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Home My WebLink About682 DARRELL ST - Building Permits� , s . � � 1. Job Address: Suite: Vicinity: Primary Occ: Parcel Number: ;� 682 DARRELL ST REAR SFD R-3 Dwellings/ Cong Res <10 42215222 TEJEDA, LOUIS Type of Conslruction: V-N Zoning: Phone: 949-463-9337 - � , ':-zZip..:�. ISSUEDB - �i:�%= - - -�-- - - .�',/G�,:,- -- .''- � , -. ---:.— ��- ATIZ MICHELE � ; ��- ' i �� 682 DARRELL ST � ��; �� - �� ' � n�� , �- , � � � � �� Phone � � /- j � �,,, ��,' COSTA MESA, CA r-' �� `; � Zip .92627d2404 �..� � ``� /ii/ / � �,. A %� �-- � _' __ - � � � , /�� 'OWNER-BUILDER�i � � - - � �::;� '�r� �� /'� V /'%%'" � . � �l �\, , � , i'�,��j,' Phone: Y�\- ,. , �\',/,�.; �� License: 000000 \`�\\�\�,\ - Phone: 2:- -� � ' ' Licenset, \ ,�'~ - w``�� '�y.,' l i i�i .. • __ __ ' __-_ - - - � ` . � l�t -' � SGVYt VI' YCKMI I CONSTRUCT A 24x20x13 FT. HIGH DETACHED PATIO STRUCTURE AT THE REAR OF AN Plan Check: $117.81 � Permit $181.25 � �SMIP Res , ' $0.99 , � SMIP�Com� '� _: $0.00 � Other. . $0.00 Inspection: $0.00 ` " �-TotaL• � �. $300.05 � - .- - -r��av�n�vwn� --.: - - <".., -��,'y /f^. ;.�v f -i;L�l;-�; n -r,1�'•��C21c' �. , �� : ,i�. . 1�.1 � ,/ �?1�'. :� n.%,Clairc t, : _. _ --! \ � `�� i� � �, q>tn � , ,;.-� � �,� , �- � ,,, - .�s _ ' _ C' - . / / 5 ' -- � ,f' - -- <'� _�% � �_ -- � �� PLANN�NG & ZONING fi SETBAC,KS_ � �\ � v Z � , tn� ? �� o�MAIN STRUCTURE Front � 0-0 � Rear -Z0� 0�� , Lefl 0 0� � Right i 0,0-i� ` \t� � 1 �' �� .+, i- , � � / a'� �a t��'+�..'.r ��%�� ACCESSORY -� Front 0�0 ?'� �' Rear 11-0` .,� ;'Lefi 13 0� z" �` '''�Riglil r%18-�0 Status: ISSUED Applied: OS/10/2007 Issued: OS/10/2007 � „ � � � . � J '' ` '$9,929.92 � �u;l;' � �,s000 � 1 �'�;�� i i,�l � �7� �j � I � _ 1 '� U,- � � i1' � �� ' � �;� j /lf /'��`,_,' Ini! , ... , / < ` / � � � , ��/ i ��/ � . �;% �fl / \ � .:� � �� /� � , PARKING ' � Existina � 0 � Reauired o � Pr000sed ' :o � j / �j� ) /,�� _ � , �., � � �i - �. � .. �� ' i�� V �� i' / � `,,� �ii �� A .-� _� ` �,� t �--� � '' . �">��/ if � �� 1 . ' ' "'�. .? ' . -- { �� / /� �-' � t. f , ' " __"__ .-� � . { / /�� V � -,/ i = �: .- A '� I /�� - �; i t V^. �T-`_ � ��VA /i�� \`\-` \ �-, ' '/� j �� i � 1 i � Li % � , -\' ' \ i l�,f r ! " /.�j / f'" �' %' ' ' __ . >� . , ,, ;: i�l%. .. ! NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12•21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 days.- INSPEC710NS: In order for the work authorized under this permit �o be considered legal, such work must comply with all applicable codes, and all required inspectlone and final approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 244&48 (8�00) � WORKERS' COMPENSATION DECLARATIOI I hereby affirtn under penalry of perjury one oi the �oilowinq declarations: ❑ I have end will maintain a certificate of consent to selt-Insure tor workers' compensation, as provitled for by section 3700 0( the Labor Cotle, for ihe pertormence of Ihe work tor which this pertnit is issued. ❑ I have and will maintain workers' compensation insurence, as repuiretl by section 3700 ot Ihe Labor Cada, for the peAortnance oF the work for which this pertnil is Issued. My workers' wmpensation Insurance carrier and policy numbar ere: Carrier: Policy Number: (This secfion need not be comp/eted if fhe permit /s velued at one hundred dollars ($100) or Iess.J i�� I cenity that in the pertoJ enceg e work lor which}6is �rmit is issued, I shall not employ any person in any manner so as to become subject to Ihe workers' compensation laws of Celi 4, nd agree�h�i+fi SF�oy become subject lo the workers' compensation provisions of Saction 3700 of the Labor Code, I shell toRhwith comply wilh Ihese provisio �// /�� nPPficenCSlOnatwe-� � .�.A L' �i Dare�„—+.S //�/� 7 WARNING: FAILURE i0 SEWFE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHP1L SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO IXJE HUNDRED TFIOUSAND DOLURE (5100,000), IN ADDITION TO TME COST OF COMPENSATION, �AMAGES A$ PROVIOED FOR IN SECTION 3]O60F THE LABOR CODE, IMEREST, AND ATTOqNEY'S FEES. LICENSED CONTRACTORS DECLARATON: I hereby affirm that I am licensed under provisions ot Chapter 9(commenr.inq with Section 7000) of Division 3 of Ihe Business and Professions Cotle, and my license is in full torce and etted. Lic. a Class x Contrectors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aflirtn ihat there is e construction lending agency for the perfortnance of the work for which this pertnit is issued. (Sec. 3097, Civil Code). Lenders Name: � Lender's Atltlress: SignaWre: Date: OWNER-BUILOER DECLARATIONS: I hereby ettirm thet untler penelry ot perjury Ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Protessians Cotle: Any ciry or county which requires a permit to consiruct, alter, Improve, demolish, or repair any sWcture, prior to its issuance, also raquires iha applicant tor such permit to file a signed statement ihat he or she is licensed pursuant to the provisions oi the Contractors �icense Law (Ghapter 9(commencing with Section 7000) oi Division 3 ot the Business and Profeuions Code) or that �e or she is ezempt therefrom and the basis tor the alleged exemption. Any violetion of Section 7031.5 by any applicam far a pertnit subjects �he epplicant to a civil penalry ot not more Ihan tive hundred dollars (5500).): �� I, as owner of lhe property, or my amployees with wages as their sole compensetion, WILL DO TME WORK, and Ihe siructure is not intended or oHeretl for sale (Sec. 7044, Business and Professions Cotle: The Contractors License Law dces not apply to an owner ot properry who builds or improves thereon, and who does such work himseN or herselt or through his or her own employees, providetl ihat such improvements ere not intended or oHered tor sele. It, howevar, the 6uilding or improvement is sold within one year of completion, ihe owner-builtler will have ihe burtlen of Droving Ihat he or she did not build or improve for purpose ot sele.). • ❑ I, as owner of the property, em E%CWSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct ihe project (Sec. 7044, Business and Professions Cotle: The conire rs License Law does not apply to an owner o1 property who builds or Improves ihereon, and who coniracts for such project wit� a contrectoqs) license pursuan o he Contractors License ws.). �I ❑ I am B: t r sec. . Business and Profession5 Code tor this reeson: I9igneWre� ^ C �Dal.b:""— � � Owner ID verified by dnvers license. Yes ❑ No Dnve v.��N� e,a��as:► j- I 3-09 I, Venfication of Ov+ners�ip by (type of tlwument, i.e. - property tav �ill or deed): DIVISION OF INDUSTRIAL SAFETV PERMRCERTIFICATION: ❑ I hereby certity that no excavation five (5) or more feet in depth inro which a person is requiretl to tlescenq will be metle in connection with work authonzetl by this permit, end Ihat no building siructure, scaXolOing, talsework, or tlemolition or tlismantling �hereot, will be more �han t�irry-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, TIIIe B, Califomia Atlministrative Code). ❑ As owner-builtler, I will not employ anyona to do work which would require a permit from iha Division ot Industrial Satery, as notetl above, unless such person has e permil to tlo such work from Iha division. Signature: Division ot Industnal Safery Parmit Number: Date: CERTIFlCATE OF COMPLIANCE AND AUTHOHIZATON OF ENTRY: I certify under penalry of perjury �hat I have reatl t�is application and state Ihat ihe infortnation given is wrrect. I egree to comply with a0 state laws and ciry ordinances releting to building construction, and authorize representatives of the Ciry oi Costa Mesa to eNer upon ihe ebove-described property tor inspection purposes. I agree not to occupy or allow occupancy of eny building authorized by Ihis permil until final inspection. CODE 1, INSVECTIONTYVE _ 1616 FixeC System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Root 201 Flnel BIocWRelaining Wall 202 203 204 Final Factory Fire Place Final Sign Final Demolition � �173��I:1� Data , %/t��d % �.Dal� COOE 1 INSPECTION 1YPE 206 Final Mechanical 20B Final Plumbing 210 Finel Electrical 212 Finel Fira Prevention 220 Final Planning Approval 222 Final Site 250 Final Building�Occupancy IZ7l�IJ111L14j 0 � JobAddress: 682 DARRELLST Status: ISSUED Suite No Applied: 08/11/2005 Vicinity: SIDE REAR OF HOUSE Issued: 08/11/2005 Parcel Nunmber: Applicant Address: 42215222 TEJEDA, LOUIS 682DARRELLSTREET Phone: 949-463-9337 COSTA MESA, CA Zip 92627 <�" � a -1.� � ��1 az. ��.. Owner: ATIZ, MICHELE ;,�, Address 682 DARRELL�ST $� ��, �,o � � � ,` Phone ° z� --� ,. .€, i COSTA MESA, CA � � � x Zip ' , , 92627� 2�404 ` ' , v � ` � ! .: ��Y� � � :y"�;\ Contractoi . OWNER BUILDER Addresst - �'<}"�� , 5{ Phone: �, � ISSUE�FEE $ - Temp servroe tesl � Res a/c:package �� New Res (1s7uni[s) � New Res (3+units) �� . Pool / Spa '.3 �.�``.. Lighhng Fixts �� 'r." Recept Outlets Switches,vs Non Res Appl ,';� ��- ResAppl' �,°�, . Service to 200a - '�' Service to 1000a �-� Service over 1DOOa Motors to 1hP ',��,�t',.. Motors to 10hp . Motors to 50hp _ Motors to 100hp �:� Motors over 100hp � �' Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole y4� l' c.EXISTING:SERVICE PF ...,,m�'.: - �,'rv�'° _ Quantity" 3,50 0:00. , r� ... . .. ,,., 0.00 ' 0.00 0 ,:Az p,.. �+�5 0 0 0 0 1 0 � 0 Zip , License: 000000 ; ", � : . ISSUED BY: _ :�— °L'� i, e e .....&:� _ +.. . . <. .rL 11111 .' . FOR EXISTING�SFD ��-�� ... . �.:- v �.� +�- ^ i g Temp Dist Systerii'/ Lighhng � � . ., y. . �Buswayt/100 ft '.,�. .,,� StandingSection�. ��,' Misc Electncal Eqwpment '� ;��,�, `Transtormers up to 1 kva/kw ,: ,,. �„ �;y: up.to 10 kva/kw� � �� Pok' -- `........upto50kva/kvi''.' �„� .. . .. up to 100 kva/kw , . ::over 100 kva/kw � �?'� LowVOlfage,Equipment �' Lo,w Volt Wiring System / Ckt 3�. _, ,,,.e;;�.�M�sc:,Conduit �'; �.' � � �� anhty �.��s��; �o� � � 0 � 0 r r s �p� a ; . p p �,�` i�� .;�. 0 �� ;{.; �f 0 � �. t �.: p��,. 0 ,0 .o� 0 y�;a �y � :l ao.vu.:' �;� � vumi�cw��aircc yvv r $0 00' 0 •�`�.*r � ,; � ; .�p. , � $0 OOs Ott� . ,y� Inve gatio� F,ee`�" .:Q;, $0 00 ,4�;' $0:00 f0 • Plan Check Fee,. � s$0 00 ��'. �$0�00. "�r0 � �' ��„�„ ReinspecGonFee� b�; - $000�" $OOO..�a., Q -,�,, :.�;,, ,.i�,��, - '��, �,. $0.00 ' 0. �'r �� TOTAL CALCUtATED FEES��$54.00 � $0.00 � p;?�",e. ,.,; ,.. .s.n:�:. wa • . NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 7, 12-21•92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 1 BO days. INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetions and final approval must be obtained. Failure to obtain inspections and final approval will resuN in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaas�as �doo� WORKERS'COMPENSAnON DECLARAnON: I hereby aflirtn under penalry ot perjury one ot ihe following tleda2tlons: E- , ❑� I heve end will maintain e cenificete of consent to sell�lnsure tor workers' compensetion, as D�ovided for by section 3700 of the Lebor Cotle, for the performance of the work for which ihis Dermit is issued. ❑ 1 have antl will meintein workers' compensation insurence, as required by section 3700 ot the Lebor Code, for the peRortnance of the work for w�ich ihis pertnit I5 Issued. My workers' compensation Insurence wrrier end policy numbar era: Carrier: Policy NumDer: (This secNon need not be completed i! the it is velued at one huntlred dollars ($100) or Iess.J fl�,.y�I+c�ertity that in iha anceyf ork for w�ich this permil Is issuetl, I shall not employ any parson in any menner so as to become subject to the workers' f' compensetion la ot Cal omie, d agree thet' ec bject ro the workers' compensation provisions of Sectio 3700 of ihe Labor Code, I shell forthwith comply with these provisio s. P aPPIIcantSig`nsMr Q21e'�V ��/�� WARNINO: FAILURE RE WO OOMPENSATION COVERAGE IS UNUW FUL AND SNALL SUBIEGT AN EMPLOVER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE MUNDRED hKK15PND DOLLARE (5100,000), IN ADDITION TO THE COST OF COMPENSATIIXJ, DAMAGES AS PROVIDED FOR IN SECiIIXJ 3�O60F THE L4BOR CODE, IMEFEST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirtn ihat I am Ilcensed under provisions of Chapter 9(commencing wiih Section 7000) of Division 3 oi the Business and Professions Code, entl my license is in full torce end eHect. Lic. a Class a Coniredors Signature: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby afTirtn ihat t�ere is a consiruction lentling agency for the peAortnance of tha work tor which this pertnit is issuetl. (Sec. 3097, Civil Code�. Lendefs Name: Lender's Address: Signature: Date: � OWNER-BUILDER DECLARA710NS: I �ereby aHirtn that untler penalry of perjury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions Cotle: Any ciry or county which requires e pertnit to construct, elter, improve, demolish, or repair any structure, Orior to its issuance, also requires ihe epplicant tor such pertnit b tile e slgnetl statemant that fie or she Is Ilcensed pursuent to the provislons of Ihe Conirectors License Law (Chapter 9(commencing wllh Sectlon 7000) oi Divislon 3 oi the Business end Professions�Code) or ihet he or she is evempt therefrom end the basis for ihe alleged exemption. Any Noletion of Seqlon 7031.5 by eny applicant for e pertnit sublecis the epplicant to a civll'penalry of not more ihan live hundred dollars ($500).): ❑ I, es owner ot t�e_property, or my empiqrees with wages as their sole compensatlon, WILL DO THE WORK, antl ihe structure Is not Intende0 or oHered for sele (Sec. 7044, Business and Professions Code: The Contraciors License Law tices not apply to an owner of property who builds or improves thereon, antl who does such work himself or hersetl or Ihrough his or her own employees, D�a�ded ihat such improvements are not Intentletl or oflered lor sale. It, however, the building or improvement is sold within one year ol completion; Ihe owner-builder will have Ihe burden of proving Ihet he or she did not build or improve for purpose of sale.). ' ❑ I, e9 owner of Iha property, am E%CWSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construCt the project (SeC. 7046, Business end Pmfeuion9 Cotle: The contractors LJcense Lew does not apply to en owner ol property who builtls or Improves thereon, antl who contracis lor such projact with e contrector(s) license pursuant to the Contractors License Lews.). ❑ I em eaempt under sec. Business antl Professions Code tor this reason: Signature: Date: Owner ID veritied by drlveYs license. ❑ Ves ❑ No Dnvefs License No. Vedlicetlon ot Ownership by (rype of Cocument, i.e. - proparty tax bill or deetl): OIVISION OF INDUSTRIAL SAFE7Y PERMR CERTFICATION: Expires: ❑ I heraby certity ihat no excavation five (5) or mora feet in depth into which a person Is required to descend, will 6e made in connection with work euthorizetl by this permit, end Ihat no Duilding structure, sceHolding, falsework, or demolition or dismantling thereof, will be more ihan thirty-six (38) leet high. (Chap. 32, Grp 2, Ar12, Sec. 341, Tille 8, Califomia Adminisirative Code). ❑ As owner-builtler, I will not employ enyone to do work which would require e permit irom the Division of Industnel Setety, as notetl above, unless such person �es e permit to da such work from the division. Signature: Date: Division of Industnal Sefery Permit Numbec CEHTIFICATE O OMPLIANCE AND AUTHORVATON OF ENTRY: I certity under penelry of perjury that I have read this epplication end state that the information given is correcL I egree to co ly with ell te laws and ciry ordinances relating lo bullding construction, end authonze representatives ot the Gty of Costa Mesa to eMar upon ihe above-desCribetl pro0e or in ction purpose a t tg.or6upy OS ellow occupancy of any building euthorized by this permit until final inspection. CO�E �. INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Finel 200 Finel Re-Rooi 201 Final BIocWRetaining Wall 202 Final Fectory Fira Place 203 Final Slgn 204 Final Demolition Pdg It�1Al�4 40UE� INSPECTIONTVPE 206 Final Mechanical 20B Final Plumbing 210 Final Eledrical 212 Finel Fire Prevention 220 Final Plenning Approval 222 Finel Site 250 Final Builtliny0aupancy PAIE I�l§ � � (714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT . Job Address: 682 DARRELL ST Suite: � Vicinity: RESIDENCE AND ATTACHED GARAGE Parcel Number: 42215222 Applicanr. TEJEDA, LOUIS — Zoning: Status: ISSUED Applied: 09/03/2004 Issued: 09I03/2004 ISSUED BY: � �- Address: _ " �� . -� _ � ' � � " ; Phone: 949-463-9337 " � . ' ii ' - . � Zip: ' . / . - _ , / - ' , . . . . / A � !l . � . - ' � � �� Owner: ATIZ: MICHEI;E� ` � � " � , .�` = �z Address 682 DARRELL�S7 , � � -- - - � ' � � � ; � � �ii,'`� ' .- _ '-- _ ._ ; � � � A�� :�'� � V . , _ � Phone: .. A _ . �� '�� .��COSTAMESA,CA � Zip: 92627-2404 �`.� �� "�� ` � � Contractor: OWNER-BUILDER � � � � . �Addressl �� . . � �;^. . , ' � Phone: ' � � . � ," �., "� _ � �. � �. - . . . . . _ _ ' �.'. - Zip:-�� , , ..License: 000000,,, _, _ ,. � " , - Arch : ' ' Address: ' � - � � ,�� Eng: � �� " � � � - . Address: �� Phone: ' License: � , , , , Phone: License: �, / , � -: - � r -. - � SCOPE OF PERMIT - � : � � - � - ' REROOF RESIDENCE AND ATTACHED GARAGE: T/O.EXISTING COMP ROOF,.REPAIR/REPLACE SHTG AS NEEDED; 1 LAYER 30# FECT; � APPLY "30-YEAR COMP SHINGLES." 2454 SQ FT. ALSO INSTALL 4 SKYLIGHTS ICBO # 3933: � •, J � �' . , ' � ., FEE SUMMARY -: , ' � � , Plan Check: ' . $0.00 — - � ' , " '' Calc Valuation: �; 85,500,00' Permit: � • $125.25 ' — ' Claim Valuation: - _ S5,5oo.00 ��SMIPRes: � � $0.55 . , -�� SMIP Com: ,_, $0.00 . - � � � ' � �� ` — — - i:"- � Other. `, � �,�,$0.00 -- �� - Inspect,ion: � � � $0.00 � , �� ` ,., , � � , ��' , ��'. ' � ,- .r ��j/ � l Total: $125.80 � _ ' � � , ... . ��j � SETBACKS� '� �" MAIN STRUCTURE� Front 0. 0 ACCESSORY Front� 0-0 PARKING Existin : 0•.. PLANNING.& ZONING ., _ ..� ,: ' /j rj; ; /i; � , = � . � , ,� „ ' �,,,; /�J/ , Rear � 0- 0_ �- -�` Ceft _� 0- 0��- � Right 0 0-�/� j' j ... �� ,/r , Rear � 0- 0 Left 0-A -�, ,�"� • Right � 0 j� . ; . , - ,.�- �� Required: 0� , ' ProPosedd �-0' .�i�=j-- %"l -_ - =--.-.,---�- _. _ ...' . NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. Nb. 92-28, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. tNSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with aN appiicabie codes, antl ail required Inspeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. I FOR INSPECTIONS CALL: (714) 7545626 2446d6(&00) WORKERS'COMPENSAnON DECLARAnON: ' �by aHirm under penelry ot per�ury one oi the tollowing declarations: I heve entl will malntein e certtlicate of consent to self-Insure for workers' compensatlon, es provitletl far by sectlon 3700 of the Lebor Catle, for ihe peAortnenca otihe work for which t�is permit is issuad. ❑ I �ave end will maintan workers' compensetlon insurance, as required by section 3700 oi Ne Labor Code, for Ne pertortnance ot tha work br which Ihis permit is issued. My workers' compensetlon Insurence carrier antl policy number are: Cerrier: Is velued et one hundred dallars ($700) or IessJ tccwh" is i eQ I shell not employ t�aq I tl bec sub ct to the workers' c Policy Number. to become subjact to iha workers' ❑.3Z00 of thg Labor Code. I shell forthwith comp with these � \ / ApPlicent ' `/ WARNING: FAILURE TO SECURE ORKE S' WMPENSATIIXJ COVERAGE IS UNLAWFUL AND SHALL SU9IECT AN EMPLOYER TO CRIMI PENALTIES AND CIVIL FlNES UP TO ONE HUNDRED THOUSAND DOLLARE ($100.000), I P.DDITION TO THE COST OF CAMPENSATION, DAMAGES AS PROVIDED FOR IN SECiION 3]Ofi OF THE LABOR CADE, IMEREST, ANO ATTORNEV'S FEES: LICENSED CONTRACTORS DECLARATION: I hereby aflirtn Ihat I am licensed under pmvisions of Chaptar 9(commencing with Section 7000) of Division 3 ot ihe Business and Professions Code, end my license is in full force and ettect. lic. # Class M Contrectors Slgnawre: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn that there is a construction lending agency tor Ihe DeAortnance oi the work for which Ihis permit is issuetl. (Sec. 3097, Civil Cotle). Lenders Name: Lender's Address: SlgnaNre: Date: OWNER-BUILDER DECLARATIONS: I hereby ettirm thet under penelry oi Derjury thet I em EXEMM FROM 7HE CONTRAC70RS LICENSE LAW for the tollowing reason (Sec. 7037.5, Buslness antl Professlons Code: My ciry or counry which requires a permit to construct, alter, improve, tlemolish, or repair any structure, prior to its issuance, also requires Ihe epplicant for such pertnit to Ille e signetl stetement that he or she is licensed pursuant to the prodsions at the Contrectars License Lew (Chepier 9(commenang with Section 7000) of DlNsion 3 of �he Busineu and Protessions Code) or that he or she is exempt therefrom end the besis for the alleged exemption. Any violation of Section 7031.5 by any eDPlicent tor a parmit sub�ects the applicant to a civil panelry of not more than five hundred dollers ($500).): ❑ I, as owner of Ihe property, or my employees wlih weges as their sole compensation, WILL DO THE WORK, and the structure is not intendetl or oNered tor sele (Sec. 7044, Business antl Protessions Code: Tha Contractors License Law does not apply lo an owner of properry who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements era not intentled or oNeretl for sele. It, however, ihe bullding or improvement is sold within one year of comple�ion, ihe ownerbuilder will have ihe burden ot proving �ha� he or she did not Duild or improve for purpose oi sale.). ' ❑ I, as owner oi the prope , E%CLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS lo construct lhe project (Sec. 7044, Business and Professions Code: The co tor nse Lew daes not apply to ner o operty who Duilds or improves ihereon, and who wmracts for such project with e contrector(s) license purs nt e ontraaors Licens !�. .,- �.-- exem t u e ea � siness and Professions Code tor this raeson: ignatur : �6ate: D v ietl by drivefs license. �'es ❑ No D vers Li se No. �� Expire Vedtication ot Ownership by (type oi documem, I.e. - property �vc bill or tleetl): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATON: ❑ I hereby certify ihat no eacevatlon five (5) or more teet in depth into which a person is required to descend, will be made in connection with work euthorized by this pertnit, entl that no building sWcture, scaHolding, talsework, or demolition or dismantling ihereof, will be more than thirry-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title e, Calilamia Atlministretive Cade). ❑ As owner-builtler, I will not employ anyone m do work which would require a pertnit tmm the Divislon ot Indusinel Safery, as notetl above, unless such person hes e pertnit to do such wark irom ihe division. Signature: Date: Division of Intlustnal Safety Permit Number: CER7IFlCATE OF COMPLJANCE AND AUTHORVATION OF ENTRY: I cenify under penalry of perjury that I have read this applicetion and state that the information givan is wrrect I agree lo comply with all laws end ciry ordinances relating to building consWction, antl authonze representatives oi the Ciry of Coste Mesa to enter upon the above-described DroDelty for in ecti n puryoses. I agree not to occupy or allow occupancy of any buildinq authorized by Ihis permit umil finel inspection. COOE 1. INSPECTIONTYPE 1616 FixeG System Final Fire Prevention 1286 Pool Spe Final 200 Final Re-Roof 201 Final Block/Reteining Wall 202 Final Fectory Fire Place 203 Finel Sign 204 Finel Demalition jtt�g INTRULS , � ! .., ,..� •♦ CODE� INSPECTIONTY7E 206 Finel Mechanicel 208 Final Plumbing 210 Final Eleciricel 212 Final Flre Prevention 220 Final Planning Approval 222 Finel Site 250 Finel BuildingiOccupanry ��Ui�i;tliiT.14'� � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT � Job Address: 682 DARRELL ST Suite: Vicinity: RESIDENCE AND ATTACHED GARAGE a Parcel Number: 42215222 Applicant: TEJEDA, LOUIS Address: �"i.. � Owner: ATIZ, MICHELE Address �687DARRELL ST � . �. "COSTA MESA, CA ' �-/ � � % -"� � , , Contractor: O W N ER-6U I LDE R 'Address: - , � ,; � ,. � : , � Zip. �` , Arch :. Address: Zoning: � � Phone: 949-463-9337 ISSUED BV: Zip: " , ,`�, , , , , �� , .�` � � � �_ � : : ,..� . . � � . . � Phone: . : . . ��- � A . - . � � �., � / '�A. �A�. Zip: 92827-2404 - � � . // � � � ��'"'� � . �- . A' �.i. Phone:. �, � :�, `�. : : �. , License: 000000 � , . � � �, �, , . , .. � , . En9: � . ' ' _ � � �� . � � - • �.. � � Address: - ', � � � �� ' � � Phone: -.. ' � . . . Phone: � � , � � License: � �License: � � Status: ISSUED Applied: 09/03/2004 Issued: 09/03/2004 ` " _ SCC REROOF RESIDENCE AND ATTACHED GARAGE: T/O�EXISTING APPLY "30-YEAR COMP SHINGLES." 2454 S� FT � - �. Plan Check: ^ $0.00 - ' Permit: $111.25 SMIP Res: , $0.50 SMIP Com: � $0.00 ',' Other: � $0.00 'ins�pection: � �� $0.00 ; Total: $111.75 . SETBACKS�.:`, �" MAIN STRUCTURE'�Front � 0- 0 ��-. ACCESSORY Front� 0-0 PARKING Existin : 0 rtrcmi i_ �, JOF, REPAI WREFLACE SHTG AS NEEDED, 1 LAYER 30# FELT, FEE SUMMARY _ . - -- , - _ _ Calc Valuation: { ' sa;soo.00, � � Claim Valuation: ;,„ Sa,soo.00 � , � � , � �,rP � - -- ! , f i �:� ,. i>, � � � �_ � l �i,, �r ii; � � i— , � ,�� j�� ' � PLANNING 8 ZONING � <-�� /,�'� �� . , / � ,:.�. � _ , ; � � :/ i/'�j �_ .� i , � i; ; i � Rear - - 0 �0 ' . �_-LeH 0- 0- � . Right � 0, �0 - , ;� �� ,� / � . Rear � 0-0 Left 0-0 � ,` � . � Right' ��0,0 % �,/ . - ` ' . . � � 'i / ,.Required: 0 � , Proposed: 0.' � � �� //�� — -,�,. �" _ A 1 i NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under California statutes and related `" �regulations. (Ord. No.�92-28, § 1, 12-21-92) � . • . EXPIRATION: This �permit 6hall automatically' expire and become void if work is not commGjiced within 180 days, or if work is suspended or abandoned fot a' peAod of 180 days ��_ � ��--_ — ! ` � � . , � ; , � INSPECTIONS: In order for ihe.work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inapectlons and finel appioval must be obtained. Failure to obtain inspections and final approval will,result in the expiration of this permit. � F ,. i• FOR INSPECTIONS CALL: (714) 7545626 ' r 2446d818/00) . . • .1 WORKERS'COMPENSAnON DECLARAnON: I hareby aflirm untler Denalry ot perjury one ot Ihe tollowing tleclarations: ❑ I heve end wlll mainlein e certificate ot consent to self-Insure for workers' compensation, es proNded for by section 3700 0l the Lebor Cotle, for the paAortnance of the work tor whlch this pertnli 15 iuue0. ❑ I heve arW will mflinWin workers' compensation insurance, es requiretl by secllon 3700 of ��e Labor Code, for the perfortnance of Ihe work for which this pe�mit is Issued. My workers' compensatlon Insurence carrier entl policy number ere: Carrier: Policy Number. (This section need not be comp/eted i/ the permiNs valuetl et one huntlred dWlers ($100) or /ess.J � I cetlity that In the pertortnance o�work for which Ihls permit is Issued, I shall not employ any person in eny menner so as to 6ecome subject to iha workers' compansetlon laws ot�a�( omi d agree thekiLLcpeWft ci ubject to Ihe workere' compensation provisions of S ction 3700 ofjjjhhh a Labor Code, I shell fan�wit� comply with t�ese p visiod .� z /// '/ Applicen� Signeture: � � �� Date: . ��1 WARNINO: FNLURE TO S E WO ' COMPENSATION CAVERAGE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOVER TO CFIMINAL PENALfiES AND CIVIL FINES UP TO ONE HUNDRED TqUSAND OOLLARE (5100.OW�. IN ADDfTION TO THE C0.ST OF COMPENSATIIXJ, DAMAGES AS PROVIDED WR IN SECiIIXJ 370fi OF THE LABOR COOE, INiEHEST, AND ATTORNEI^S FEES. LICENSED CONTRAC70RS DECLARATION: I hereby aHirtn that I em licensetl under provisions oi Chapter 9(commencing with Section 7000) ot Division 3 of ihe Business and Protessions Code, and my licensa Is In full torce ana enect. uc. a class k ConirectoYs Signeture: Dete: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirm ihat Ihere is e constmction lending agency for the pedormance of Ihe work for which ihis permit is issuad. (Sec. 3097, Civil Code). Lentlels Neme: Lentler's Atltlress: Signature: Dete: OWNER-BUILDER DECLARATIONS: I hereby effirtn thet unCer penalry ot perjury that I em EXEMPT FROM THE CONTRACTORS IICENSE LAW for Ihe Following reason (Sec. 7031.5, Business entl Professions Code: Any ciry or counry which requires e permit to construct, elter, improve, demolish, or repair any sWcture, pnor to its issuence, also requires the epplicant for such permit to file a signed statement thet he or she Is Iicensetl pursuant to Ihe provislons oi the Cantradors License Lew (Chepter 9(wmmencing with Section 7000) of Division 3 oi the Business entl Professions Cotle) or t�et he or she Is exempt therefrom and the besis for the alleged exemption. Any violatlon oi Section 7031.5 by any applicent for e pertnit subjects tha applicant to e civil penalry ol not more Ihan fve hundrad dollars (5500).): �RI, es owner of Iha properry, or my employees with wages es �heir sole compensation, WILL DO THE WORK, end the structure Is not intended or oHeretl tor sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to en owner of property who builtls or improves thereon, and who tloes such work himselt or �erseli or through his or her own employees, provideC Ihai such improvements ere not Iniendetl or oHered for sale. If, however, the builtling or Improvement is sold within one year oi completion, Ihe owner-builder will have Ihe burden of Droving that he or she tlid not build or improve for purpose of sale.). ' ❑ I, es ownar of �he praperty, am %CLUSIVELV CONTRAC7ING WITH LICENSED CONTRACTORS to consiruct ihe prqect (Sac. 7044, Business and Prafesslons Code: The comra Licen w tloes not epply to en ow er of propeny who builtls or Improves t�ereon, antl who contracts for such project with e conirector(s) . license pursue to th Co r ctors License=�sy�—j �%/D // ❑ I am e:empt nder se 1 Business antl Prolessions Code tor this reeson: � / �f" Slgneiure: �Date? Ownar ID verifia by ers Ilcense. ❑ Yes N Drivefs Licensa No. Eapires: Verificetlon ot Ownership by (rype of tlocument, i.e. - properry tu bill or tleetl): DIVISION OF INDUS7RIAL SAFETV PERMR CER7IFICATION: ❑ I hereby certity ihat no e:cavation tive (5) or more feet in depih into which e person is requiretl �o tlescend, will be made In connection with work euthorized by this permit, and thet no building siructure, scattolding, falsework, or demolition or dismantling �hereot, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, TIOe 8, Celitomia Adminisiretive Code). ❑ As owneo-builder, I will not employ enyone to do work which would require a permit trom the Division of Intlustrial Safery, as noted above, unleu such parson has e permit to tlo such work trom the division. Signature: Date: Division of Intlusirial Safery Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATON: t W III Ihe applicent or present or tuture building occupant need to tile end certify a Business Plan tor emergency response to release or threatened release oi a hazerdous matedel? ❑ Yes ❑ No (Section 25505 oi the Celitomia Health antl Sefery Gode requires, with some ezceptions, that a Business Plen be filed with the Costa Mesa Fire Department Dy every business which has at any one time dunng a reported year a quantiry of harardous matenals equal to or greater Ihan a weight ot 500 pountls, or a volume o155 gallons, or 200 cubic taet of compressed gas et stantlard temperature and pressure). .......'...... ... ......................................... .............................................................................................................................................................. ............ ..... . ..... ........... ................. ......... . 2 Does or will the epplicant or present or tuture building acupant need to file e regisiration form tor ecutely hazerdous materials. ❑ Yes ❑ No (Section 25533 oi the Celifomia Health and Sefery Code, with some exceptions, requires ragistration with ihe Costa Mesa Fire Depanmant Dy eech business which et any one tlme has on hantl e quantiry of acutety hazartlous metenels equal to or greater than a weight oi 500 pounds, or e volume of 55 gallons, or 200 cublc feet of compressetl pas at standard temDewture end pressure). ........................................................................................................................................................................................................................................................................................................................................................................................ 3 Does or will the applicant or preseN or tuNre building occupant need to prepare an RMPP (Risk Menagemeni entl Preveniion Program tor acutely hazertlous materiels)? ❑ Yes ❑ No (Section 25534 of tha Califomia Healih and Safery Code provides that ihe Costa Mesa Fire Depariment may require the preparation, cerlification and tiling with Ihe Fire DeDenment of an RMPP �y businesses which are requiretl to register ecutely hazardous matenals with the Fire Department. en of the Califomie Health end SafeN Coda been will the eppliCent or present or luW re ouilamg otcupan[ reqWre ror Ine worK wNcn is lne suoJect m South Coasl Air �uality Menegement Disirict or irom any other eir polWlion control disMct or agenc� 658502 ot the Calitornia Govemment Cotle requires that the requested infortnation be furnis�etl on WIII eny part pf yes , the � boundanes with7 LJ Ves ❑ No ............................................................................................. ppliwtion a pertnit for suc� constructlon or � Yes C] No cations for nomresidentiat buiiding permits). .............................................................................................. :haol7 ❑ Yes ❑ No �ry must meet the requirement of Sactions 25534 entl 42303 of the Califomia Health entl Satery Cotle). ......................................................_.......................................................................................................................................................................................................... the South Coast Air �ualiry Menagement Disirict or other eir pollution control disirict or egency is reQuiretl tor �he � all oi the disclosures prescnbetl by Calltomia Health antl Safety Code Section 62303 been mede? ❑ Yes ❑ No Qf yes", attec� certificate of wmpliance irom ihe appropnate atr ponutwn coniroi onicer). CERTIFICATE OF COMPLIANCE: I certity ihat under penalry of perjury the iniortnation given above is correct. I agree to comply with all stete laws antl ciry ordinances regarding HazerGous Matenals antl Emissions. Signawre: _ CERTIFlCATE OF COM correct. I agree to corF flbove-describeC � per _�/ �07E t. INSPECTIONTYPE 1616 1288 200 201 202 203 FI:eC System Pool Spa Fine Final Re-R� F�'fial Factory Fire Final Sign / / Final Damaftion lews end c purposes.l Date: untler penalty ot perjury thet I have read this epplication and state that the uilding conswction, and authonze representatives oi ihe Ciry ot Gosta Me�. �w occupancy of eny building authorized by this permit urylil finaf,jnspection. �Finel Mechanical B- � Final Plumb' / 210 Fin EI 212 Fina ire reven 220 Final nninq A� 222 Fi I Site 250 inel BuiltlindOc i given is upon ihe / Properl /Owner , , .. . • � • CITY OF COSTA MESA BUILDING DIVISION ROOF COVERING CERTIFICATION Contractor State Contractor License Number Classification >� I hereby certify that I have instalied, or caused to be installed, a minimum Class C roof covering at the above address in conformance with Chapter 15, and Appendix 15 of the latest adopted edition of the Uniform Buiiding Code, and the installation instructions of the manufacturer. �I further certify that I am the owner of the property. (Owner-Builder permittee only). ❑ I further certity that I am: ❑ Owner of sole proprietorship company ❑ Full partner of the company ❑ Limited partner of the company ❑ Officer of the corporation I certity that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shail be binding on all successors or assigns of the company or corporation. I shall deiiver 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: / r �/ u r I► �: : 0996d6MW6O0 W�ite-Buil6rqDrv:Canary-Cmuxtor;Pink�Owner or Corpora�a Name Adtlress / � �D a Signet Date / /U%G�fi ' �i Printed or Typed Name a (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 682 DARRELL ST Suite No Vicinity: RIGHT SIDE SFD Parcel Nunmber: 42215222 App�icant: ATIZ, MICHELE Address: 682 DARRELL ST COSTA MESA, CA Ownec' � ATR; MICHELE� Address 682 DARRELL ST COSTA MESA, CA Contractor: OWN ER-BUILDER Address: Arch / Eng : Address: ISSUE FEE �., ` Backflow irrigatioo � BackFlow Preventer Bathtub Clarifer System Connect Qce,Soda,etc) Dental Units Dishwasher Drein, Floor Drain, Rainwater Drein, Roof PLUMBING PERMIT Phone: 949-293-8593 Zip: 92627-2404 Phone: Zip: 92627-2404 Phone: Zip: License'. 0�00�� Status: ISSUED Applied: 12/01I2004 I ssued: 12/Ot/2004 ISSUED BY: EXpIRED� \ �A'� � � �Syo S ' Phone: . _ _ � � � Zip: ' � � - ,� License:, , � . ; - -.� SCOPE OF PERMIT � � CHANGE-OUT AND, RELOCATION (RIGHT SIDE OF SFD) OF A WATER HEATER IN AN EXISTWG� � � �-, SFD. _ � __ - . , � , ' 1 WATER HEATERJVENT � • � r` NOOTHERWORKAUTHORIZEDWITHTHIS�PERMIT. �' . ' _ �. . . � ; � _ . , .� � FEE SUMMARY �-� �; � � � AMT QTY '.. ` . . � AMT QTY. ' :T � ;. �� `,.� ', . .. AMT $23;50 - Laundry Tub / Washer $0.00 0 SuFrip Pump � . . � /$0.00 -� $0.00 0� , Landscape Irrigation� - �` $0.00- 0 - � Swimming Pool - ` �0.00 $0.00 - 0 � � P-Trap - . � $0.00 0 . � � - Trap Primer. � $0.00 $0.00 � 0. _ �� - Pressure Regulator - ` $0.00� ' 0 � � Urinal -'� , � ` � �� $0.00 �$0.00 0 Process Piping (per 10 ft) $0.00 - 0 Vacuum Brkr BkFlow(1-4) 30.00 �$0.00 0 Receptors -$0.00 0 Vacuum BrkcBkflow(5+) 50.00 $0.00 0 SepticTank $0.00 0 . WashBasia $0.00 $0.00 0 Sewer Cap for Demo -$0.00 0 Wash Basin Set 50.00 $0.00 0 Sewer Connect $0.00 0 , Waste and Vent System $0.00 $0.00 0' �� Sewer Private Line� $0.00 � 0 . Water Cbset (Toilet) $0.00 $0.00 0 Shower $0.00 . 0 � � Water Heater / vent $12.30 QTY 0 0 0 0 0 0 0 0 0 0 1 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall aUtomatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor 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 Irequiretl fnspections and final approvnl must be obtained. Failure to obtain inspections and tinal approvai will result in iha expiration of this permit. FOR INSPECTIONS CALL: (7/4) 7545826 2446-48(8�00) WORKERS' COMPENS�TION DE�LLARATION: _ • _ I hereby aHirtn under penalty ot perjury one of the following tleclarations: � �•-� • � ❑ I have and will maintain a certificate ot consent to selt-Insure for workers' compensetion, es provided for by section 3700 of the Labor Code, tor t�e pertormence of the work for which Ihis pertnit is Issue�. ❑ 1 have entl will malntain workers' compensation Insurance, es requiretl by secGon 3700 ot ihe Labor Code, for the pertortnance of Ihe work tor which �his pertnit is issued. My workers' compensation Insurance wrner and policy number are: . Cerrier. Policy Number. (This section need nof be completed i! the permif is veluetl et ane hundred dollars ($100) ar less.) b➢ I certify Ihat in the peAormance ot the work tor which this pertnit is issued, I shall not employ any person in any manner so as to becoma subjec� to ihe workere' �� compensation laws of Califomia, and agree Ihat il I shoultl become subject to the workers' compensetion provisions of Section 3700 oi ihe Lebor Cotle, I shell torthwith comply with these provi ' ns. - ,/ Applicent Signeture: �� Dete: �� T WAiiNING: FAILURE TO SECURE WORKERS' � PENSATION CO GE IS UNLAWFUL AND SMALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNORED T}IOUSAND DOLURE ($100,000�. IN pDOITIqJ FO g6.CC6i-BrmMPENSATION, DAMAGES AS PFOVIDEO WR IN SECTION 3]O60F THE LABOR CODE, INiEREST, AND ATTOFNEY'S FEES. j LICENSED CONTRACTORS DECLARATION: ' I hereby attirm that I am licensed untler provisions of ChaD�er 9(commencing with Section 7000) of Division 3 of ihe Business and Professions Code, and my license is In full �. torce and eflect Lic. a Class p Goniractors Signawre: Date: CONSTRUCTION LENDING AGENCY: ' ❑ I hereby aHirtn ihat there is a construction lending aqenty tor ihe performance ot the work for which Ihis pertnit is issuetl. (Sec. 3097, Civil Cotle�. Lentlefs Name: Lendefs Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby afllrm ihat un0er penalry at perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor ihe tollowing reason (Sec. 7031.5, Business end Protessions Code: Any ciry or counry whic� requires a permit to construct, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires Ihe epplicant for such pertnit to lile a signeC statement Ihat he or she is Ilcensed pursuant to Iha pmvisions ot the Contradors License Lew (Chapter 9(commencing with Section 7000) oi DlNsion 3 ot Ihe Business end Professions Code) or Ihat he or she is exempt therefrom antl the basis for the allegetl exemption. Any violation of Section 7031.5 by any applicant for a permlt s �ects ihe aOGliwnt to e civil penelty of not more ihan fiva hundrad dollars ($500).): � I, as owner of tha properry, or my employees wi�h wages as �heir sole compensation, WILL DO THE WORK, and Ihe structure Is not intanded or oHeretl tor sele (Sec. 7044, Business and Professions Cotle: The Contractors License Ww does not apply to an owner of properry who huiltls or improves Ihereon, antl who tloes such work himself or herseN or through his or her own employees, provided ihat such improvemeNs are not in�ended or oHeretl tor sale. fl, however, the building or improvemen� is sold wit�in one year of completion, ihe owner-builder will have the burden of proving that �e or she did not build or improve lor purpose of sale.). ' ❑ I, as owner of Ihe pmperty, am EXCLUSIVELV CONTRACTNG WI7M LICENSED CONTRACTORS to wnstruct the project (Sec. 7044, Business end Pmfessions Code: The coniractors License Law does not apply to an owner of property who bulltls or improves theraon, and who contracts for such project with a conirector(s) licensa pursuant to the:Contrectors License Laws.). ❑ I am exempt un0er sec; �� c••a.__� Business and Professions Code for this reason: Signa�ure: ��' � .. �� . Da�e:" � � Ex ire Owner ID verilied by driv . Ves ❑ o- DmerS LiCense No. p Vedficetion oi Ownership b(type oi Cocume , i_e. property taa bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certiy Ihat no excavation tive (5) or more teet in depih into which a person is required to descend, will Da matle in connection with work euthorizetl by this permil, end Ihat no building structure, sceHolding, falsework, or demolition or tlismantling thereot, will be more than thirty-six (36) fee� high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Ttle B, Calitornla Adminisirative Code). ❑ As owner-builtler, 1 will not employ enyone to do work which would require a permit irom the Division of IndusMel Safery, es noted above, unless such person has e permlt to do such work trom the division. Signature: Date: Division ot Indus�rial Sefery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AUiHORIZATION OF ENTRY: I certify under penelty ot perjury that I have read this application and state Ihet tha infortnation given is correct. I agree Io comply wiih all s�ate laws and city ordinances relating to building consiruciion, and authorize represen�atives of t�e Ciry ot Coste Mese to enter upon �he ebove-tlescribetl property for in Gier+p rposes. I agree not to occupy or allow occupancy of any building authorized 6y this permit until final inspection. � /a /i /o � SignaWreO� Own�e(s�� ate . COpE �. INSPECTIONTYPE Q�¢, INi1TI�L3 1616 Fized System Finel Fire Prevention 1288 200 201 202 203 Pool Spa Final Final Re-Rooi Final BIocWReteining Well Final Factory Fire Place Final Slgn 204 _ Final Demolition CQOE I INSPECTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electncal 212 220 Final Fire Prevention Final Planning Approval 222 Final Site 250.. Final Building/Occupflncy :I / �I � � D'�i PFCdel,lnoosess: 682 DARRELL ST owxeesname LEVINE, ARTHUR C nooREss: 682 DARRELL ST COSTA MESA,CA 92627 642-1254 PflCHIENGWEEH: PEG.NO.: uNiT: POOXESS: UNIT: PEPMITiEE: DISCOUNT SIDING SUPPLY ( 714 ) 633-9037 nooxcss: 1228 W COLLINS AV ORANGE CA 92667 LICENSEU CONTHALTOfl OELU1flATI0N: I hereby atlirm Iha� I am licensed under pmvisions ol Chapter 9lcommencing wi�h Seclion 7000� of �rvision 3 0� Ihe Business and Pmie i C d ntl my license is in tull lorce and eltec�. CITY UC.: 0�3� STpTE LIC.: �� CLA55' —� Dale: � �— �� Signature: �y_� i '�OBREHS' COMPENSATION OECLAXATION: I hereby atfirm I�a� I have a cetli�ica�e oi consen� to self-insure or a cetlilicale oi Workers' moensaron q�lo�g o� �og�ey grp �got �sec�ion seoo, �ao. gy 7/ O 1/ 9 4 oucr xo.: FREMONT COMP ExP. oate: COMPFNY: �( ❑ Cenifietl copy is herebY �umis�ea. LI Cehifie0 copy is hl wilh the cit din ivisian. Date: _ �Q � � APolicant � � E%EMF ON FBOM WOflKEflS' COMPENSpTION UECLAflRTION: (This sec�ion nee ol be comple�etl il IAe permii is lar ane hunAretl ($100) or less). I cetl y �hai in I�e pedormance o� ihe work tor which this permit is issued. I shall not employ any person in any manner sa as �o become sublect to ihe Workers' Compensa�ion Laws ol Califorma. �aie: SigreNre: ' NOTICE If. at�er makmg this aeclaralion, you shoultl become sublect Io the Workers' Compensa�ion pmvisions o� the Labor Cotle. you muSl Iorthwii� comDly wilh suc� pmvisions or �his permi� s�all be tleemetl revoked. CONSTPUCTION LENOING PGENCY: I �ereby altirm thai Ihere is a cons�mction lenaing agency lor the petlormance o� Ne work for which Ihis Oermit is issuetl (Seclion 3097. Ciu. C�. LENDEB: aooeess: OWNEP BUILOEB OECIAflRTION: I hereby aflirm Ihat I am exempl �mm [he Coniradors' S�ale License Law �ar Ihe following reason �Sectmn 7031.5 Business and Professional Code: Any ciiy of county which requires a permi��o constmc6 al�er,impmve,demolish, or repair any 51mcWre. prior to iis issuance. also repuires Ihe. applicant for such De�mi� Io lile a signetl staiement [hal he/she is licensetl pursuam Io Ihe pmvisions ol lhe Comractors' Siale License Law (C�apler 9(commencing with Section 7000) ol �ivision 3 0l �he Bu5ine55 antl Pmlessions Code) or Ihat hels�e is exempl Ihere�mm and the basis for ��e allepe0 exemp�ion. Any violatian of Section 7031.5 by any apPlicanl for a permi� sublec�s Ihe applicant �o a civil penalry oi nol more than �ive �undretl tlollars (8500). I, as owner of ihe OmDeny or my employees with wages as ineir sole compensation, will do ihe work, antl tne ❑ simcwre is noi intentled or olferee for sale (Section 7044, Business ane Professional Coae: The Comractors' State �icense Law does no� apply lo an owner oi a pmpetly who builtls or impmves Ihereon, and wha tloes such work him5ell/hersell or thwugh �is or her own employees. pmvi�etl Ihat such impmvements are noi intentletl or otfered tar sale. Ii, however �he builtling or impmvemenl is 5altl wiihin one year ol completion. Ihe owner will have �he buraen o� pmving he/she di0 no� build or impwve for the purpose oi sale�. I,as owneraf�he pmpetly.am exclusivety contraciing with licensetl contractorsto cons�mc�ihe prolect(Section 7044, Business ❑ antl Protessions Cotle'. The Contracmrs' Stale License Law Ooes not apply Io an owner ot pmDenY who builds or improves thereon anU w�o contracis lor suc� pmjec�s wit� a coniractoqs�li[ense pur5uan�io the Conlraciors Slaie License Law�_ I am aware Ihai Droof of Iheir Worker'S Compensation insuranre should be pmvitle0 �o me. � I am exemp� under Sec�ion: B. 8 P. C. lor ihis reason: � CZTY OF COSTA MESA — BUILDING PERMIT , � _ PERMIT NO: B 065775 PLAN CAECK NO: N , . CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION : REPLACE S WINDOWS IN RESIDENCE SQ FT: 3,387 CLAIM VALUE: 3,387.00 CALC—VALUE: 3,387.00 GROOP OCC: R-3 / COMMENTS: NO OTHER WORK AUTHORIZED HY THIS PERMIT i�+r**x�x�**�r**�t**i�*�t�t**x�i�**+�*x�**x�x�***�**�r**+t�*******�*�t*******+�***x�********�tir***** Z O N I N G R E Q U Z R E M E N T S S E T B A C K S ------------ MAZN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR; FT IN FRNT: FT IN AEAR: FT IN LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN PARKZNG REQ; PROV: PARCEL; 42215222 ZNE: REF NO: PLANNING NOTES> i if if iElf iE 1E 1E 1E if 1E 1F 1E 1f 1E if 1f ik 1k 1E 1F iElE iE 1E iE f! 1E k j! 1E 1f iE �f !F if 1E jE if !f ik iE if 1f iF 1E �)E iElE iF ff iE 1E iF �E 3ElElf if iE iE iE 1f jE fE if 1E fE iE if iFlF �E iE jE iE iE jf ff 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 DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY; �� DATE: � I ��1 1lfEiElfiffliElfiEiEiEaFillEi4iEfEfEfEfffE1l3F3��if�FiF�F�if�3f��FiFTf3F3FiF� �iFiE�1E7E1EiEiEiElEfflf 1EiE iF 1E 1E iE if k iE iE iE iE iE iE k iE iE iE 1E 9E iE iE iE iE iE 1E iE iE iF iE iE if if iE iE iE if iE iE 1E 1E * 3f iE iE �E �E iE jE iF 9E �E 1Elf iE iE iF iE iE iE iE 1E iE iE �F iP iE �)E aF if �E iE iE %iE iE 3E iE �1E iE if LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 63.00 .50 SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> PERMZT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 63.50 0,00 0.00 63.50 63.50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 63.50 OVER/SI-IORT; .00 BLDG PMT PLUMHING ELECTRIC MECiiANIC FIRE SMIP/TOT GRADING PLAN—CHECK 63.00 .50 if iE iE if iE if iE iE 1! 1E %iE iE iE i! iE iE iE 1E iE iF if if iE 1E it iE iE iE �f if it iE iElf iE iE iF 1!!f iE if iE iF iE iE iF iE iE iE iE K iE iE if if 1E if 1E �E if iE if iF iE iF iE �f iE jE �f !E iE iE iE * iP �E 9E I N D I V I D U A L F E E H R E A K D O W N TYPE oate: Ownec I SFR I tlo hereby ceniry Ihat I am aware ol ana unUersland ihe requiremems of Caltlomia Heal[h and Sa�ery Code Sections 25505, 25533, and 25539 ana Nat I or any INure builtlmg occupant will/will nol (circle one) nee0 �o comply with saitl state codes and ihe requiremen�s �or a Dermil �ar constmnion or moailication imm Ihe Pir Ouabty Managemenl Uisiricl. Fesidential constmc�ion aDPlica�ions are exemp� Irom Ih25¢ pmv4ion5. Daie'. Ap0licam: I here�y cerlity Iha� I have reatl I�is apPlicaiion and sla�e thal Ihe above in�orma�ion is correcl. I agree Io compty wi�h ail cily and coun�y ortlinances antl siate luws rela�ing l0 6uiltlmg cons�mction antl hereby au�honre represen�a�ives al t�to en�er upon Ihe abovtmen�ionetl pmperty lor inspemion purpases / _ W�e' SignaWre'. O�/ ,� �nver Lmense or ocia 5�� t6ai a6 W�ite—Bwlding; Green—Cotle Eniorcemeni: Canary—ApplicanL Pink—Revenue: Goltlenrop—Assessor QTY D E S C R I P T I O N 3387 ALTER HY VALUE RESIDENTIAL NOZONE END OF FEES E X P I R E�t�ons � com lete lnsA � ��ata Sig UNIT COST TOTAL COST 1,00 3,387,00 �1 JfS154DS2-0025YE1,3 TiaT ha.�Q QFITt: OS�i�"%i�F �irlG: �`:i6 / I �� / �oonEssosem�nxc: 682 DARRELL ST awr+ursnw%icM^m: LEVIT]E, ARTI-IUR CHAF,LES �--r:u. � �LEVINE, B£ATRICE R .682 DARRELL 5T �rr�. wuuxc �ooness: COSTA MESA,CA 9�627 APCIIRECT OP FNf�NEfH: �xcx. on u+o.•s �ooxEss: CONfPACTOP'S N�1�: LWIfl�CTORSYNIPlG IWOIIESS: UNT: uc ra.: uNr: uc xo.: UNT: LICENSED CONTRRCTOHS DECtANATION: 1 hereby eflim uMar penetly d pe�ury thet I em licemad undar prwieiona N Gheqer 9 lcanmwrnp wnn Sxtion ]000) d D'rvieion 3 d �he Buvmae eM Pmleeeiona Code. ud mY limrue u in IWI face vM ellea. CT' UC. NO.: LIQ CU55: LIC. NO.: .�+X �; Jete: comreaor. OWNEN BUILOER DECIANATION: llereby eifirm under pO�Y a perNrv �M1e� I em eRemp fmm IM ConVetlaa lioeme lew lor Ne fdbx'aq �aeson (SeUbn 10J1.5 &niima end Rdeeaions CNae: AnY ciy a mumy which rpuirea a peemil to wnstriwl, allx. impo.e. demole�, a repei any aViwYure, p'v lo na uaueMe, e6o reVuiree Ihe applimnl lar wch pe�mA lo fib e ep�red a�etaman� Ihat ha a eM n licensed pursuanl to iM provisiona ol IM Comrenore Lice�se Lew �Chepter 9(mmmena�q v.nA Seaion )000) d D'vwion 3 d �hs Busineae enC Profeaeona Code] or thet ha m aha is exempt �M1e�aM1om end �he besia lor IM ellegeE exemption. My violelion d SeUion ]W t.5 by eny eppirant 1« e permN wbjeds �he epplicenl lo e cil panelry d M mae Ihan (rve hurkred tlollen �fS00��. �] I.avow�erdiMpeopanyamyampbyeaswthwepeaesiheieobwmpansetian.x{IIEo�hexoM.erdiMst�udureu�inteMed «aRered M aeb (`�� 10u. Bud�wsa aed PmlesaiMs CoCa: T�e Conveawa Lirarua lawdoea rot eppFy�oen owmr d popMy who W1M a mCrovea ihereon. arM who Eoes euM waM him WI «hanel w Nraqh hc a Mr mm emWnl�e. VA'�bad ihei euch im0��enb ere mt in�ended a dlered for sele. X, howareq �ha buiMinp a imqovemenl ia aotl wilhin me yeer d mmpinion, the owrerbuiMar wi0 heve Ihe buMen d provinB he or eM1e d'M nd WiIA or im0� �w ihe WR�e W eela�. � I. e� owner d �he NOVeM, em a�d�ivNY oonireaM wnh licenaad conveclon lo canatrW ihe i�ol� (Setlbn )OM. Buai�a end Frotessbns GoCe: The Cont�ecm L'cense lew Aon M aPON to en awew d papMY whoJtuilda or ImYo+m Ihereon aM Mn cnmrav Irc arh qopas wnh e caMratla(a) Icenaed W�� to iM Canir Limnsa l�Ni) � I em K p uMer lion: B. 8 Pp.�,/t�W" /a/remon: ��/J D�e: � � omy'c�.� L�ii-� �ii/Ge� i m �nnr i.m =w�a a.�e �m��e in. �`a�� ^«�• w cm.ome �nn �e serorv cme s«a�. nws. zssaa. �d 25531. eM thet I enY �ure bnMi�p ocwpenl xill / wil yd (arcb me) � to canply wih vaid pets codee vd iM �puiremeMe br apermilipwnt ctianwmodifi�atanhwntMAi ei3i .�y ane9a�tDiatiiq.Reeipenlielconstiutloneppicelianeneumphomlhefe Moviaiona. Dme: Appli�eM: WOPKER'3 COMPENSATION DEttARATION: I Mroby e1R� �r penMy d pajury an W the Idbvrirp datleic�una: � I Mve eiM wil meinlen e cerlilicete d conaent io vaMiro�re k� wvke�a' campemeiion, ee provked fw by Saeion 3100 d tM lebor COEe, la Ihe pe�lorme�we d ihe Mork tor wlich Nin pa�n'�s'imued. � I heve arM xil meinten xnrken' oompenaelion ineurerc�. %s �Vuired by Seaion ])00 d the lebor Code. Ior �M peelarmenm d �M work ta whirl� ihu {amn'n ivued. MY warken' compB�se�bn inwrarce rems eM pdi�y num Wr ere: Cemer: ad�v H�mn�,: (This aecliwr neeC nw be compbred'A �he qrmAia lor one Nundred dolleis (f100� w lew.) � I eenA'thm in �ha parloemeMe d tM work br whkh �hia parme u beueE. I ehell nd em IOY �Y Oe� in vry menrw eo m lo became wdea !o ipe wwken• oomw�eetion 4we d calilanu. e�d ea�ae the J hmM bacbme vibjsa b �M waken' canperis fai pmvi '6na d Smion 3100 d IM lebor Wde. I ehdl l�h camply �' Noee pmv�ore. oma: ` nvW�^c � Wem/np: eN�nll�CYroWOIkIl�COI11pNIfItlOI1COWIpy01lVIINWNI�IIItllIY/IlUb/KflIIllllpl0)'IffOCIIIMMI�INNMNIIIO elvll llrro� �q b ne huMrM tMua�ntl 4oNan lffOp,Opp1, M arM/fbn ro �h� eost o/ rorrpewebM1 tlsmqp� �� prevWetl br In SecHon 9)OS o! Ms L�or Coes, InMuL entl ettomsy i �M+� CONSTqUCl10N LENDING AGENCV: I Mreby elRrm u�de� Oand�Y d pmN�Y Ihm �Mre e a eannivaun NMieq a�jerx.y Irc IM �n�� a m< w� m, .m�d, mA ro�� o ea�aa �saaon aos�. cH. c). . LENDEP'S NAME: � LENDEH'S ADDPESS: ICMilylhetlhevereed�haepqicq'gn}M pde�np�he eboreiM«melbniacwred.IqpeetocomplywnhellaryerdeouMyadineMes endei xsrelmm9tobuikmpg6y5wfbnendM1e/ebY��'°rae�epreeentmiveadlhntiry,roenteruponthaebouc.memionedpropeM �Of p11P11fp09B9. !� Dme: (5151de.WP) Whne-BuiNiq d Sefn:OreemFb: Cv�vy-Appir,ant: Fnk-Rerenue: Gddenro�Assmen . CITY OF CUSTA MESA — BUZLDING P�RP4IT PEP.M P70: B 071991 PERMIT NO: B 071991 PLADI CHECK NO: N GOC'T; N SUPF: N CON5TP.UCTIUN TYPE; PERMIT TYPE: STR FURPOSE; OTH JUB DESCP.IFTIOP7 ; TiUFF REP.00F W/COMP SHINGLES Stz PT; 1,200 CLAIM VP.LUE; 1,zeo.oe CALC—VALUE; 1,200,00 GP.OUP OCC: P.-3 / COMMENTS; SMOKE DETECTORS REQCTIRED PER 92UBC, REROOF 1200SF RESIDENCE #it#iE#fatx?Fit+E ita iF###�F+s, ri:itl.iiu�Fffikifr ir�lFuvif'tiFi�-+tirt,eiti:i�i�it�iEirit w#ii��iF#z�Yil�r�.a#ir�ai:i.i«�k-#viE+F;�#a:�cni.0 2 O A] I N C R E t� U I R E M E N T 5 � E T B� C K S --------- — — MAIb1 bUILDING ---------- --------- ACCESSOP.Y BUILDING --------- FRNT; FT IAl AEAR; FT IN FRNT: FT IPJ REAR; FT IN LEFT; FT IN RGHT; FT IN LEPT; FT I�3 RGHT; PT IA3 FARI{ING REc� • PROC': FARCEL: 422152Z2 2NE; REF NO; PLANNING N6TE5•> • i iE 1f 1f iE if �lf if iR Y� V�')f af 1F iE'K� if ?f if iF i41E if iE if N- i Y iF K if if iF if if iE if it �Y j4 Y iR iF �1F �1f iF iF �IF iF 1E'X� iF �N �E a4 if �IF 1F 1E if iF'N' ik if X'M- iF �)f % if'�IG iF iG X�% iF AF i4 i4 Y D E V E, L O P M E N T S E P. V I C E S R E Q U I R E M E N,T S ZONING APPROVED BY DATE: bUILDIA7G APPROVED BY ; DATE: . APPLICATIOI•� ISSUEP BY; �� DATE: " iFif�tEiE+tiEitil�itiFiFuitiRi4K�k-i�iFififirit�k+t*it�r-if�t..ititi�iFu�icK�fiFtfriF:FiF+t*v�ri�iF+.+t�acs�fiFifa.iEac.irfRr+f.+r��r�tt♦F jt��ifr�?r� LEGALI2ATIUP];N F E E S U M M A R Y STRU�TURAL SEVMENT;Y BLDG PMT PLUMBING ELECTRIC MEChANIC FIRE"� SMIP/RES GRADIDIG I�ERMIT 29,00 ,50 SMIF/NON—P.ES PLAD] ' ISSUE FEE BUILDIA]G—DIl*—> FERMIT ISSUE PLAN—CHECK TOTAL � PAZD DUE TOTALS----> 29,50 0,00 0,00 29.50 29,SU ,� ,00 REVENUE DIVISION TOTALS--> COLLECTED; 29.SQ OC'ER/SHORT; ,��' ,00 HLDG PMT PLUMBIAIG ELECTRIC D9ECHANIC FIP.E SMIP/TOT GRADING�PLAN—CHECY. 29,40 ,50�• ?f if if if aE if i(�ih'N�iE'lE iE k'!E M iE iE # iF I�'1f if Y-i('if 1FifiE iF'If iE iE�IE aE'lE'M�'k �h?F iF ifM M-if �FY-if Y1E YiF-1F i4 iF 1f 1F-Y if if iM1 Y i4 if 1F if if it iF af i4 iF 1M1 if if 1( Al��f Y-1� I N U 2 C' I D U A L F E E B R E A Y. D O W N TYPE SFR QTY U E S C R I P T I O N 1200 REROOF BY C'ALUE RESZDENTIAL NOZONE END GF FEES UNIT COST 1.00 /. TOTAL COST 1,200.00 �: UO2SG3�6-0028�33� T C�`£ 24.4C� 6qTE� 04/22/95 TfME= ?;.2E , � CONSTRUCTION AND PLANNINti -• POOI & SPA . �PROVALS Permit � Date Inspector qppROVALS Permit #� Date .'nsp�ctor I ' TemporarY Electrical Service or Pole , 52. Pooi & Equipment Location ' � 1 ; a��ii Pipe-Undrgmd. . 53, Sceei Reinforcement :' 3. Electrical Conduii Utility-Undrgtnd. � 54. Forms " 1 � 4. 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. Electrica� Conduit-Undrgrnd. � ' B. FoundatiOn 59. Gas Pipe, O Undrgmd., Test � 9. Water Pipe-Undrgrnd. 6Q. Backwash Lines, P�Trap, `��. U(idrgrr.d. 10. Structura� F�oor System 61. APPROVAL TO �ECK t � i t. Property Sewer line & House Connection . . 62. Backwash & Receptor�Final 12. Sewer Cap 63. Heater & Vent-Final -. � 13. Roof Dra�ns . 64. Plumbing System � Final � 74. Rough Plumbing . 65. Electrical�Finai � - � 75. Rough Electrical-Conduit �' 66. Solar SYstem-Finai , 16. Rough Electric Wiring . 67. Pencing & Access Approval � . 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL � 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough F2ctory Fireplace . • �. APPROVAlS Permit # � 2t. Qucts, irt Structure � � 70. Undesground Hydro 22. Ducts, V¢ntilating 71. Produci Pipinr,'7Gas COiI 23. Gas Pipe-Rough & Test � 72. Underground Fiush -. 24. Roof Framing ,� 73. Undergrnd. Storage Tank �7 Gas ❑ Oil 25. Roof Sheathing � Z?-�,�j �� C(/� 74. Overhead Hydro 26. T�Bar Ceiling SSiructurall & Monocoat 75. Dry Chemicai - 2J. Frame and Flashing � 76. Dry Standpipe � 28. Lathing & Siding ' ' 77. FIXED SYSTEM.FINAL 29. Insulation � 78. FIRE PREV. FINA� 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 Neating & Air Conditioning � , • � 35. Final Gas Pipe-Test . 36. Hood or Canopy 37. Final Factory Fireplace � � � 38. Final Plumbing - 39. Water Ser�ice�Final - 40. Gas Service�Final . 41. Solar pomesticFinal , . � . 42. Backflow Preventer - 43. Backflow Irrigation Y^ZS !t' S CJ.' G, 44. Landscape Irrigation SYstem . � , �� 45. Sound Attenuation , � � . ' , 46. Handicap Regulations � _ � 47. FINALSTRUCTURE&BUILDING _l.j�c, (e'(,v ' • 48. fINALPLANNING � 49. Electric Release to Edison 50. Gas Release to Southem Californla Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date ' JOB ADDR�55 68e Darre GENERAL CONTRACTOR Qj� AP No. l l r,_Fil9�h9 LOT nvSP�CTIONS OCCUPANCY 0 (#1) ?et (es'd %�/rre//�_ �Td er TRACT 2,}��s FIRE ZONE � Signature� ' DAT]'s GROUP na7r 9-6-61 VALUE $ 1j�UUU.UU DESCRIPTION OP WORK� .TTYP� V 7,ONE sU[3CONTRACTOR 7�.��.c�.� �� . �� - .� _ .:. �tiE cd,�Pa,�u, ��1.�� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 9f7 COBTA MEBA. CALIFORNIA For Applicanf fo Fill In Complefely E,�S �TYPE OR PRINT BUILDING � /'� / ennwrea iYTY COSTA MESA. CALIFORNIA 0 �EE R��FI��D n,� qUG 291969 FINANCE DEPT: CITY OF GQSTA MESA APPLICATION FOR PERMIT euanin�� For Office Use Only RECEIPT NO. I PCflM ! '� �� ZI S�P ° gE y- COSTA MESA, CALIFORNIA �-- APPROVED BY dr ZON � NO.OF �� PUN9 LEGAL �ESCRIPTION OP BLDG9. � ON LOT e o un I I C �' USE OF YAROS EXISTING BLDG. APPROVED SETBRCK LIN6 FPOM �^ � � (CCNTER LINE BTJ CENTER OP BTREET J REAR YARD :� FRONT I SIDE YARD ILEFT RIGHT � � R.SIDE DESCRIpTION OF WORK NO. OF EXTERIOR WALiP COVERING J USE oF BU��DIN< ES 1 HEREBY AGKNOWLEDGE THAT 1 HAVE H¢AD TH18 APPLIWTION AND 9TAT6 THAT TXE ABOYE I6 CORRECT AND AGREE TO COM- PLY WITH ALL CISY ORD�NANCE6 AND BTATE LAW6 REOULATINO BU�LOINO CONBTIiUCT10N� SIGNATURE OF PERMITTE AUTHORIZED AGENT THE AMOUNT BHOWN UNDER VALUATIDN �8 POR TXE PURPO6E OF EBTABLI6HING A PERMIT FEE ONLY. .UATION +� C� PERMIT FEE $ � ✓ � $ /� ��IPLAN V Y'�-; . � .-�i �` u.1 i.+ .� Q cJ W G. � a � � F �, i" c �.t D\ LL �wN E� OB ADDR �ENERAL TRACT FIR � XOUGH PLUMBING'�1 �ROP. SWR. LINE u MOOSE CON. SPRINKLING SVSTEM AIR CONDITIONING UNOERGRaUNO L I POWER FOfJGM WIRING DATE' SUBCONTRACTOR 5 I I STEEL REINF. I I I I �I � FLOOR SV5 BONC BEAM SNEATHING FRAME ANO FLASHING LATHING — IN�_� PLASTER,BFOwN COAT SiRUCTURRI,FINPL HEaTING, VENT., qEFF�� PLUM9ING. FINAL ANO ��. �� 4'7697 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626 � 6200 �;j�g�79-' 76.50 T4 ��-;�.y�., , �' � .- �'�i43) `�hs:r. APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RECEIVED BV DATE RECEIVED DATE ISSUEO BUILDING�Q� �/1 � / ADDRESS 6 f/ 4 � � OWNEP (�. • I�/O�l J� �/ �l� PERMITNO. A.P. N0. i�/ iG MAIL BUILDING .�� / ADDRESS �+DDRESS (�L� TEL. TRACT LOT BLOCK CITY NO. CANSTRUCTION EW ADD AL ER P LENDER BRANCH /] TC OWNER � • /�/ O�r�i ADDRESS M VALU� ARCHITECT TEL. S OR ENGINEER N FIRE ADDRESS ZONE TVPE GROUP O � e ' L1 � APPROVED CONTRACTOR /(/ �� BV DATE ADDRESS TEL. ZONE/ ,///�J NO.OF �J USE OF NEW CITV NO. /� (s P�� (r BUILOING — STATE CITV �'ARDSAPPROVED VARDSAPPROVED LIC. NO. LIC. NO. MAIN BUILOING ACCESSORV BUILDING SIZE NO.OF BLDGS. (FROM C/LSTR ET OF LOT NOW ON LOT FROM FT. VSE OF EXISTING BLDG. SI E FT. FT Se arate ermits are re uired for � p p Q L. SIDE FT. FT. electric, plumbing and hea[ing work. �� REAF FT. FT. USE OF BUILDING AND WORK TO BE PEFFOFiMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCE55. B�DGS. F� VAR.# DATE C.U.P.� APPROV^ED APPROVE � �, ' �5� /� �� ✓ I hereby acknowledga that I have �ead this application antl state that the above information is correct antl agree to comply with ail laws ragulat(ng buildin8 construction, and I shall not employ any person in violation ot the workman's compensation laws of the State of Celifornla. I hereby certily that I am p�ope�ly Ilcensed as a conttacto� under Q• FT. the State of California Business and Professions Cotle, Div(sion 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that sueh licenses are In full force antl effeci, or I THE PUFPOSE OF ESTABLISHING A PERMIT FEE ONLV: am exempt t�om the p�ovislons of the State of California Business VALUATION PERMIT FEE entl Professions Code, Divislon 3, Chaptet 9. ///�� $ . Signature �� PLAN CHECK $ Permittee $� TAX $ � A�thorizetl Agent TOTAL PAID 5