HomeMy WebLinkAbout871 DARRELL ST - Building Permits.lob Address: 871 DARRELL ST
Suite:
Vicinity: REARYARD
Primary Occ: R3
Parcel Number: 42236303
Applicant: ZOSACK, LISA
Address: 24512 BRIDGER RD
LAKE FOREST. CA
Owner: MP
Address 871
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"� Zip: 9263
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Type ot ConsUuction: V-N
Zoning:
_. Phone: 949-859-8466 �
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_ � � ' _ � "., ;� �� . Phone:' _ 949-338-4189 . ,
a. CA �� . "- �; � , Zip: .. 92627 : -
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DLS-OF SOUTHERN "CALtFORNIA
ERRD6'S- _�� � .� . .
'i"%',;-� Phone: 949-859-8466 �
License: 440333
Status: ISSUED
Applied: ' 02/21/2007
Issued: 02/21/2007
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ISS
, 'A�ch :! ��,, 1�/ji-' Eng: AARON J COWE
Address: � ���. ; ' " � � Address: � - -
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�'� CONSTRUCTION pF A NEW �422 SQ FT INGROUND GUNITE POOIJSPA IN REAR YARD OF SFD -
N- P E
Phone:
Li'c'ense: 58878 °,
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�i � (��� � �, j � ! , _ - FEE SUMMARY �_� �
� �� P,lan Check / .=�'$313.72 � ! _� '�,� ��' /,',� � ,,� ,"�, �r,' ; ;1. `i� �`Calc Valuation � ��
, , :, _, Permit r, t$482.65 � _' - '"✓ '.. - f -:. `_ _ }Claim Valuation: ,
SMIP Res. '` ' $3.40 --- - . �
� ' SMIP Corti; � '�. ' $0.00 ` �
� •� Other:� , $0.00 , ' � � ' . � � ��
�,. Inspection:': ��.� � $0.00 -- .� _ % i` � -- .
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� Total\ . :� , $799.77 �
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�=�� �• ' . ` - , PLANNING & ZONING
SETBACKS�' `
V, � . ' �
MAIN STRUCTURE Fronf �20-0 ; Rear 4 0..:.; Left ." 20-0,�_� . Right 4-0 -'
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ACCESSORY '� Front� `0_0��, ��""��Rear =0-0 � Left 0-0" ""`_ Right ;0=0
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j , $34,000:00
$34,000.00 �
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PARKING'�� Exiatin � 0����Re6uired 0� 1 - Pr000sed.- �0 "�� '����� �'/
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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 it work is not commenced within 1 BO days, or if work is suspended�or abandoned
for a period of 180 days. /
INSPECTIONS: In ortler tor the work authorized under this permit to be considered legal, such work must comply with all applicaWe codes, and all
required inepectlona and (inal approval must be obtained. Failure to obtain inspections and final approval will result in the expirationfof this permit.
FOR MSPECTIONS CALL: (714) 7545626 �I
zaas<a ��oo�
WORKERS'COMPENSATION DECLARATON:
I hereby attirtn untler penalry of perjury one ol the following tlaclarations:
❑ I have and will maintain a cenificate of consent ro seN-Insure for workers' compensation, as pmvided for by section 3700 of tha Lsbor Code, for the pedormance of ihe
� / work lor which this permit is issuatl.
�I �ave antl will maintain wo ers' compensation insurance, as required by section 3700 of the Labor Cotle, for the pertortnance of the work for which this pertnit is issuetl.
My,'y��7 rkars c m ensatio Insurance carriar antl policy number are: � (��' � I
Cartier:
Y 0�� PolityNumber: _�L`j �%�� �\ ��
(This section neStl not be canpletea i! fhe pertnit is va/ued et one hundred tlollars ($700) or Iess.J
❑ I cetlify Ih31 in the ormance ot Ihe wo for which this pertnit is issued, I shall not employ any person in any manner so as t0 become subject co the workere'
wmpensalion I California, and agre hat If I should become subject to ihe workers' compensation provisions oi Section 3700 of the Lebor Cotle, I shall lorthwith
comply with th o ia . �/� ��
Applicant Signawre Date:
WARNING: FAILUFE SEC E WORKERS' dJMPENSATION COVEPAGE IS UNLAWFUL AND SHALL SUBJELT AN EMPLOVER TO CRIMINAL PENALTIES AND QVIL FINES UP TOONE HUNDRED
TFqU$ANODOLLARE($100, �,INADDITIONTOTMECOSTOFCOMPENSATION,DPM4GESASPqOVIOEDFORWSECTION3]O60PTHElABORfAOE,IMEREST,ANDATTORNEY'SFEES.
LICENSED CONTRAC70R5 DECLARATION:
I hereby aHirm IPat I am I' e dgr p�o '' ns ot Chapter 9(commencing with Section 7000) of Division 3 of the Busi �a Professions Code, and my licanse is in full
torce end eNect. Lic. p �J'� Class a
ConlrectoYs Signature: Date:
CONS7RUCTION LENDING AG CY:
❑ I here6y aNirm ihal there is a consimction lending agency br ihe peAortnance of tha work for which ihis pertnit is issued. (Sec. 3097, Civil Code).
Lendefs Name: Lenders Atltlress:
Signeture:
Date:
OWNER-BUILDEA DECLARATIONS:
I hereby aHirtn tPat undar penalry of perjury that I am E%EMP7 FROM 7ME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Busineu and Pmfessions
Cotle: Any ciry o� counry which requires a pertnit to constmct alter, improve, tlemolish, or repair any siructure, pnor ro its issuance, elso requires t�e applicant fo� such pertnit
b tile e signed s�atement that he or she is licensetl pursuant b the pmvisions of the Conirectors License Law (Chapter 9(commencing with Saction 7000) ol Division 3 oi ihe
Business and Pio�essions Cotle) or that he or she is eaempt therefrom and the basis for the alleged exemption. Any violation of Sedion 7037.5 by any applicant for a permit
subjects the applicant to a civil penalty ol not more than five hundretl tlollars ($500).):
❑ I, as ownef of the properry, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and Ihe sVucWre �s not ime�ded or oNered tor sale (Sec.
7044, Business and Protessions Code: The Contractors Licensa Law tices not apply to an owner of properry who builds or improves ihereon, and who does such work
himself or Perself or through his or her own amployees, provided ihat such improvements are noi intentled or oHered for sale. I(, however, the builtling or improvement is
soltl within one year ot completion, the owner-builtler will have ihe burden of proving that he or she did not builtl or improve for purpose of sale.).
❑ I, as owne! oi tha property, am EXCLUSIVELV CONTHACTING WITH LICENSED CONTqACTORS to consiruct the project (Sec. 7044, Business and Pro(essions
Cotle: 7he comractors Licensa Law tloes not appty to an owner of property who builtls or impmves ihereon, entl who coniraas br such projaq with a cOmractor(s)
license Dursuant to the Contractors License Laws.).
❑ I am e:emp� under sec. Business antl Professions Code for this reason:
Signature: Da�e: _ _
Owner ID veritied by dnver's license. ❑ Yes ❑ No Driver's License No. Expires:
Verilication ol ownership by (type ot document, i.e. - property tax bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certity ihat no excevation five (5) or more feet in depth into which a person is required to descend, will 6e made in connection with work au�horizatl by this
permit, and that no building stmcture, sceMolding, talsework, or demolition or dismaNling thereof, will be more ihan thirty-six (36) tee� high. (Chap. 32, Grp 2. Atl 2, Sec.
341, Ttle 9, Cali(omia Adminisirative Code).
❑ As ownerbuilder, I will not employ anyone to do work which woultl require a permit fmm the Di�ision of IndusMal Safety, as noted above, unless such person hes e
pertnit to tlo suc� work irom the division.
Signalure: Date:
Division oi Industnal Safery Permii Number.
CERTFICATE OF COMPLIANCE AND AllTHORIZA710N OF EMRY: I cenify under penalry of perjury �hat I have read this application and state fha� ihe information given is
correcL I agree to comply with,all state laws anG ciry ortlinances relating to building construction, and authonze representatives of the Ciry of Costa Mesa to enter upon ihe
above-descriDeO p�openy for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by ihis permit until tinal inspection.
COOE t. �y$Q��NSTPE
1616 Fixetl Sys�em Final Fire Prevention
1266
200
201
202
203
Pool Spe Final
Final Re-Roof
Final BIOcklRetaining Wall
8
Final Faclory Fire Place
Finel Sign
204 Final Demolition
9A� IMRIALS
50pE! �SPECTIONTYPE
206 Final Mechanical
208 Final Plumbing
270 Final Electncal
212 Finel Fire Prevention
220 Final Planning Approval
222 �Final Site
250 Final BuiMingfOccupancy
ORTE INTITIAlS
�
CHAP. 31 B, D/Y.11
3750B
3/54.18
2007 CALIFORNIA BUILDING CODE
Division ll—PRIVATE SWIMMING POOLS (STATEW/DE)
NOTE: These regulalionsaresubjeRla local govemmenf modificafion. The applicable loca(governmenuequiremenn ar the fimeofapplitalion far a 6uilding
permi� shauld 6e verified.
NOTE: Thesesfandardsberomeapp�(�oble commrncingJanuary l, /998, foa pri�mrc, sing(e-family home for which o mnsrcucfion permil for a newswimming
poo( Ms 6ren issued on or aftoJanuary 7, ]998.
SECTION 31508 — DEFINITIONS
As used in this division, the following terms have the following
meanings:
APPROV6D SAFETY POOL COVER means a manua(!y ar
power-operated safety pool cover that meets alI of Ihe perfor-
mance standards of theAmericnn Sociery for Testing andMateri-
als (ASTM), in compfiance wifh Standard F 1346-91.
ENCLOSURE means a fence, wal! or other barrier tha� iso-
(ates a swimming pool from access to the home.
EXIT ALARMS means dev(ces tha[ make audible, continuous
alarm sounds when any door or window that permits access Jrom
the residenre to the pool area, that is without any intervening en-
closure, is opened ar is left ajar. Exit alarms may be ba�lery oper-
ated or may be conneded �o �he electrical wiring of the 6uilding.
PUBI,lC SW/MM/NG PQOL means a swimming pool oper-
ated for the use of �he general pu6lic with or wi(haut charge, o� for
�he use of themembers andguestr ofa private club. Pu61ic swim-
ming poal does not include n swimming pool foca�ed on the
grounds of a priva�e single fqmi(y home.
SW1MM/NG POOL or POOL means any svucmre intended
for swimming or �ecrealionn! bathing that cantains water over
]8 inches (457 mm) deep. "Swimming pool" includes in-ground
and above-ground structures and includes, 6ut is not limired ta,
hot [ubs, spas, portable spas nnd nonportable wading poofs.
Reference: Heal�h and Safery Code Section 11592]
Au�horiry: Nealth axd Safery Cade Sectrort 18942(bJ
AB 3305, S�atutes 1996, C.925
SECTION 3151B — CONSTRUCTION PERMIT,•
SAFETY FEATURES FEqU1RED
Commencing lanuary I, 1998, except as provided in Section
3154B, whenever a tonstruclion permit is issued for construction
of a new swimming poo! at a privaie, single family home, i! shall
be equipped with at least onc of ihe following safery featu�es:
1. Thepoo(shallbeisolatedfromaccesstoahomebyanenclo-
sure lhat meeLs ehe requi�ements oJSec(ion 31528.
2. The pao! sha!( be equlpped wi[R an approved safety poo(
cover.
3. The residence sha(1 be equipped with �it alarms on those
doors providing direc! access to the poo(.
4. A[ldoorspsovidirtgdirectaccessfromthehometotheswim-
ming poo( sha(1 be equipped with a self-c(osirtg, self-lalching de-
vice wi�h a re(ease mechanism placed no lower thnn 54 inches
(1372 mm) above the floor.
5. Other means of profection, if the degree a%protection af-
forded is equa( to or grea�er than tha� aJforded by any of rhe de-
vices set jorth in !lems I-4, indusive, as determined by the
building o�cial oJ�he jurisdic�ion issuing the applica6le bui(ding
permiL Any ordinance governing child access mpoofs adapted by
a poliricalsubdivision on or beforeJanuary ], ]997, is presumed
1-299.76
[o aJfordprotection that is equal [o orgreater than that ajjarded by
any of the devices set for�h in /tems 1-4, incltu'ive.
Reference: Henith and Safety Code Section ll5922
Authority: Health and Safery Code Section 18942(b)
AB 3305, Statutes 1996, C.925
SECTION 3152B — ENCLOSURE; REQUIRED
CHARACTERISTICS .
3152B.1 Anenclosureshallhaveallofthefol(owingcharacteris-
�ics:
1. Any access gates through �he endosure open away from the
swimming pool and nre self-closing with a self-la[ching device
plared na (ower thart 60 inches (1524 mm) above [he ground
2. A minimum heigh� of 60 inches (1524 mm).
3. Amaximumverticafclearancefrom�hegroundtothebottom
o%�He enclosure of2 inches (SI mm).
4. Gapsorvaids,iJany,donotallowpnssageofasphereequal
m or greater [han 4 inches (102 mm) in diameter.
S. An outside surface free of protrusions, cavities or other
physica! charac�eristics that would serve as handholds or fooP
holds thnt could enable a child be(ow �he age of five years m c(imb
over.
Reference: Health and Safery Cade Sec[ion ]I5923
Authority: Health and Snfety Code Sectian 18942(b)
AB 3305, Statutes 1996, C.925
SECTION 3153B — AGREEMENTS TO BUILD; NOTICE
OF PROVISIONS
Any person ers7ering into an agreement to bui(d a swimming pool
sha(! give tBe consumer notice of �he requiremenu of this article.
Reference: Hea!(h and Safety Code Section 115924
AutRoriry: Heal�h and Safety Code Section 78942(b)
AB 3305, Smmres 1996, C.925
SECTION 3154B — EXEMPT FACILITIES
3154.IB Therequiremen[softhisar(ideshallnotapplytoanyof
the folfawing:
1. Public swimming poo(s.
2. Hot tubs orspas wi�h Jocking safety covers �ha[comply with
�he American Sociery for Testing Materials—Emergency Perfor-
mance Specification (ASTM-6S 13-89).
3. Anypoolwithin[hejurisdictionofanypoliticalsubdivision
tha! adopts an ordinance for swimming pool safery that indudes
requiremen�s tha� are at least as stringent as this divisioa
4. Anapartmen�mmplrxoranyresidentialsettingotherrhana
single fnmily home.
Reference: Health and Safery Code Secfion 115925
Au[hority: Hea(th and Safety Code Section 18942(b)
AB 3305, Smtutes 1996, C.925
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POOL AND SPA REQUIREMENTS
The following informa[ion is required in a cleaz and legible manner. All information shall be complete and on
the plans.
Three sets of plans showing all of the following with measurements shown from property lines, buildings,
patio covers or other swctures.
1. Name, address, phone number of owner.
2. Name, address, phonz number, type of license of any contractors or subcontrac[ors.
3. Pool and/or spa location.
4. Equipment location.
5. Gas and electrical me[er locations.
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9.
10.
11.
12.
13.
14.
15.
16.
17.
I8.
19.
20.
2l.
22.
23.
24.
25.
26.
27.
Overhead service lines and serving pole location.
Type of gas and electrical conduits to be used.
Size of main elec[rical service (if less than 100 AMP, service is probably inadequate and will have to
be upgraded to minimum City requirementsJ
Ra[ing (horsepower, voltage, amps) of all electrical equipment.
BTU rating of gas heater.
Distance and size of gas line.
All electrical outlets within I S fr. of pooUspa.
Capacity of spa (spas only).
Handrails, ladders, slides and diving boards (if any).
I,oca[ion and de[ails of solar panels (if any).
Location of doors and windows within 5 ft. of pooUspa.
The type of construction—gunite, poured concre[e, prefabricated fiberglass or o[her.
The pool dimensions, including the dep[h and adequate cross-sections drawn to scale.
Computations, stress diagrams and other data sufficient to show the correctness of plans; including
reinforcing steel schedule and details.
A statement by the applicant conceming [he anticipated nature of the soil under and around Ihe pool
structure (expansive, moderately expansive, non-expansive). (A soils report may be required by
Building Division prior to permi[ issuance.)
The Engineer's wet ink signawre is required on pool plans and calculations.
All semi-private pools and spas shall conform [o Califomia Administrative Code Title 24
handicapped requirements (hotels, mo[els, recreation areas for lease to public or publicly funded
projects).
Where a permanently ins[alled pool is construc[ed, at least one 120 volt ceceptacle shall be installed a
minimum of 10 feet and not more than 15 feet from the inside wall of [he pool and shall be protected
by a ground fault circui[ interrup[er.
Indoor installa[ion of spas and ho[ tubs, recep[acles shall not be closer [han five (5) feet [o spa/tub.
Receptacles located within twenty (20) feet of a spa or hot mb shall be G.F.C.I.
Receptacles for spa/ho[ mb motors shall be G.F.C.1. protected.
Comply with Costa Mesa City ordinance 93-12 requiring pro[ective barriers, fencing and/or
enclosures.
�u,y-.e i�r�. �ne�
GENERAL REQUIREMENTS
1. If capacity is 750 gal. Or more, backwash and P-Trap shall be installed.
2. All P-Traps shall tie in aYlower terminus of house drain.
3. If permanent fill line is not installed, neazest hose bib shall have an anti-siphon valve.
4. All PVC shall be ]8 inches underground.
5. PVC gas lines shall be tested at 60 P.S.I.
6. Pressure [est required on entire system (35 P.S.I. air [es[ or water fill) prior to back fill.
TYPICAL SETBACK REQUIREMENTS
Equipment 4 ft. from property line
4 ft. from doors/windows
4 ft. from attic vents
18 inches from house/gazage
PooUSpa: 5 ft. from property line
5 ft. from structures
l. Overhead Edison drops shall be installed per NEC 680-8 (see attachment).
2. It shall be unlawful for any person to install, remove, alter, repair or replace any plumbing, gas or
drainage piping or any fixture, swimming pool heater or treating equipment in a building or
premises without firs[ obtaining a permit to do such work from the City Building Division. '
3. Clarification or addi[ional informa[ion may be obtained by [elephone: (714) 754-5273, between
8:00 a.m. and 4:30 p.m.
FENCE AND GATE REQUIREMENTS (see attached)
1039�96 (REV. �50)
(714) 754-5273 • Fax (714) 754-4g56 • www.ci.costa-mesaEi6sCTRICAL PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
.lob Address: 871 DARRELL ST
Suite No
Vicinity: REAR YARD
Parcel Nunmber: 42236303
Applicank ZOSACK, LISA
Address: 24512 BRIDGER RD
� "�Phone; ,949-859-8466 ---�.
LAKE FOREST, CA � � � �-�!%�� �- Zip 92630 " ' _ - �
../r"� -� _ - .
Owner: MAYNARD,�STEPHEN, � , ,
Address 871-DARRELL ST�� . - - . . ' �
��,;
/: �=� A '• � - � �- ; Phone: 943650-1812- -
/ , 1 i� � � � ' �`�,.-' - . .
/ � COSTAMESA,.CA% .�� �� -� - Zip: 92627 " -
/r%i/i / � �� -.
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Contractoc SWAN"POOCS OF SOUTHERN CALIFORNIA
-� AddreSs: 24512.BRIDC,JER RD
' �'% ,' � � ��i:'' .
� ., � . :�� /�, �, Phone: �949-859-8466
LAKEFOREST, CA Zip: : 92630
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" ����r� � „License:440333
� , _ . n_���' / l.
' , status: ISSUED
aPPi�ed:� ozrzvzoo�
Issued: 02/21/2007
ISSUED BY:
�'
� ` � � `" � ' ` � ��� ` ' _ SCOPE OF�PERMIT � � �
�- . �%� f�ELECTRICAL P RMIT FOR THE�CONSTRUCTION OF A NEW 422 S�.FT. INGROUND GUNITE POOL/SPA �
' - � �.�':�"IN REAR.YARD OF SFD. -/ �� � � , ' - �
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. . "V `•- �� .REF#: B07-001'99 � ' � � ,_ � ,
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' ',1 _WORKTOINCLUDE 1'POOtlSPA r i � -� � � . ' � "
. ;� � . .��„� ' � �� ,� � � A - • �
( ` V FEE SUMMARY -
. . �� , G � � � . � Quantity, .. QuanUty . . �
r
� ISSUE FEE � $23.50 _- - -� �� � Temp Digt System /,Lighting - $0.00 0 , �
�,Temp service test $0.00 - � � -� - ' "- �' - Busway /100 fl� ,� ' � - ' � $0.00 0 � �
�Res. a/c package-��, � • ' $0.00 " � � � ' - Standing Section - $0.00 0 -� - ' �
New Res(1-2 units) .� a, �. $0.00 , 0 Misc Electrical�rEquipment $0.00 0. ,' ,'
New` Res (3lunits), '_ `��� �. $0.00 / 0 Transtormers up to 1 kva/kw � $0.00 0��. � • � � �
PooU�Spa ,. i,�•. \��",. $49.50 '� 1 .........:..:::upto�l0kva/kw $0.00 0;,. ,.. ..� .
Lighling Fixts�` t �' ;'. $0.00 0 .._...._._....up to 50 kva/kw $0.00 ��0'; _', _ � � `
...
Recept Oullets � , , � $D.00 0 �; - � - �, ....:...........up to 100 kvalkw $0.00 0 � - -
Switchea �:A . ; ' `��' � $0.00 0 „i =,!„ ;r ....... : :._..,.over 100 kva/kw $0.00 .'�-0 '
Non Res Appl N \$0.00 i 0 .�V ', " Low Voltage Equipment $0.00 ,� 0 .
ResAppl�;�� , ( ��$0.00 0;., ' • ��LowVOltWirmg;System/Ckt �$0.00" � 0.�� -
Serviceto200a� - - $000� �'?>- 03' �. . Misc:Conduit� �>-'� ' �� � . . $000� 0� , � -
Service to 1000a � j�/ $0.00:; � - 0 _ �� � Misc. Conductor . -$0.00 �. 0
Service over 1000a � !/� $0.00\ti ` 0 -'� _ �� � Circus ( gen or ride) ,�- $0.00 -� , 0
Motorsto7hp V� �` /' � _ -: � ' � � � "
,�� � , "$0.00 ��-0':� -Circus (mech dde or lights)��; � $0 00 � ;� 0 � �
Motorslol0hp ;A ,,,'$000,7 0,=� �� �-�� ChristmasTreeStand����- $0.00 "0 � /
Motorsto50h ��'�� � � V � �� - - � ��$0.00 �0�'i
p � ��A $0.00 � 0� r- Fireworke Stand �' ' �
Motors to 100hp ����A�$0.00�<' �� ��,0�� , " - --- _ Other Eledrical�Fee �, �'�' -$D.00 ��� ��
Motors over t00hp �, � $0;00��;' ",� 0�; � ,=_ � �.� _ -. , � - "-� � .
Communicationdrops �,$0.00� ��'0-�. .' .--�,�' �-� � .- �`InvestigationFee� ` ' $0.00 %
Sub panel to 200a $0.00'�.`�-� 0' � -� ' " , Plan Check Fee �� , . . .50.00
Pole LigM Pkg g0.00� � � `.0�� ` �� - . � � Reinspedion Fee � � � - $0.00
SignCircWls $0.00 A'0��- � - . � �
Temp Pwr Pole $0.00 0- -_' -�-, _;,TOTAL CALCULATED FEES E73.00
Intermed Pole $0.00 0 � -
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 suspendetl or abandoned
tor a period of 180 days.
INSPECTIONS: In ordar for 1he work autFrorized under �his permit to be considered legal, sucb work must comply wi�h all applicable codes, and al!
reqWred inapections and final approval must be obtained. Failure to obtain inspections and final approval will resWt in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
244638 (6/00)
WORKERS'COMpENSAnON DECIARATON:
I �ereEy aRirm untle� penalry of perjury one ot the following tleclarations: -
❑ I heve and will maintain a certificate of conse�i �o self-Insure tor workars' compensation, as provided tor by seqion 3700 of the Lahor Cotle, for the pertormance oi the
�[ work for which this permit is issued. �
ICL I,have anQwill maintain worke ' compensation insurance, as required by section 3700 of the Lebor Code, for the peAortnance of �he work for which Ihis pertnit is issued.
�M^�ers��ompensation urance carrler and poliry numbar are: ���] � 33 a3y .
,6a nr er. _�� P.dicyNumher.�-r" " �
(ihissec on need na� be campleretl il (he permil is valued af one hundred dollars ($700J or less.)
❑ I cetlify Ihat in ihe p ormance of the work lor hich Ihis pertnit is issuad, I shall not employ any person in any manner so as to become subject to the workers'
compensalion ws Califoml , en agree that � should become subject to Ihe workers' compensalion provisions ot Section 3700 of the Labor Cotle, I 5hall forthwi[h
comprywithtp sa vi ns. �^../ 1
ApP� n��Signetur� D�N—/T I ��
WARMNp:�FAILURE 7 WORKERS' COMPENSATION WVERAGE IS UNLAWFUL PND SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVII FlNES UP TOONE HUNDRED
TYIOUSANOOOLLAREIE100, ,INADDITIONTOiHECQSTOFCOMPENSATION,DAMAGE5A5PFiOVIDEDFORINSECTION370fiOFTHELABORCO�E,INTEREST,ANDATTORNEY5FEE5.
LICENSED CONTPACTORS DECLARATION:
I hareby aNi�thal�.a'Ii�ebya4 n v' ' ns of Chapter 9(commencing with Section 7000) of Division 3 of ihe Busine (essions Code, and my licanse is in full
force�entl eNect°lJc.x � �'i Class x
Comredor�Wre: Date:� �
r----^".. �.i i I _Y.a:
CONSTRUCTION LENDING AGE Y:
❑ I hereby aNirm that ihera is a construction lentling agency for the pedormance of ihe work for which ihis permit is issuetl. (Sec. 3097, Civil Cotle).
Lentlefs Name: Lender's Address:
Signature:
OWNER-BUILDER DECLARA710NS:
Date:
I hereby aHirm ihat under penalry ot perjury that I am E%EMPT FROM 7HE CONTRACTORS LICENSE LAW tor �he tollowing reason (Sec. �031.5. Business and Pwlessions
Code: Any ciry or county which requires a permit to constmc6 alter, improve, demolish, or repair any simcture, pnor to its issuance, also requires the applicent for such pertnit
to tile a 5igned statement Ihat he or she i5 licen5ed pursuant to Ihe provisions oi ihe Contrectors LicenSe Lew (Chapter 9(commencing with Saction 7000) ol Division 3 oi Ihe
Business entl Prof9sslons Code) or that he or she is exempt therefrom antl the basis Por ihe allegetl e:emption. Any violation of Section 7031.5 by any applicent for e permit
subjects the ap0licant to a civil penaliy of not more Ihan five hundred dollars (5500).):
❑ I, as owner oi the property, or my employees with wages as Iheir sole compansation, WILL DO 7ME WORK, and the siruc�ure is not intentled or oHerad for sale (Sec.
7044, Busine5s and Professions Cotle: The Contractors License Law dces not apply to an owner of pmpeny who builds or improves ihereon, antl who does such work
himsetl or herself or through his or her own employees, provided that such improvemenis are not intendetl or ottered for sale. I(, however, the builtling or improvement is
soltl within one year of completion, the owner-�uilder will have tha burtlen of proving that he or she did not Du�ltl or improve for purpose of sale.).
❑ I, as owner of the O�operty, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the pmject (Sec. 7044, Business antl Professions
Code: The contracbrs License Law does not apply to an owner ot propetly who builds or improves thereon, antl who coNracts for such project with a coniractor(s)
license pursuant to tha Contractors License Wws.).
❑ I am eaempt �nder sec. Business and Professions Code tor ihis reason:
Signature: Date:
Ownar ID venfied by dnvers license. ❑ Yes ❑ No Driver's License No.
Veritiwtion ot OwnOrship by (type ol document, i.e. - property taa bill or deetl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
Eapires:
❑ I hereby certiry ihat no excava�ion five (5) or more faet in depih into which a person is required to descenq will be matle in connection with work authorized by this
permit, and lhat no building sirudure, scaHolding, falsework, or tlemolition or dismantling �hereot, will he more tha� thirty-siz (3fi) teet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Galitomia Atlministrative Code).
❑ As ownervbuilder, I will not employ anyone to do work which would require a permit imm iha Division of Indusirial Setety, as noted above, unless such person hes e
permit to tlo such work from Ihe division.
Signature: Date:
Division of Indusinal Satety Permit Numbar:
CERTIFlCATE OF CoMPLIANCE AND AUTHORIIATON OF EMAY: I certity under penalry oi perjury ihat I have read this epplication and state ihat the information given is
wrrecL I agree to Gomply with all state laws and ciry ordinances relating to builtling constmction, and authonze representatives of the City of Cos�a Mesa to enter upon the
above-descnbed qfpPerty tor inspection purposes. I agree not lo occupy or allow occupancy of eny building authorized by t�is Oermit until tinal inspection.
COOE 1,
1616
1266
200
Fixed System Final Fire Prevention
Pool Spa Final
Finel Re-R�1
201 Final BIocVJRataining Wall
i
202 Final Factory Fira Place
203 Finel Sign
204 Final DemJlition
jl�jE IAL
CODE� INSPECTIONTYPE
206 Final Mec�anical
208 Finai Plumbing
210 Final EleclnCal
212 Final Fire Prevention
220 Final Planning Approval
222
250
Final Site
Final Building/Occupency
17.I1�l:�Tiil]G9
�' � � .0
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
� .
MECHANICAL PERMIT
Job nddress: 871 DARRELL ST
Suite No
Vlcinity: SPA .
ParcelNumber. 42236303' .
77 FAIR uHNE, GOS7A MESA, GA 92626
SWtus: � ISSUED
Applied: 02/21/2007
Issued: 02/21/2007
appiicanc ZOSACK, LISA �-� -, _ � issueo av:
, >c�,:,_ .
Address: 24512 BRIDGER RD"'�=i.i�.'- "� � � - ` � -
i���,i; •- �-
,; „ii .:- ,-^� . -, �� �Phone: 949-859-8466` . , .
LAKE FOREST;�CA'"� `" �, � Zip: 92630 ;
,�i ;-'..�� -� � � , ,' . .
Owner: MAYNARD;�STEPHEN. :
� _ -
Address: ���871�DARRELL ST : = , - ..'= - - � - , - � ,
� ' � ,� , •" '� �'� ��� �� Phone: 949-650-1812 � � `� . .
i
��''���C STA EM BA;CA �'��� Zip: 92627 � � ,. , . , ,
,
i���'/ V �✓ �i �y .. ,- � ,.
C ntracto� SWAN {? O 3 OF SOUTHERN CALIFORNIA ��.., �
�/Address:�, 24612.BRIDGERRD � �\. `,
�� � � � � ,!%��� Phone: •949-85&8466
. ` ���,� LAKE"FOREST,CA � ' '
� ,�i�f
� ( ''� "^//7 ( ? s?; �
'���� � -- ,"'�MECHANICALP-ERMIT:
"J ,POOUSPA, N REAR�YA
'� , /
� Lp. . 92630
' ; License: 440333' ; ° '
\. :
><'? "c�nr�se nc o�ow�
1E CONSTRUCTION OF
SFD.
0
422 SQ FT'INGROUND GUNITE � „ �
� REF#: B07-00199,, j \ '.: '
.. �'.,��-, �`,j! �_, - .� `���� . �
` . i �' � � WORK TO INCLUDE 1 INST'FAU > 100�K BTU � -- � - - '
� �� � : f � /� /: �"^"1-'� ��' ! lii. 'i �� .�' � / \�' -
.. _ '>--. � ./ '.. .....,. _
. . ,.�,. . ..i� .. ._ _; .
___ _ = � � .. ': -FEE SUMMARY � ..., _. "-'. ,
`� ,. � �
�„ „ .--•� �'f�"�'. , �� Quantity � �1;; , �. � Quantity.
�ISSUE�FEE . : $23.50 Repair/AltAbsorbtionUnit ' $0.00 0
InstFAU<100kBTU,� �� $0.00-'�0- �- — - � �`. �Repairl_AltRefrigeration'Unit � $0.00 0
Inst FAU >100 k,BTU :., $1820�=;1 � _�`__ ����' � � .. � Ventillation System : $0:00 0 '
Repair / Alt' Cooling/Heat $0.00 0 �� �� � Evaporative Cooler � � � $0.00 �0 •
Inst LRep. Recess WaII,Htr $0.00 0 Commercial Incinerator . "-1 � $0:00 �- �0 � - ;
Re(rig Sys <100 k�BTU „"� $0.00 0 Domestic Incineralor � $0.00 , 0 .
Refrig Sys >100 k�BTU�� `' ' $0.00 0 Comoressors /Absomtion Svstems � ��-- - � - �
Gas Piping `, ��, � $0.00 0 Up to 3 hp / 100 k BTU "-,�$0.00 0;
Factory Fireplace � �- � $0.00 0 �_ � �•.3,To 15 hp / 500 k BTU :�,-i ' � $0.00 0.�
Hood w/Mech Exhaust �L ` $0.00 0 f,G �- 15So�.30 hp / 1,000 k BTU '� ' ��$0.00 - 0�
VAV Box ���`� ��1 V Cl $0:00 0 �' �� 30 To 50'hp / 1,750 k BTU � .� $OAO ' 0
Vent Fan�/.Single Duct, ' � ; $0�00 0 i- - • ` Over 50 hp'/;Overv1,750 BTU � . . . $0.00 ` . 0
Appliance A :•` ' � ���:$000' 0�'- �� � � �'Boilere ' . ` ' . � � .
Fire Dampers, A,A ��� '�SO 00 0 � � ` � %, Up to 3 hp � -.' i . � � $OAO 0
Smoke Dam ers �; \ � $0 00 � �0 �'- � � �' �- . --3 To 15 h " � � , � � ,' $0.00 0
Inst or Relocate Appl Venf �f ��$0 00 �0� �� ° � k�� � � � � 15�to 30 p �, �r'� � 'i� "�' � - �' $0.00 0
Air Handlers < 10000cfin� �� / � $0.00 0 �'�'� �'�� � � � � 30 to 50 hp ;,� ,`%� � �:� i ' � , !� ; '$0.00 0
Air Handlers > 10000cfm,; �A `�� $0.001 0. � �� �_ = '�' �"' �' - OJer 50:h � ` ',' � � � � i � �
� p �" � � $0.00 0
Floor Fumace � � �'" $0 00 0 ^`� � � -- � - - � Othe� Mechanical Fee � - % � -
Floor or Suspend Heater� �-A� $0 00 0`i` `- - Investigation Fee', � $0.00
� �� � �\t ; r �1i �`� �� - � � � Plan Check Fee>, 30.00
- `� ==�. �,, 1 � .
..=- � - . ' � ' Reinspedion Fee , $0.00
-�_ �. . r- . ���
- - ' _ _ _ . - � - - TOTAL CALCULATED FEES E41.70
- , — .. __l/IC.JL��.J�i .
COMMENTS I SPECIAL CONDITIONS
,, �
, _ `� "
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under California slatutes and related
regulations. (Ord. No. 92-28, § 7, 12-21-92) �
i
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
Irequlred Inspeetlons end final approval must be obtained. Failure to obtain inspections and final approval will resWt in t�he expiration of this permit.
I FOR INSPECTIONS CALL: (714) 7545626
2d4G4fi (N00)
WORKERS'COMPENSATION DECLARATON:
I hereby aHirm under penelry of perjury one of the fotlowing tleclarations:
❑ I hava and will meintain a ceRiticate ol consent to self-Insure tor workers' compensation, as provitletl tor by section 3700 0l Ihe Labor Cotle, for the pertormance ol ihe
work tar which Ihis partnit is issuetl. ,
� I have and will m�intain worke ' compenution insu�ance, as required by sectlon 3700 of the Labor Code, for ihe pertormance of Ihe work for which this permit is issued.
y„_My.'�J k� r,s,'�� m�Pensation urence carrier and policy number are: , ' \' I ' 1�
Carn��A ,� PolicyNGmber. UVV}i �J�'���
,(.Thls secfion need nof be comp/efed i/ the Dermit is velued at one huntlretl dollars ($100) or /ess.J
❑ I certify Mat in thB i�rtormence ol ihe work for which this pertnit is issued, I shall not employ any person in any manner so as to become su6ject to the workers'
compensatio IaW o� California, antl egr that if I should become subject to ihe workers' compensation provisions ol Section 3700 0l ihe Labor Cotle, I shall forthwith
comply with t es ov' io �� I��
App;cflnt �IgnaWr Data:"�'✓ :-'
i
WAqNING. FAILURE T S WORKERS' COMPENSATIqJ COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYERTO CRIMINAL PENALTIES AND GVIL FINES UP T00�1E HUNDRED
TYIOUSNJDOOLLARE f1�. .INADOITIONTOTMECOSTOFCOMPENSATION,OAMAGESASPROVIDEDFORINSECTIIXJ3lO60FTHELA80RCODE,IMEREST,qNOATTORNEV'SFEES.
LICENSED CONTRACTORS DECLARATION:
aHirm that I aR�
of Chapter 9(commencing with Section 7000) of Division 3 of the
Code, and my license is in lull
CONSTRUCTION LENDING MGENCY:
❑ I hereby attirm 1h9� ihere is a construction lending agency tor the pertormance of the work for whic� this pertnit is issued. (Sac. 3097, Civil Code).
Lendels Neme: Lender's Address:
Signature:
Date:
OWNER•BUILDER DECLARATIONS:
I hereby aHirtn that under penalry oi perjury that I am E%EMPT FROM TME CON7RACTORS LICENSE LAW for the following reason (Sec. 7031.5, eusiness and Professions
Cotle: Any ciry or counry which requires a pertnit to wnstruct, alter, improve, tlemolish, or repair any structure, pnor to its issuaoce, also requires the applicant tor such parmit
to file e signed statemBnt that he or she is licensetl pursuant to the pmvisions of the Cantractors license Law (Chapter 9(commencing with Section 7000) of Divislon 3 ot the
Business and Professions Code) or that he or she is axempt therefrom and Ihe basis tor t�e alleged exemption. Any violation o� Section 7031.5 by any epplicant for a pertnit
subjects the aOD�iwnt ta a civil penalry of not more ihan live huntlretl tlollars ($500).):
❑ I, es owner oi ihe G�aPerry, or my employees with wages as their sole compensation, WILL DO T1E WORK, antl ihe structure is not intentletl or oHeretl for sale (Sec.
7044, Business and Professions Code: The CONractors License Law tices not apply to an owner of property who builds or improves thereon, and who tloes such work
himsetl or herself or throu9h his or her own employees, provitled ihat such im0�o�ements are not intendetl or oNerea for sale. If, however, the building or improvement is
sold within one yBar oi completion, the owner-builde� will have the burtlen of proving that he or she did not build or improve lor purpose of sale.).
❑ I, as owner of Ihe P�operty. am EXCLUSIVELV CONTRACTING WITH LICENSEO CONTRACTORS to consfruct ihe project (Sec. 7044, Business entl Professions
Code: The contractors License Ww does not apply to an owner of property who builds or improves thereon, antl who contrects for such pmject with e coniractor(s)
license pursuant lo the Contrectors License Laws.). •
❑ I am exampi under sec.
Signature:
Owner ID verified by tlrrvar's licanse. ❑ Ves ❑ No
8usiness and Pwfessions Code br ihis reason:
Verificelion ol OwnerSHip by (type oi document, i.e. - properry tax bill or aeetl):
DriveYs License No.
Date:
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certity ihat no excavation tive (5) or more teet in depth into which e person is required to descend will be matle in connection with work authorizetl by this
permit, antl that no building sWCWre, scattoltling, falsework, or demolition or dismantling thereof, will be more than thiny-siz (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title e, Califomia Administrative Cotle).
❑ As owner-builder, I will not employ anyone to do work which would require a permit Iwm the Divisian ol Industnal Safe�y, as noted above, unless such person has a
permit to do such wark irom the tlivision.
SignaWre: Date:
Division of Indusinal Sa�ety Parmit Number.
CERTIFlCATE OF COMPLIANCE AND AUTHORVA710N OF ENTTiV: I cetlify under penalty of perjury ihat I have reatl �his application and state that the information given is
correct. I egree to comp�y with all state laws end ciry ordinances rela�ing �o building constmction, antl authorize representatives of ihe Ciry oi Costa Mesa to enter upon ihe
above-deq�cribetl property ior inspection puryoses. I agree �ot to occupy or allow occupancy of any building authorized by this permit until final inspection.
COUE �• INSPECTIONiVPE
1616 Fixed Systam Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Root
201 Final Block/Retaining Wall
202 Final Factory Fire Place�F
203 Final Sign
204 Final Demolition
Q�TE I TN RIALS
COOE♦ INSVECTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Elecirical
212 Finel Fire Preven�ion
220 Final Planning Approval
222 Final Sita
250 Final BuildindOccuoan<
�� �
JobAddress:. 871r DARRELLST ' SWtus: ISSUED
Suite No Applied: 02/21/2007
''Issued: 02/21/2007
Vicinity: POOL/SPA REAR YARD
Parcel Nunmber: 42236303 ,.
Applicant: ZO�SACK, LISA
Address: 24512 BRIDGER RD _ - �. ;�, �� ; �.- , ' � -
^i
- � �, -Phone:. 949-859 8466_ _�=
LAKE FOREST,�CAi � � Zip: 92630 .
,:
r'�,�=i ."-
, . ,
/,%�.��_.. A..�1 1
owner. MAYNARD, STEPMEN 1 �`,.r � '-/
Address / 871 DARRELL'ST � ���- "' , = -_ � - - - '•
i
� 4(l/ � i A �� > � %�; `�. . - Phone: 949-650 1812 '
� �� -
��`; �/jCOSTA MESA,�CA'�,%'< y Zip: 92627
j�� J� � \`�r%%ij'- .
c�� �� , , �//,.: ;�'
vacto�: SWAN POOLS OF SOUTHERN CALIFORNIA
��Addressi� 24512�BRIDGERRD -
i .,� r� � ' �';�/ Phone: 949-859-8466
�` � L4KE�FOREST, CA Zip: `92630
.;'i ,,�.., i
, � ' , ,' ', ' � "�Licens,e: 440333� "
. � , � i � .'/�� , ' = � _ !-r -
� �
� ' ' � /1;; � .� , .;'���I�,� .. '- _ � ._
r �
,
ISSUED BY:
!^, ` � .
� � ` �.
' = ' - � SCOPE OF PERMIT - � �
-�i"' �BLUM8ING PERMIT FOR THE CONSTRUCTION OF A NEW 422 SQ.Ff. INGROUND GUNITE POOUSPA IN
� �� �REAR YqRD OF SFD: � l . � �
�.�\.__ 'I�/r � u > . ., �
,' , � � REF#:B07-00199 �_ - -- -� �. --. - - � � - -� •
' � �r"r.'rl��,,� �� - ','. . . ,�
�
"� � L j,'-WORK TO INCL`UDE 1.GAS (1-0 OUTLETS) FOR,F,UTURE BBQ; 1�PRIVATE�SPA AND 1 SWIMMING'r '
i i 'j ;s,,, POOL. - -- � _ - - -_ _ _------�
� �--� . ' , C ..�..----` -- ----- - '�J
!
, , ,
. �' � �' . . . AMT
ISSUE FEE, -� �� t `,;'^ � $23.50
Backflow.irrigation �- ;, �, $0.00
BackflowPreventer `���•, $0.00
BethtUb� =1, �,`,,� � $O.OD
ClarifeiSystem �' � '�.�$0.00
Connectppe;Soda,etc) ��'$0.00
Dental Uqits � i�' �$0.00
Drain Floor��\ <'�',%
Drain, Rainwater ,
Drain, Roof�`��
Drinking Fountam)� �j
ExpansionTank���'� ''�
Gas Earthquake Valve�,
Gas (1-4 outlets) �V �:��,
Gas (Over 4 outlets) A� ��
Gas Repipe .
Gas Service
Interceptors (Grease, Oip
Interceptors (Sand Auto )
$0.00
� � �,� _FEE SUMMARY'"`�� � , ' � �
.�--�:--=.��=,.._ti=.�r_-'-� �� _;AMT�, ��Q_TY'�' _ .' ; \AMT
� ,• -� - Laundry Tub / Washer �' $0.00 � 0' - - Sump Pump �t' ' $0.00
0 Landscape Irrigation $0.00 �' 0 Swimming Pool; „,_ -, $6075 •
0 � P-Trap �'$0.00'�� 0 �._Trap Primer �, - $0.00���
0� Pressure Regulator ; $0.00�. ;r�0 Urinal �' $0.00
0� Process Piping (per 10 fi) $0.00 0 Vacuum BrkcBkflow(1-4j �' $0.00 �
0 Receptors . $0.00 0 Vacuum Brkr BkBow(5+) ��$0.00'
0 Septic Tank�,.-. �e: � � ., $0.00 0 Wash Basim -� , $0.00
0� Sewer Cap.for Demo �$0'00 ,- 0� Wash Basin Set .$0.00
� 0� SewerConnect . $000 .�0 . Wasteand�VentSystem �'.$0.00
\?,�0 4�a,. -%p�SewerPrivate�Linep-.- � ,. $0.00 i�0� � "�WateiCloset(Toilet) /� $0.00
`��0� :, Shower. •� , -$0.00 0 � WaterHeater/vent ," . $0.00
`0,� �� '-Smk �bar � :� $0.00 � 0 � �== -Water Piping (Inst or Rep.)�� $0.00
J„�0 ��.,,�,,;Smk commeraal - .$000 ° 0 � �;. j�rWaterR�pipe� /'-,; $0.00
!. �0 ~ - � �Sink; Floor ` - . � $0.00 - 0 ' _� , Water Service .� $0.00
! 1�,A �`'Sink,'kitchen�<-,.-� .-.$0,00=.'-0��" r ;�,WaterSoflener � - $0.00
' v� \0, � f� ��Sink, service/mop _ _ ; "_ $0.00 ` 0 � OTHER .-, %/ $0.00
0 � ��� � Spa;(private) $3025 � 1� � ��� � �VIOLATION , $0.00 .
�A�� ���� 'Spa{putilic)-�' � �� � "" $0.00.�'0 � � � PLAN�CHECK $0.00
,`�0`� � i. � � � ' ' ' ' . -.REINSPECTION $0.00
� �0 -� �; � _- . . . , . . :
� - �"� ,"r � _ ._ � ;/',/ ��� ;TOTAL CALCULATED FEES: E120.65
=_�_. ---- - ` �- _
,_ �c:.�, _,-,_-.� ..�.. � . -
� , i
'. . ' , . ' , , � . .
�
l�
on
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
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, Y2-21-92) ��
EXPIRATION: This permit shall automatically expire and become void ii work is not commenced within 180 days, or if work is suspend�or abandoned
tor a period of 180 days.
INSPECTIONS: In order for tne work authorized under �his permi� to be considered legal, such work must comply with all applicable codes, and all
required Inspeotlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiratiori�ot this permit.
FOR INSPECTIONS CALL: (714) 7545626
2d6fiifi (fi�00)
WORKERS'COMPENSAnON DECLARATION:
I hereby affirm untler penalty of perjury one of the following declarations: �
❑ I have and will maiP�ain a certifica�e ot consent to selbinsure for workers' compensation, as pmvided for by section 3700 of the Labor Code, br ihe pertortnance of the
work tor which this pertnit is issueA.
❑ I certify thai in the peAo
compensation la o�
comply wit Ihese r i
AppllcienY�SiB�aWre:
WMNINGFFILURE TO S URE
hKK15AND DOLLARE (5100.000).
compensation insurance, as require0 by section 3700 ot ihe labor Code, br Ihe pertortnance of the work for which Ihis pertnit is issued.
rance carner and policy number are: ��� �� �' /
.�
,Policy Numtier.
i fhe permit is valued a( one huntlretl dollars ($100J or less.)
of the work for w ch this pertnit is issued, I shall not employ any person in any manner so as to become subject to iha workers'
, end agree that � I should become subject to the workars' compensation provisions of Section 3700 of Ihe Labor Cotle, I shall forthwiN
o����—al��
RS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJEGT AN EMPLOYER TO CRIMINAL PENALTIES AND dVIL FlNES UP TOONE HUNDRED
'ION TO THE COST OF CAMPENSATION, OAMAGES AS PROVIDEO FOR IN SECTION 7lCfi OF THE LABOR CADE, IFREREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aflirm that I am G e s d pg, v,�ons of Chapter 9(commencing with Section 7000) of Division 3 otthe�Bus' d Pmfessions Cotle, and my license is in full
�arcaaneenectrcic-a_ JJ %�assn•
Contracta'a�Sgn`8ture oale:---�^- �
�-,r� 1 �-+ ..r
CONSTRUCTION LENOIN GENCV:
❑ I hereby eHirm that �here is a construction lending agency for the pertormance of ihe work for which this permit is issued. (Sec. 3097, Civil Code).
Lendels Name: �ender's Adtlress:
Signawre: _
Date:
OWNER-BUILDER DECLARATIONS:
I hereby eflirm Ihat under penalty ot perjury that I am E%EMPT FROM TME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions
Cotle: Any ciry or counry which requires a pertnit to construct, alter, improve, demolish, or repair any sWcture, prior to its issuance, also requires ihe applicant tor such permit
to file a siqned statemen� that he or she is licensetl pursuant to the provisions of tha Contractors Licensa Lew (Chapter 9(commencing with Section 7000) ol Division 3 of t�e
Business antl Profeuions Code) or thet he or she is exempt therefrom and the basis for the alleqed eremption. Any violation oi Section 7031.5 by eny applicant for a permit
su6jecls Ihe applicant to a cNil penalry oi not more than live hnndred tlW1ars ($500).):
� I, es owner ol the p�operry, or my employees with wages as iheir sole compensation, WILL DO TME WORK, and the siructure is not intended or oHered for sale (Sec.
7044, Business and Professions Code: The Coniractors License Law tloes no� apply to an owner of property who builtls or improves thereon, and who does such work
himselt or herselt or ihmugh his or her own employees, provitled that such improvemenis are not intended or ottered for sale. If, however, ihe builtling or improvement is
sold within one yea� of completion, ihe owner-Duiltler will have ihe burtlen of proving that he or she ditl not build or improve for purpose of sala.).
❑ I, as owner of Ihe p�oPery, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct tha project (Sec. 7044, Business and Professions
Code: The contraclors License Law tloes not apply to an owner of pmperty who builtls or impmves ihereon, antl w�o contracts for such project wilh a contractor(s)
license pursuent to the Comracbrs License Laws.).
� I am exempt under sec. Business and Professions Code tor ihis reason:
Signatura:
Owner ID veniietl by dnvers license.
❑ Ves ❑ No Drivers Licensa No.
VenficaUon oi Ownership by (type of tlocument, i.e. - property tax bill or deetl):
DIVISION OF INDUSTRINL SAFETY PERMIT CERTIFICATION:
Da�e:
Expires:
❑ I hereby certify ihai no excavation five (5) or more feet in depth into which e person is required to descend, will be mada in connection wilh work euthorized by �his
permit, and that no builtling structure, scattoltling, talsework, or demolition or tlisman�ling ihereot, will be more than thihy-six (36) teet high. (C�ap. 3.2, Grp 2, ArI 2, Sec.
341, Ttle 8, Calitornia Adminisirative Code).
❑ A5 owner�builder, I will not employ anyone to do work which would require e permit fmm the Division of Indusinal Safety, as noted above, unless such person has a
permi� to do such work irom the tlivision.
SignaWre: Date:
Division of Indusinal Safery Permit Number.
CERTIFlCATE OF COMPVANCE AND AUTHORIZATION OF ENTRV: I certify under penalty of perjury ihat I �ave read this application and state that �M1e information given is
correct. 1 agree to comply with all state laws and ciry ordinances rela�ing �o building constmction, and authorize representatives of the City of Costa Mesa to enter upon the
ebove-describ�d property �or inspeciion puryoses. I agree not to acupy or allow occupancy ot any building authorized by ihis permit until finel inspection.
CO�E �. INSPECTIONTYPE OATE
7616 Fizetl System Final Fire Prevention
1266
200
201
202
203
204
Pool Spa Final
Final Re-Roof
Final Blak/Retaining Wall
Final Factory Fi�e Place
Final Sign
Final Demolition
INTRIALS
�
CODEI LNSPECTIONTYPE
206 Final Mechanical
20B Final Plum6ing
210 Final Electncal
272 Final Fire Prevention
220 Final Planning Approval
222 Final Si�e
250 Final Building/OccuOancy
le`�
O1/al/07 15:15 FA$ 714 708 1919 CDFA/RIFA i COSTA MESA � 002
Ja�•3G• 2001 4�OdPM SV 'O�LS No•2458 P. I
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olisoi07 TOE 14:45 [lkixx rro sas21
�
, Applicant to fill in all soaces except tnose within heavy Doreer lines ana sign all apProOriate tleclaralions.
CITYOFCOSTA�MESA C NSTRUCTIONPERMIT
r l
Pr�o+ct,iddress �� � I A�iQ.�= �-L-' S�/ - .
Ap'n�icant's Maili Address
.
Owner'sName {`w G +lNE � Pho eS�L._�•
Address ; � � ( ��(} (L D L. l �
Arch/En9. License No.
Ad�ress
Contractor's Name Phone
Address Imailing) �
City License No. -
LICENSED CONTRACTOR DECLARATION
I hereby elfirm thal I am licensetl untle�, provi51on5 of Cha�ter 9(Commencing
with section ]000) of pivision 3 of the, Business antl Professions Cotle, antl
my license is in (uil force antl efiect. ,
License Class License No.
'.;=�'Ne � Si9n3turG
�s;"RKERS'COMPENSATION DECLARATION
�`-`r:reby atfirm that I have a certifica[e ot consent to self-insure or a certiflcate
�of Worke�s' Compensation InSurante, O� a_ce�tltietl copy tnereof (Section
3800, Lab. C.) '
Policy No. � Company
eCertifietl copy is hereby furnishetl. � ,
Certitietl copy is tileG with the city Builtling Division.
Date Applicant - .
EXEMPTION�FROM WORKERS' COMPENSATION DECLARATION
(This section neetl not be mmpletetl if the permit is for one huntlretl ($100) or
less).
I terlily tnat in the performance of tbe work for which this permi{ is issuetl, I
shall not employ any person in any manner so as to be me wbject to the
WO�ke�S' CO 1p20 IIQO LdWS O( Cd�l( f _
Date � Signature '
NOTICE: f, aiter makin9 this tleclara ion, you shoultl ecome sub' to the
Workers' Compensation provisions ot the Labor Cotle, you must [hwith
comply wi[h suc� p�ovisions or thi5 permit shall be tleemetl �evoketl.
CONSTPUCTION LENDING AGENCV
1 hereby a(Flrm that there is a construCtion lentlin9 a9ency for tne oerformance
of the wark tor whith thi5 p¢rTit is issuetl (Section 3097 Civ. CJ
Ixntler'z Name
Lentler'S Atltlre55
OWNER BUILDER DECLARATION
I hereby affirm ihat I am exempt from the Contractor's License Law for the
tollowing reason (Section 7031.5 Business antl Professional Code: Any city or
county whicM1 require5 a pe�mit to construct, alter, improve, tlemOlish o� �¢pair
'any structure, prior to its issuance, also requires the applicant tor such permit
file a sign¢tl statement thdt he/She is li[¢n5etl pu�5uant to tite p�ovisions ot
•. Contractor'S License Law (Chapter 9(commencing witn $ection ]000) o(
vision 3 of the Business antl Protessions Cotle) or that he/she is exempt
.nerefrom antl the basis tor the allegetl ez¢mption. Any violation of Section
703L5 by any applicant for a permit subjects the applicant to a civil
pe0dlty of nat more than tive huntl�¢tl tlolla�s ($500).
❑ I, az owner of the prope�ly ov my employe¢s with wa9e5 as tM1eir Sole
compensation, will tlo the work, antl the struCture I5 not int¢ntletl o� ott¢rEtl
for sale (Section 7044, Business antl Professional Cotle: The Contractor's
License ldw tloes not appty to an owner ot a property who builtls o� imp�oves
� thereon, antl wM10 tloes such work himself/herself or through his or her own
employees, provitletl that such improvem¢nts ate not intentletl o� offeretl tor
I Sale. H, M1owever, [he bulltlin9 or improvement is soltl wl[hln one yea� of com-
pletion, the owner will-have the burtlen of proving he/sne Eitl not builtl or im-
prove for the purpose ot 5ale). '
❑ I, as owner ot the property, am exclusivety contracting with licensetl con-
t�actors to const�uct the projett (Section 7044, Business antl PrOfes5ion5 COtle:
The Contractor's Li<ense Law tloes not appty [o an owner of property who
builtls or improves thereon. antl who contracts for Such oroiect5 with a con-
tractor(s) license pursuan[ to me ConLraCtor's Lic¢n5e Law). I aT aware thai
proot of their Worker's Compensa[ion insurance shoultl be provitletl to me.
❑ I am exempt untler Section B. & P. C. for this reason
Date Owner
I here0y certiry tliat I have reatl this application antl state that the above
intormation is correct. I agree to comg ty with all city antl munty ortlinances
antl state laws relatinq to Guiltling yerntruction, and hereby duthorize repre-
�'1 I Signature([��iL�1G���
Drivers' License or 55
0865-46, rev. /88 White - Bui
3�3�#543 ��
TVPE OFCONSTRUCTION NE
❑ CONVERSION. 0 DEMOLISH
DESCRIPTIOLV OF yJpFjK(USE OF
J ADD" LJ A�.TERATION LJ REPAIR
OTHER _1
TYPEOFPERMIT LJ GRA�ING LJ FOUNDATioN I�SrRUCrUR�. ' -
�❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION St;. F7!r�— • F . oCCUPANCv
CONSTRUCTIONTVPE �_ � VALUATION$ I�'�]Ci�J �
ZONE GRADINGCU.VOS. ACRES
Remarks:
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains �
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Lavatories
P—Trap
Roof Dreins
Reinspac[ion Fee � $15
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System � Multiple ❑
Firepl/FacL Blt. ICBO dk
Heating System & Ducting
❑0-100,000 BTU � 100,000 BTi
Rainspection Fee I $15
Applicanp Pink - Accounting; Goltlenrotl - Assessor
PLUMBING
Service Sink- �
Sewer Cap ,
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Wa[er Service
Auto-Wash
Laundry Trays
Issue Fee
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration Sys[em
❑0-t00,0008TU ❑100,0006T
System Repair/Alteration
F ire Da mpers
Registers
Issue Fee
a.P. # y — a
S Main Building:
E
T Front
ARear
C Right
K . Left
S
Ping. Ref. # - '
Planning Notes:
FEES Automatic Washer
Construction Pole Su
Cooking Unit
D ishwasher
Oryers ❑Gas ❑EI
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
� Generator �0-5 KW
Zone
Bui
Req./Provided
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑ovei100amps
KW
i,� I Feinspection Fee !'$15 �
DEVELOPMENT SERVICES REQUIR
$ 3 iZonin9 APProved By
�FEES�* �Buiidine APP�oved By
I AppllWtl011 ISSUBd BY
Sub Panel
Motors �0-7 HP 07 %- 8
Inc.Soiar 09��5 HP �16-15+
Microwave '
Pole Light '
Range
Sign
Standing Sections
Trash Compactor
Issue Fea
N
_ �
N
G
R
E
Q
M
T
S.
FEES
$ 3
SUMMARV OF FEES .�
BUILDING PEFMIT $ � SMIP $
PLAN CHECK $ �^�= PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGY P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ MICROFILM $ L�
MECHANICAL $ TOTAL FEE $ ✓�
PLAN CHECK 25% $
� cooasc3?-caoa9�s4 �r� � �s�e �
LniF; �il�dvj$$ II{9G� Z'��'SY - .
/�
�
,_�CONSTRUCTION AND PLANNWI F & SPA
APPROVALS� � Permit# Date Inspector qppROVALS Permit# Date Inspector
r� : TemporJry,Electrical Service or Pole �' 52. Pool & Equipment Location �_�
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement -"��
l j.
3: Electiical Conduit Utility-Undrgrnd. �- 54. Forms ;%�
4 Elect,ryical�CondNit�Undrgrnd. 55. Electrical Bonding -'y
5. Steel��Reinforcement 56. Rough Plumbing & Pressure Test �,�ji•
� ..
6JEleciricalUFERGmd. 57. APPROVALTOCOVER-GUNITE �"y'a�
7�FooU� gs S�/�L � 9� �'!; 58. Electrical Conduit-Undrgrnd. �4 �.,.L 1
8:^Founiiation -� 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. Sewe_�Cap ' � 63. Heater & Vent-Final , , N�
13. Roof.Drains '�" 64. Plumbing System - Final ��
14. Rough Plumbing � 65. Electrical-Final �
15. Rough Electrical-Conduit 66. Solar System-Final
,.�
1�6. Rough Electric Wiring � � 67. Fencing & Access Approval
�7'. Rough W�iring Sign . 68. APPROVED FOR PLASTERING
-18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
,,
�19. Rough�Heaiing & Air Conditioning FIRE DEPT. REQUIREMENT
�r-
20. flough,�actoryFireplace APPROVALS Permit# �
w
21. Ducts, in Structure � 70. Underground Hydro .
.22. Ducts, V,entilating ;�I � 71. Product Piping O Gas ❑ Oil �
�23. Gas Pipe{Rough &�Test 72. Underground Flush
}2,4rRoof Framing -� 73. Undergmd.StorageTank OGas ❑Oil.
=25! Roof Shesthing � - 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 PREV. FINAL
� 30. Drywall IVailing . HEALTH DEPT. REQUIREMENT
� 31. Plaster Bcown Coat •: 79. FINAL INSPECTION
� � _ ..' .
32. Electrical Power M�t�r-Final 80. FOOD CERTIFICATE ISSUED
�.
. 33. Final Electric Notes: 6`
34. Final Heating & Air Conditioning 30 � �d
d
35. Final Gas Pipe-Test
-�36. Hood or Canopy '
37. Final Factoiy Fireplace
r38. Final Plumbing �''� .
��39. Water Service-Final
40. Gas Service-Final � _ ,
r, '
�41. Solar pomestic-Final
i
"42. Backflow Preventei' ' ��•,;
43. Backflow Irrigation' � 3 , �^I
�
44. Landscape�lrrigation SYstem
,
45. Sound Attenuation '
46. Handicap Regulation's � �
47. FINALSTRUCTURE&BUILDING .� 8�-- '--'�-^
i
48. Special Requirements Completed
�
�49. Electric Release to Edison ��� ; , ,
.
"50. Gas Release to Southem Califomia Gas Co ,'' ��, � � (�
51. CERTIFICATE OF OCCUPANCY '. n� ,.� ''
; � I j�
No. Date � � •� -
� !i,'� �
'—+�'i�'
��������D
City of Costa Mesc Buildi�g Dept.
BY —�. ��C�.4 i �• � 1 �
_ �
ThIESE PLANS h4U5'i E'c ON JOu AT ALL TIMES MAKE
MO CHANGES `i.'ITHOUS PR!OR APPP,OVAL pF OEPT.
t� ��s
T4E�ISSI!At�CF G3 �RAN'IYG CP A PcRMIT OR APPRC`�AL Of
�LANS ANL' SPECiRCAT10N5 SHALI NOT BE CONSRUED TOBE A
PERMn FCZ, O2 F>: ,.PVRO`/AL ^vF, ANY V!OiATION OF ANY OF
THE FROVI$IaNS Oi �ih]5 CODE N0 7ERM.�T P?ESUfdING TO GIVE
:eUTkGkiT'! 7C ��.'ICt<::;; OR � ANCEL THE PRQYISIONS OF TNIS
CODE SMAiI BE vAiiD,'cFCEPi IN SC FAR AS TME WORK ON USE
WHICH IT AUTnORLES {� ti�.\i'FUI.
THE ISSUANCE CF r' �E%J.tiT BhSED UPON GlAFS AhD
SFEpFIUFfIONS SHAIi h+CiY ?kEbENT SHE BUItDING OFFlCIAL
FROM T!:En'cFfTER itEGUtRIPi: THi CCiRftECTIC�N Cr EftRORS IN
SAID F7AN5 HNU SPEQfIC�?tCin> V� FROid� PRE�ENiIN('i
GUIIDING UPEF.ATIGNS CEIrvG f,pg1eC ON THEREU�DE2 `.'/NF��
IN VIOLATION OF THIS CGDE OR Or o.;Jy p7tic; ^;i;15 rY H.
THE CITY.
{..v.�.,..—_ . ... . .
II[ND[NC[
11[{ID[MC[
I \ I ��� ���17Y�
_ � �re `�_STREET
' `� ,� --... _...
,n�. � �, ��� �'pp7y�'���
� r,� � � NN1NG p6MESA �"'4 �il
-... a�_T0 BLD6. DEPi.TgEQ
�p � � DAT '� ,� �
""���xa�+N�No
11[�IB[MCL
�
IIGID[MC[
,
TYPICA�, 6�� CONCRETE BLOCK FENCE `�
Cement Coping Ootional �
Channel8lock With 13/8�
Norizontaf Top of all
Fences
For Fenees 5' or Less
Vert. Bars 3/8" ¢ at 4' �0" O.C.
Fo� Fences Higher Than 5'
Vert. Bars 3/8"Q at 32" O.C. �
Fill Cells Soiid With Grout
Whe>e Steel Occurs
Reinforcing Steel Shall
Conlorm to $ec.A-15�39
A.S.T.M.
All Steel to be Lapped
24" or to Code
NA7URALGRADE
'TYJO 3/8"Q BAR$ ��
CONTINUOUSTOV �
& BOTTOM
HOQ7ZSTEEL MUST BE TIED IN
PLACG AT TIME OF TRENCM
�NSPECTION.
rc x
LL F
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r w
a =
a
> _
> -
a
i 'o
W O
U H
2
w M
LL
.
��- -
n 'p i�
�n --
A '
F+-WIDTH
p SEE CN!
� BELOW
D' I �,
ING REQUIREMENTS CHART
WALL HEIGHT 6'
WlDTH !4"
THICKNESS . _ . .10��
DEPTH OF EARTHTOOTM . 24"
SPACING OF EARTHTOOTH . 12'
City of Costa Mesa, California
Building Deparf�ent
, . . , _, n'_evn� �-1ov. ez
GENERAL- NOTES �
MORTAR; pne Part Plusfic Cement, and
T�ret Parts Sand
GROUT: One Part Cemenf Three and
One Half Ports S�and
COPING: One Part Cement, Three
Parts Sand
CONCRETE: Well Mixed 1:2-I/2:3-I/2
Mox. of 7- I/2 Galtons o?
Woter Per Sack of Cement
GROUT 1.1AV BE POURED FROM THE TOV
OF TME FENCE IN CELLS WHERE STEEL
OCCUHS.
CELLS AND AHEAS OF h10RIZON7AL REIN�
FORCEMENT SHALL BE CLEAR, CLEAN 8
FqEE OF ALL MORTAR OEBRIS, ETC.
N GF E4RTNTCOTH
i/? ThIE HEIGTH OF FENCE
F3ELOW BOTTOM OF FOGTING
sca�e: v2" = �'
14" . . . 12" . . . . 12��
. . . 10" 8 ". 8 .�
20" . . 16" . . . . I 2"
14' . , 16'. . . . 16'
. v
C�
. _, ,. �- �� ,�
TliLS AC3tEEhg3.T, mede and entered inta this
. �:
::
B + � day of
f��ousi' _ 1581 r�. bi' and beb►een (�i��i4.-� 5u��•1 V��NNEy
—o — �`
hereinaftez referred tv as •LAt� �+t�R•, and C c�� � c/ `r �'C9 (t/�
hereinafter referred to as •AATAC�STI' PR[.PF.+7.3 d7NER'.
It is hereby agreed that a party rall will be wnstructed on the
PropertY line betreen
8% � 17q¢Re � � St. Ces'i� W1�S4 C�} 5 2.62 �
�' %� qa2e ( � S�l- � si-c Wl�s c C!4 9' 2,62,7 .
in the City of Costa Mesa, Co�nty of Orarx�e, State of California, as per mnp
recorded in Book � , Page_ of Mliscellaneous Maps, in the oifice o� the
Co�ty Recorder af said Co�nty. Tl�e party wa:l shall be permitted to encroad,
IN WITN�SS W�REOF,. the parties have entered into this Aqreenent the
day and year fiist above written.
7Ai1D iritv�R
(SignaLae)
l�, ll i�a,-.-. �"o h W t�iniucY
Nazne (Ryped or Print )
8�1 IJ Ql2RGL� sr. cnS�-s mes� �A
(Ad�ess ) 9 Z 6z �
�iSj�ra. ��,��• :�► •.r.ta:
�ir �, G /, �� : ,�b'
(S �gna t�se )
C d O' � G� o�t`' L'U l/I/I
tJ�ne ( or Prin )
V�7 `J�a�1�'��� � f'
(A�iE55 )
1 � �� '�' �' �I,9
Cify of Co esa Building Dept,
BY......_......._.._...._..'. ' '..' ..__.___..._....DATE..�(..�'� 199,<
THESE PLANS MUST BE OPJ JOB AT� ALL TIMES
MAKE NO CHANGES WITHOUT PRIOR APPROVAL
OF DEPT.
THE ISSURNCE OR GRANTING OF A PERMIT OR .4PPROVqL
OF PLA�'S AfJU SPEf,fFICATIONS SHALL NOT BE CONSiRUED
TD BE A PERMIT FOR, OR PN APPROVAL OF, ANY VIOIhT10N
OF ANY Of THE PROViSIONS OF THIS CODE. NO PERMIT PRE
SUMING TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE
PROVISIONS OF THIS CODF SHALL BE VALID. EXCEPT IN SO
FAF AS 7HE WORK OR USE VJHICH 17 Al1THORIZES IS IAWFUI,
THE ISSUFNCE OF A PERMI7.BASED UPON PLANS AND
iVECIFlCATIOMS SNALL N0T PR[VENT THE BUILDING OFFICIPL
FRnM iHEREAFiER REQUtRIMG 7HE CORRECiIOW OF ERRORS
+IN SFlID PLSNS AYD SPECIFlCATIONS OR FROM PREVENTING
6lll! DIP1G OPERATIOYS BEING CARffIED ON THEREUNDER WHEN
� IN \'I^13Ti0� OP THIS COOE OR OF ANY OTHER ORDINANCE
j �S THE CIN.
�
RESIDEN�E
�
W
W
T
�-
y
60
fiE51DENCE
87�
STRUCTURAL APPROVAL ONLY
SEPARATE PERMITS ARE REQUIRED
FOR ELECTRICAL, ?L'J".9�1i,' :, I
HENTlNG, VENf1LFt11NG AivD �
REFRIGERATION WORH
� � /—���+_`+
� THIS NUMBER P��!ST ACCOMPANy !
� ALL INSPECTION REQUESTS �
!� FOR BUiLGifdGS WH'tn; pExgp�S ARE T0�
EE EPAPIDYED, WE Si1tuE5T THq7 THE
SiAiE OF CALIFp,q�y�q DiVISION 0F �
INDUSTRIqL SAFF7Y 8€ 6BfvyY�,�� �
AUD17101YAL REQUIR�M�ryj',�
R[SIUENGE
FESIDENCE
1�" ' "� TA M �
PLANNfNG DEP7.
S�BJECT i0 BLpC DBL AHi -
� GF pWOlpfg
d,
�
W
W
2
�
�
� � I � � � • a,
. ��
— ���� srReer �
i��—l35 �
TYPICAL
Ceinent Coping Optional —�
Chonnel Black'�With 1-3/8 —
0 Hoiizontal' Top of oll
Fences �� ,.
6" Concrete "Biock Fence
For Fences 5� or`'Less —�'
Vert. Bars 3/8" 0 at 4'-0�0.
For Fences. Hig her Than 5� =
Vert.. Bars 3/8�_0 a) �32'_O.C.
Prpvide Inspection and
Ciganout Hole at Location
of Vert. Reinforcement
FII Cells Solid With Grout---
Where Steel Occurs
NATURAL GRADE
��;�,:r:l A�
'�y��>;� i _
���i/�'C_ `� ��
TWO 3/8�� Q BARS �
CONTINUOUS I
-+-1
STEEI MUST BE TIED IN
PLACE AT TIME OF TRENCH
INSPECTION.
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0
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6" ,CONCRETE BLOCK FENCE
. ,.� ,
. —� �---,
0
p o.
o ' .o.�-pN .n. . . .. . n
� . e
. AE�� . � . o . . . �.c . . .
� F�—WIDTH TO 16� O. C. A
SEE CHART �
�
v Bf LOW ,
�D�'` �e�`�i�
e' 3
10'� �0�� �
s � . e � . �
a
� e
D:
e .
0 _ �
L
�
2 �.
CENERAL- NOTES
MORTAR : One Part Plastic Cement, and
Three Paris Sand
GROUT : One Port Cement 7hree and
One Half Parts S�and
COPING: One Part Cement, Three
Parts Sand
CONCRETE: We11 Mixed 1:2-I/2:3-I/2
Max. of 7- I/2 Gallons of
Water Per Sack of Cement
REIfJfORCING STEEL SHALI. CONFORM T-0
SEC. A-i5-39 A.S.T. M.
ALL STEEL T� '�AP WHERE SPLICED, 2-0�
MINI�AUM.
GHOUT M4Y BE F'OURFD FROM T�OP OF -
FENCE IN CELLS WHERE STEEL OCCtIRS.
HOLES SHALL BE CLEAR,CLEAN, AN�
FREE OF ALL MORTAR, DEBRIS, ETC.,WITH
INSPECTION HOLES AT BOTTOM.
BONGS SHALL B[ FROVIOED BY LAYING
BLOCKS IN STRETCHER COURSES SO
THAT VERTICAL JOINTS ALTERN4TE IN
EACN COURSE.
DEPTH OF EARTHTOOTH
i/3 THE HEIGTH OF FENCE
BEI.OW BOTTOM OF FOOTING.
SCALE: I/2"= I'
/ CHART
HEIGHT. 6�. . . 5�. . . . . . . . . . . . 4� . . . . . . . . . . . 3�
WIDTH . . . . . . . . . . . . . . .14° . . . . . . . . . . .14': . . . . . . . . . . . 12°. . . . . . . . . . . 12„
THICKNESS . . . . . . . . . 10��. . 10�� . . . . . . . . . . . 8��. . . . . . . . . . . 8„
DEPTH OF EARTHTOOTH . . . 24'� . 20° . . . . . . . . . . . 16". . . . . . . . . . . 12°
SPACING OF' EARTHTOOTH. 12� I4� . . . . . . . . . . . 16'. . . . . . . . . . . 16�
City of Costa Mesa, California
Building Department
FOqrw DU2�-dM_0-e].
OWNERS NANE: _ _ _ — — _ _ _ .� _ _ _ _ _
JOB ADORESS: — _ _ — — _ _ _ _ _ _ _ _ _
PERMIT NUMBER:— ._ — _ _ — — — � _ _ _ _ _
SIGNATURE: _ _ _ _ _ _ _ _ ` _ _ _ _ _
CITY OF COSTA MESA, CALIFOR.
NOTARIZED S7ATEMENT OF RESPONSIBILITY
T0: WHOM IT MAY CONCERN I Building Permit No
This Permit No.
�7� �f��''�T�� � ,
Street A dress AP Number
�•r
I, (�7Z�'X�Q,cc. J. ��[c.�c��y� , as Owner in Title of the above refer-
enc� property, do hereby requ t permits to be issued as Owner-Builder.
Should any person become an employee engaged in the improvement of the
property, I shall irtmediately provide Workers Compensation Insurance coverage
and cause a certificate of that coverage to be filed with the Building Division
of the City of Costa Mesa, as required by State of California laws.
As owner/builder in fact, I understand and accept that my responsibilities do
not transfer to any other person, company, or corporation.
I agree to indemnify and hold the City of Costa Mesa and its employees or
officers harmless from any claim resulting in damaae or personal injury to
myself or any other parties.
GuiL[./�4M J. �i,u,e�e
Printed Name
. �
Signy� ure �
Notary's Statement:
A�,e�L �S. /Y�o
Date
ili��! `! rv>
�OWNER MACE, R. $,
JOB ADDRESS H'71, D&
GENERAL CONTRACTOR
�e� ivo. 115-573�_ 03 7
iNSPF.CTT(1NR
5—$-64
Inc. vALUE $ 5, W0.00
FIRE ZONE DESCAIPTION OF WORK g
'E I GROUP 2 TYPE V ZONE
SUBCONT6ACTOR
�. 22102
} -OSTA ME�A BUlCbING-SAFETY DEPARTMEM
P.O. BOX 9/7 �. G09TA M6BA. CALIPORNIA
For Applicanf to Fill In Complefely
TYPE OR PRINT
BUILDIN6. �/ a�re L L ' 7-
AD�RESS
COSTA MESA, CALIFORNIA
OWNER d C/ �
MAIL C�I ' �y Y Y� L` ST
ADDRESS O
� � �y8
FEE RECEIVED
MAY 7 1984
FINANCE DEPT.
,��YicQ�ru���R�nir
BUILDINCi
For Office Use Only
' q6CBIP� NO. �
� ec er owrs xecerv o qA
�"l� 5 r ,� ��tL . 5 _
�G+� 'C S � NO. y ZONB '' �
CITY �
APPROVE
ARCHITECT ' �" TEL. ��� BY .DATI
OR ENGINEER N . ..
ZONING .
ADDRESB" � �
� ` NO. OR �U6E OF NI
' /}� � , PLANH �1 - I lYILDINO
/�
CONTRACTOR l
(� // LEOAL � '
ADDRH88 U 71 _ E G� � T� v� DeecR��i�oN �
l. �i �
f
USE OF j
EXISTING BLD6. 'e /
BETBA<K L�NE FROM ' ��--y� �
C
� d , A. P: NO. � � '- V
/7 NOTE: NO EAVE OVERFIANG SHALL BE LE88 THAN
� ^�/ -D GL� 90"TOSIDEBREARP.L. ' '
EAVES
�o.oceLOOe: ALLOWED � <U.6.C.REQUIREMENT
NOW ON IAT
. - ' YARDSAPPROVED YARDSAPPROVED
- MAIN BUILDINR AGGESSORY 6UILDIN6
� (FROM WLSTREET> '
DESCRIPTION OF WORK
NEW ALTERATION ADDITI
REPAIR MOVIN6 DEMOL
BUILOING � NO.OP
SIZE ' ROOM9 6T1
EXTERIOR WAL ROOF `I
COVERIN6 COVERIN6
USE OF BUILDING AND WORKTO BE PERFORMi
1 HEREBY ACKNOWLED06 TXAT 1 HAVB R86U THIH FPPLICpT10N
AND BTATE THAT TX8 ABOVE IB COHNECT ANO A6HEE TO COM.
PLY WITH �LL QTY ORO�NANC68 ANp 6iAT8 We REOULATINO
BIIILUINaCON9THUGTIOJi.� /��j ��
/
SIGNATUREOP'f�y^ ����/
PERMITTET�/r/ /� b� ��
AUTHORIZED A6EN
0
VAR. #
C. U. P. #
APPROVED
BET. MAIN d
ACCESS. BLI
DATE
� a� so. �r.�,�,__.
TXE AMOUNT 6HOWN UNDEP
PURPOBE OP E9TABL19HIN�
pOq THH
: ONLT.
�
�
i ��o
OW NER BRTSTOL ESTATES - onre 9-5-56 '-
JOBADDRESS 871 Darrell Street BUILDINGPERMITNO. #3�1
GENERALCONTRACTOR $. 0, Hunsaker VALUE $ �j�i�S(�.QQ
LOT 5% BLOCK TRACT 287,3 Single Res. W�8tt. �ST'.
GROUP I& J TVPE V ZONE �fy FIRE DISTRICT 3635
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
DATE I NUMBER�
Footing Trench
Foundation Forms and Grade to
Plumbing,RoughtoSlah —i�)ry.fF,.v.,�< I �JplS'G I�01'�ee-�urvn(1oiT�n�.G. I%-��-SI_ I ( i'a0 "'
Plumbino. Rouah Complete /77 G S /0 /�
�, Final
House
Lathing, In Out kj� � �
Plastering
Plumbing, Fin�al, Fixtures CompleteJ'j?� � _�
Plumbing, Fin,al Gas Test .$' �J� ,2�
Wiring, Final �
Occupancy � � `� ��.
FOFM 210 3M 10�95
R
-y-S6 I /O/s —
� 4'�. C�L 7 n 9.(�. �
�osta Mesa Bniiding Department ����PLICATION FOR PERMIT
�,.. P.O.Box3�� • � BUILDING '
r CO$Tq, MESA, CALIFORNIA
• FOR OFFICE USE ONLY
FOR APPLICANT'd`O FII.L IN Receipt No. Permit No.
Bulldin9 � � � A L.�. �� �/
Address
Costa Mesa, California Recei 6y Date Rec'd. Date Issued
�,e__e�. ,-. � ,��' I�� � .c-r__ I .�� r-s�
Owner
Architector ✓
Engineer —
ContracMr
Metes and
l_,As /Gi,
/J��•� Tel.
Lic.
No. of Bldga
�' /GO Now on Lot D
No.of No.o}
—"' Familiea Rooma
_ i Rear Yard .IS '
Addition
Costa Mesa, California
Nearest
Cross St.
Zone " :% I No. of I Type � i _
CORRECTIONS
Building /� j� � No. of /
Size Rooms S. Stories
EMerior Wall Roof �p 1 )
Covering �«� Covering GC A(+.iC" �]pPR.�V�
Use of New � .
Building s '� �C� �,[ ,Q l[� Foundation Location Inspector
Forms, Materials,
� — �' �.� Under-Pinning
� �.� " Frame: Fire Stops,
�' Bracing, Bolts
I hereby acknowledge that I have read Uils Applicatlon
and state that the abwe is correM and agree to comply Lath. Int. -
with all City Ordinances and State Laws regulating
building construction. Lath. Ext
Signatureof � . _�-..ZZ p �
Permittee ��Ff�L Plaster, Int
��
Authorized Agt..� Plaster, Ext
Valuatlon Pe�mk Fee $�,� �— Masonry Reiniarced
/ Plan Check�$ � Bond Beam
$ � Y�56 � 7ota� ��,� .�
Fee $ `J FINAL
qm aoa �o�ss o. v. e s. _
�_
Date
=Fi�F
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2
D
r
OWNER �TTTAM 7_ Prn7NFv DATE 4-15-80
JOB ADDRESS g71 Darrell Street BUILDING PERMIT N0. 49960
GENERAL CONTRACTOR -�n......,-in..; i.v...- DESCRIPTION of WORK ni...aJ..,�i i
AP No.
GAS
WRT
PROP. SWR. LINE �_� NOUSE WN. L
SPRINKIING SVSTEM
MISCEILANE0l15
FOUGH HEr1TING PN� �Ifl CONOITION
TEMPO(iSRY SERVICE OF"POLE
UNDERGROUND � POWER �
ROUGH WIRING
TRENCHES FORMS STEEL
FLOOR SYSTEM
BONO BEFM STEEL REINFORC
SHEATHING O/�%Zd�yy. T
FRAME ANO FLRSMING
LATHING - IN � OUT n
PLASTER,BROWN COAT
PLUMBING. FIN4L
FIRE
SUBCONTRACTOR
F�+
FG
WM
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3
CGSTA'N{ESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applican[ to Fill in Completely — Use Ink O�nly
BUILDING ��/ `� ,
ADOflESS /� �^/� V
T� NANT�R /TLCf��_ V . / ififrft�Da
CITV
BRANCH
ADDRESS
TEL.
ADDRESS
CONTRACTOR �(/'LL.�_
ADDRESS
TEL.
qTV NO.
STATE CITV
LIC. NO. LIC. NO.
SI2E ^� NO.OF BLDGS.
OF LOT I� �pV NOW ON LOT
USE OF
EXISTING BLDG.
Separate permits are required for
electric, plumbing and heating work.
USE OF BUILDING AND WORK TO BE PERFORMED
I hereby acknowlatlge that I have �ead this application antl state
that the abova information is correct entl agree to comply with
all laws reBulating building <onstruction, and I shall not employ
any person in violation of the workman's compensation laws ot
the State of California.
1 hereby cert(fy thai I am properly licansetl as a contractor under
the State of Calitornia Business antl Protassions Code, Division 3,
Chapter 9, antl that such licenses ara in tull force and effect, or I
am ezempt trom the provisions of tha State of California Business
antl Protessions Cotle, Division 3, Chaptar 9.
Signeiure of
Permittee
or al
Authorized Agent Date T
�
APPLICATION FOR STRUC`PUItA� PERMIT I 0.50 TL
I
RECEI V PERMIT %'�T 49960
1'
A.P. NO.
BUILDING ��/
ADDRESS (
UNIT OR
SPACE NO.
OWNER
�
APPROVED
PLANNIItlG ACTION
:PAIR MOVING DEMOLISH
1
� 4
1
VALUE /D
� $ ��
r-
� GROUP
DATE � �S �O
�
�
i
m
m
SQ. FT. �
7
THE AMOUNTSHOWN UNDEfi VALUATION IS FOR ¢t
THE PURP�E OF ESTABLISHING A PERMIT FEE ONIV: �
VALUATION PERMIT FEE $ q
n
PLAN CHECK § ^�
g�D � o
$ TAX $ LL
a �
TOTALPAID $ �/'� rw