- ;/ Switches' �' Sign OWNER BUILDER DECLARATION I I . - ' _ ,. I hereby affirm "that I am exempt from the Contractors License Law for the Lavatories - _ i - Garbage Dis osal " 9 P 'Standing Sections following reason (Section 7031.5, Business and Professional Code: Any city or r/ county which requires a permit to construct, alter, improve, demolish or repair. P -Trap I ,i� ". 1 I Generator ❑0-5 KW ❑5.15 KW Trash Compactor ' P any structure, prior ,its issuance, also requires the applicant for such permit ), to -file a signed statement that he/she i5 licensed pursuant Sects provisions of 9 Section 7000p Roof Drains �► License (commencing with of the Contractor's License Law (Chapter Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031'.5 by any applicant for a permit subjects. Ahe applicant'to a civil - 1 '� enalty of not more than five hundred dollars ($500).1 1, as owner of the property or my employees with wages as their sole •'- _ ' R¢inSpeCtien, Fee $15 _ Issue Fee $'3 -compensation, will do the work, and the.structure ebot intended or offered ' - •- Reinspection Fee- $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's - i ;MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work. himself/herself or through his or her own' _ 'Hood - �� ) - - DEVELOPMENT SERVICES REQUIREMENTS: I employees, provided that such improvements are not intended or offered for Boiler ,� or Type 1' ❑ i- Zoning Approved By f' Date sale. If,', however, the building or improvement is sold within one year of com- Canopy Type I I ElI plation, the owner will have the burden Of proving he/she did not build or im-' Duct'- Under Ground Building Approved By Date drove for the, purpose of sale). • L (J I„as'owner oft he property, am exclusively contracting with licensed con- i Duct- Structural Refrigeration System Application Issued By L� Date [ �S tractors to construct the project (Section 7044, Business and Professions Code: The,. Contractor's License Law tloes not apply to an owner of property who Duct - Ventilating ❑0-100,000 BTU ❑100,0.00 BTU I = a ' _ SUMMARY OF FEES builtls or improves thereon; and who contracts -for such projects with a con- - -, - tractor(s1 license pursuant to the Contractor's License Law). am aware that - - Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof o their Worker's Compensation insurance should be provided to me., f/ , PLAN !CHECK $ - PERMIT ' ❑ am exempt under Section B. &P, C. for this reason i Firepl/Fact; elt. ICBG # 1 +' - ISSUANCE $ / PLUMBING $ I n Ower. Date& ' - 1 ng ysem Ducting � Heating S t D 1 , PLAN CHECK . 25% $ ENERGY P.C. $ ; I hereby'certify'that 'I have read this application' and state that the -above - 730-100, 000'BTU-D100,OOOBT ELECTRICAL' $ GRADING $ Information is correct. I agree to'compil with all city and county ordinances and state laws relating to building constru jion, and hereby authorize repre- 1 i PLAN,CHECK 50% $ .MICROFILM $ sentativesoft this qty to enter upon above-mentioned property for i Inspection Sf ; i ! .{ O our Date ' MECHANICAL $ : 'TOTAL FEE $ v- Signature Reinspection Fee 1$15 Issue Fee $ 3 PLAWCHECK '25% $ Drivers' License or SS # CMF 0865-46, rev. 4/84 White- Building; Canarv_.Annl;a^, n'-'--^------. ina�Goldeorod- Assessor - - - - 4 j CONSTRUCTION AND PLANNING e APPROVALS, ' Permit # J , Date Inspector .,. • 10L & SPA _ - APPROVALS Permit # Date, - Inspector r1. Temporary Electrical Service or Pole•-+ - 'i 52. Pool:& Equipment Location - .2. Soil Pipe-Undrgrnd. C +•-: �� . iJ _ - 53. Steel Reinforcement: '3. Electrical Conduit'Utility-Undrgrnd. - .54. Forms 4.•Electrical Conduit ,Undrgrnd. 55:.Electrical Bonding 5. SteelReinforcement", rte- 56. Rough Plumbing &'Pressure Test 4•� 6. Electrical UFER Gr Ad 57. �APPROVAL TO COVER-GUNITE �• '" ,%I 7. Footings - /• Electrical Conduit-Undrgrnd. -8. 'Foundation r 59. Gas Pipe; O Undrgrnd., Test r9.• Water Pipe-Undrgrnd. - + • �' '60. Backwash Lines, P-Tiap, O Undrgrnd. - ' 10. te .Structural Floor Sysm if' 61.- APPROVAL' TO DECK ' 11. Property Sewer Line & House Connection 62. Backwash &Receptor -Final 12. Sewer Cap '�; - -•� _ 63. Heater &Vent -Final f' 13. Roof Drains. - 64. Plumbing System: Final.. fr.. 14. Rough Plumbing j - 65. Electrical -Final 15. Rough Electrical -Conduit , - - - - -- - - 66: Solar System -Final - ' -• -• 16. %Rough Electric Wiring ., ;• '67. Fencing & Access Approval- -, - 17. Rough Wiring.Sign - - -68. APPROVED FOR PLASTERING 18. •Rough Electrical -T Bay. Ceiling .69. POOL/SPA SYSTEMS FINAL - - ` 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - EQUIREMENT-20.Rough APPROVALS Permit# i ' 20. RoughFactory Fireplace ' 21.;Ducts,in Structure i 70. Underground Hydro 22. Ducts, Ventilating ,� 71. Product Piping O Gas - ❑ Oil '23. Gas. Pipe -Rough & Test - 72. Underground Flush -- - 24. Roof Framing - 73: Undergrnd. Storage Tank 'O Gas ❑ Oil + 25. Roof Sheathing 74. O've`rhead Hydro 1 26. T -Bar Ceiling (Structural) & Monocoat -175. Dry -Chemical - 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77: FIXED SYSTEM FINAL - 29. Insulation 78: FIRE PREV. FINAL 30. Drywall Nailing , i HEALTHDEPT. REQUIREMENT 31. Plaster Brown Coat ' 79. FINAL INSPECTION ' 32. Electrical Power Meter -Final + 80! FOOD CERTIFICATE ISSUED ' 33. Final Electric I Notes:, 34. Final Heating'& Air, Conditioning t 35. Final Gas Pipe -Test , I 36. Hood or Canopy i - 37. Final Factory Fireplace - - - 38. F nal Plu 39. Water Service -Final .4r + 40. Gas Service -Final . I , 41. Solar Domestic -Final . 42. Backflow Preventer 43. Backflow Irrigation 44. •Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations• 47. FINAL STRUCTURE & BUILDING - I 48. Special Requirements Completed I 49. Electric Release to'Edison 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE.OF OCCUPANCY No. Date - _ 4 OWNER YALE PROPERTIES DATE 10-17-58 _ )OB ADDRESS 204 Dartmouth BUILDING PERMIT NO. 7807 GENERAL CONTRACTOR Dike & Colegrove VALUE $ 13,919.00 AP. No. LOT 10 TRACT Gpol IP I & i TYPP. t coat FIRE ZONE DESCRIPTION OF WORK ZONE Rl PLAN NO. DATE I SUBCONTRACTOR I ____ PERMITS ISSU %lid 4 OWNER hKLOFA PAUL DATE AP No. 141-455-06 LOT 10 TRACT 2955 FIRE ZONE VALUE $ M. 800.00 INSPECTIONS Signature Date TYPE V GROUP T ZONE Rl SOIL SUBCONTRACTOR I!EPMJED GAS Dote Number Si nat WATER - PI mbin ROUGH PLUMBING ' _ PROP. SWR. LIN[ =HOUSE CON.Q SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNOE ROUND POWER ED ROUGWWIRING TRENCHES FORMS STEEL REINF. Lj Heatin and Vent. . - Q FLOOR'SYSTEM- BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING — IN OUT -7'7 ,'L• '� PLASTER, BROWN COAT ') STRUCTURAL, FINAL Electfle HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING. FINAL AND GAS TEST ELECTRIC, FINAL BUILDING, FINAL O' Oma'—? 7 OWNER GFORC'F SPT'NK DATE 76 �. JOB ADDRESS pnh Tlartmnnth Plaoe BUILDING P ITE'RTNNO. 2:491 GENERAL CONTRACTOR B1Ae 118Ven Fools DESCRIPTION OF WORK Private Pool AP No. 1111-7155-06 TATTRACT FIRE ZONE VALUE $ 2.400.00 INSPECTIONS Signature Date GROUP J TYPE III ZONE R-1 Soil SUBCONTRACTOR PERMITS ISSUED Gas Date I Number I Signal Water Plumbing Rough Plumbing �S' E�l'.e =p 1413G 7-30V3 Prop. Swr. Line p House Con. ❑ Sprinkling System Miscellaneous Rough Heating and Air Conditioning Temporary Service or Pole Underground ❑ Power;n Rough Wiring Heating and Vent. Trenches p Forms ❑ Steel Reinf..E] Floor System Bond Beam ❑ Steel Reinforce ❑ Sheathing Frame and Flashing Lathing — In ❑ Out p Plaster, Brown Coat Structural, Final Electric Heating, Vent., Refrig. and A.C., Final JhCk RICkzFS .34- S Plumbing, Final and Gas Test ❑ Electric, Final Building, Final .O '—