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HomeMy WebLinkAbout1125 DANIELLE DR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 1125 DANIELLE DR Suite No Vicinity: Parcel Nunmber: 41207439 Applicant: NOCK, CANDY, Address: 11612 KNOTT ST SUITE217 GARDEN GROVE, CA Owner: UPDIKE, MARK AND JUDITH Address 1125 DANIELLE DR Contractor: Address: Arch / Eng : Address: ISSUE FEE " Backflow irrigation Backflow Preventer Bathtub Clarifier System Connect (Ice,Soda etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve COSTA MESA, CA NOCK PLUMBING 11612 KNOTT ST. , SUITE 217 GARDEN GROVE, CA Phone: (714)895-,1246% Zip: 92841 Phone: 714-697-2028 Zip: 92626-1601 Phone: (714)895-1246 Zip: 92841 License: 707775 Phone: Zip:..- __ -_.__License.: _ -- SCOPE OF PERMIT CHANGE OUT WATER HEATER Status: ISSUED Applied: 11/04/2004 Issued: 11/04/2004 ISSUED BY: 26 Sly! I ob OATS '-lJ..�t ew'e�.1-�'✓' I,r.= 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 for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754.5626 Zaao-aa (&W) FEE SUMMARY AMT QTY ,-'''' -;AMT , ,QTY AMT QTY $23:50 ; Laundry Tub / Washer $0.00 `•; 0 Sump Pump $0.00 0 $0.00: r 0 += Landscape Irrigation-. $0.00 -10s : _ . -; Swimming Pool. $0.00 0 $0.00 _`'o '. P -Trap '$0.00 0 Trap Primer 1$0.00 0 $0.00 "0 -. Pressure Regulator - - $0.00 0 -Urinal - - r $0.00 0 -$0.00 - 0 . Process Piping (per 10 ft) $0.00 0 _ Vacuum Brkr Bkflow(1=4) $0.00 0 $0.00` 0 -Receptors" $0.00 0:- '. Vacuum Brkr Bkflow(5+) $0.00 0 $0.00 0 -Septic Tank' - $0.00 0- Wash Basin $0.00 0 $0.00 10, Sewer Cap for Demo " $0.00 0 Wash Basin Set $0.00 0 '$0.00 0 Sewer Connect $0.00 "0 Waste and Vent System $0.00 0 $0:00 0 Sewer Private Line " $0.00 0- Water.Closet (Toilet) $0.00 0 $0.00\0 Shower $0.00 0 - Water Heater / vent $12.30 1 $0.00 "0-.` - Sink, bar . $0:00 0 - - Water Piping (Inst or Rep.) $0.00 0 $0.00 0 -Sink, commercial $0.00 ,0 Water Re -pipe $0.00 0 $0.00 0 Sink, Floor $0.00 0 - Water Service $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 suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754.5626 Zaao-aa (&W) DECLARATiONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the _ _work for which this permit is issued. 1 Have and will maintalq workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permi Is issued. `My. Y n Insur nc ier dotic number are: _ l l(lo- iii annex lP Policy Number: (pissed said not be completed i/ e p R rs va u d of one hundred dollars ($100) or less.) _ - — ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree tha 'f should become subject to the workers' compensation provisions of Section 3700 of th Labor Code, I shall forthwith comply witht�apbrts-- 7. =meq y/ rAppllcan St Igna ru( e: - --�/-" �// Date: _ ' I WARNIN(%;FAILURETO S CUE RE WORKERS' COMPENSA COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37W OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm.that,l amlicense r of Chapter 9 (commencing with Section 7000) of Division 3 of the Busines nd Pj�fessions Code, and my license is in full Jorce and,effecL Lit. #=� Class # � 1 Cori racto s Signature:' T - f Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Coda: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property,�am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractorsilLicensa Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License ❑ % Laws.). ,1 I am exempt under sec. � Business and Professions Code for this reason: Signature: '' -+- - Date: Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, ialsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, All 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building Occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ......................................................................................................................................................................................................................................- ............................................................... -.............. ................ ............. ........................................ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ................................................................................................................................................................................................................................................................................................................................................... 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. .................................................................................................................................. ........................................................................................................................................................-.................................................. ............ .................................. 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ............................................................................................................................................................................................................................................................................................................................................................................................ 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication aZermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Ii Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ....................................-.................................................................................................................................................................................................................................................. ....................................................... 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (It "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ......................................................................................................................................................................................................................................_............................................................................. 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No .................................. tta-.....................l'is..........................................................................................llut................trol................................................................................................................................................................................................... e (If'yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. re Of al Owner(s) And/ Of Au1h1J7,.J'Applicant _ 4 te_ CODE INSPECTION TYPE DATE INTRIALS CODE N INSPECTION TYPE 'DATE INTRIRLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Root 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy Applicant to fill in all spaces within heavy border lines and CITY OF COSTA MESA PERMIT NO. TRACT NO. CONSTRUCTION PERMIT E Address 7 _ e✓y Q ArchlEng. - License No. Address LICENSED CONTRACTOR DECL4tRATION I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business antl- Professions Code, an my license is In full force and eff ct.. License C ass icgnse No. Date= .P;) Siy t i il-LC_0/I WORKERS• COMPPNSATION DECLARATION I hereby affirm that I have a Certificate of Consent to sell -Insure or a certificate of Workers' Compensation Ins ante, or a ce tifietl Copy thereof (Section H 0, Lab. C.). Policy No. Company CLIcertified COPY is hereby furnished. Certified copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section- need hot be completed if the permit is for one hundred ($100) or less. I Certify that n the performance of the work for which this permit is Issued, 1 shall not employ any person In any manner so as to become subject (os a We kers' Compensation Lasv3 of llfornla. - Date / '2 Signature X R &oo NOTICE: f aft r making this declaration, you should become subject to the Workers' COmpensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTIONLENDINGAGENCY I hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit Is Issued (Section 3097 Civ. C.). Lender's. Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to Construct, alter, Improve, demolish Or repair any structure, prior to its issuance, also re- quires the applicant plicfor such permit to file a Signed statement that he is to the provisions of the Contractor's License Law (Chapter 9 -(Commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit Subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, Will do the work, and the Structure is not intended or offered for sale. (Section 7044, Business and Profession$ Code; The Contractor's Licens@ Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not. intended or offered for sale. If, however, the building or improvement is sold within one Year ofcompletion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). ❑ I, as owner of the properly, am exclusivelycontractingwith licensed contractors to construct the project (Section 7044, Business andProfessionsCode: The Contractor's License Law tloes not apply to an owner Of Pro Perty who builds or improves thereon, and who con- tracts twin such projects with a contractor(s) IiCesnetl pursuant t0 the Contractor's License Law). ❑ I am exempt under Section_* B. & P. C. for this Date Owner ' I hereby certify that 1 have read this application and sta4 Information is correct, 1 agree to comply with all C ordinances and state laws relating to construction, and h representatives of this city to enter upon the ,abs P roperty for iAeCflo-pt({-gpses. -_ Signature K &_ / / LQQ/1 Date all appropriate d LOT NO: BI TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR. ❑ CONVERSION El DEMOLISH El OTHER DESCRIPTION OF WORK TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL 0 TENANT ELECTRICAL ❑PLUMBING ❑MECHAI ❑ OTHER PROJECT DESCRIPTION - SO. FT. OCCUPANCY_ CONSTRUCTION TYPE VALUATION ZONE GRADING CU. YDS. ACRES REMARKS: 2°79 IPI,IJ/12 4e0, TL Cancel A.P. $ ZONE REAR YARD (TO P/L) PKG. SPACE REO. STREET WIDTH ZONING APPROVED RY SPECIAL CONDITIONS: FILING. REF. � GR(PEIRTDYNLINI PROVIDED PARK FEE PLUMBING PLAN CHECK - ELECTRICAL PLAN CHECK - BATHTUBS SHOWERSSO FT qQ_FT_ TOILETSURINALS GENERATOR' 0.1 KW__1-10 KW • TRANSFORMER LAVATORIES _ DOUBLE LAVS APPLIANCE 10-50 KW_50+KW KIT. SINKS .DISHWASHERS - MOTORS 04 HP -1-10 HP SERVICE SINKS " SUMPS- - (INC. SOLAR) - 10-50 HP 50+HP FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES DRINKING FOUNTAINS GAS TUBE SIGNS - INTERCEPTORS CLARIFIERS POLE LIGHTS - SWIMMING POOL PTRAP Lu... RTTC7TC"W POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB GAS SERVICE OUTLETS SERVICE AMP ' WATER HEATERS BTU OUTPUT Qom• SEWER CONNECTIONS - - - SOLAR TANK COLLECTORS SOLAR PIPING SYS. ISSUE FEE - G� ISSUE FEE APPLICATION APPROVED BY - - OATE ' MECHANICAL PLAN CHECK SUMMARY OF FEES . .. - BUILDING ' HEATING SYSTEM 0-100,000 BTU PERMIT Is SMIP $ AND DUCTING _ _ 100,000 + BTU' PLAN CHECK $ PERMIT - - ISSUANCE $ REFRIGERATION - 0 -100,000 -BTU PLUMBING $ ' P I y(-�, D GRADING $ SYSTEM 100,000+BTU PLAN CHECK $r- ;� $ BOILERS BTU ELECTRICAL $ v` I fe MICROFILM $ SYSTEM REPAIR, ALTERATION rCH PLAN CHECK $ L FEE $ EXHAUST SYSTEM S MULTIPLE MECHANICAL—$1 - - LESS AD-' _ PLAN CHECK- $ VANCE PC $ ,�•-n �'y v ISSUE FEF ' -' - FINAL FEE $ - Drivers' License or 5S� - CMF 0865-46 White -Building; Canary -Applicant; Pink-ACCounting; Goldenrod -Assessor APPROVALS 1. _ Permit Temporary Electrical Service or Pole POOL & SPA •� spector APPROVALS Permit # _ Date .Inspector - 43. Pool & Equipment Location--- - - 2. SoilPipe-Undrgrn 1 44. Steel Reinforcement - - -- - 3.. Electrical Conduit Utility-Undrgrn 45. Forms 4.- Electrical Conduit-Undrgrn 46. Electrical Bonding - 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn_ 48. APPROVAL TO COVER-GUNITE - 7. Footings 49. Electrical Conduit-Undr rn - B.- Foundation _' -- - 50. Gas Pipe, ❑Undr rn, Test 9. Water Pipe-Undrgrn - 51. Backwash Lines P-Trap.Cl• ndr rn ' 10. Structural Floor System 52. APPROVAL TO DECK - 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final . 12. .Street Sewer. Connection - 54. Heater & Vent -Final - 13. Rough Plumbing - - •-• -- •• -- 14. Rough Electric -Conduit - - -56.--Electrical-Final 15. Rough Electric -Wiring •-- - ` - - " - - - 57. Solar System -Final - - 16. Rough Heating & Air Conditioning Fencing & Access Approval - 17. - Ducts in Structure - 59. APPROVED FOR PLASTERING 18. 19. 20. - Ducts, Ventilating Gas Pipe -Rough &Test Roof Framing 60. - POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing - - _ _ NOTES: _ 23. - Insulation _ �„ - 24. Lathing & Siding 25. Drywall Nailing 26.-- Plaster Brown Coat - - 27. _Electrical Power Meter -Final 28. Final Electric - 29.-' Final Heating&.Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing - - - 32. - Water Service -Final 33:. -Gas Service -Final - 34. Solar Domestic -Final 35. Landscape Sprinkling System - 36: - Sound Attenuation 37. Handicap Regulations - �- - 38. FINAL STRUCTURE&BUILDING - - 39. Special Requirements Completed - - 40. Electric Release to Edison - - - 41. Gas Release to Southern California Gas Co. -- - - 42. CERTIFICATE OF OCCUPANCY No 4 Date - - - - CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT NO. !� �/ (p DATE /V - LOT NO. L� 1/�///)1� �//� ADDRESS I �S� dil, L /L!/l 1 The developer of the above entitled tract desires to sell the above set forth"1 lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. /I V The undersigned, by executing this agreement, acknowledges that (he -she -they) (was or were) //U GLo— advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the city at the time the final tract map was approved. The city assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the city harmless from any claim s resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. RECEIVED MY OF CcsT, vPsA jU! -181979 pM PM 7181911UIli 112111210I JI516 representative' CITY OF COSTA MESA _ BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT PERMIT B98-01434 (714) 754-5273 Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 1125 DANIELLEDR Status: ISSUED Suite: Applied: 08/12/1998 Vicinity: Issued: 08/12/1998 Parcel Nunmber: 41207439 Zoning: R1 R1 Applicant: FRANK MIRANDA Address: Phone: Zip: Owner: BUTLER, DENNIS G Address BUTLER; JUDI A - - COSTA MESA,CA - _ Phone: - - - 1125 DANIELLE DR Zip: 92626 Contractor: ISLAND PACIFIC ROOFING Address: 17762 CAMERON ST ' Phone: H.B. CA Zip: 92647 ' L License: 631472 Arch / Eng : . . , - . / Address: "Phone: _ Zip: License: SCOPE OF PERMIT T/OFF SHEATH & REROOF 2600SF RESIDENCE WILT WT TI FEE SUMMARY Plan Check: $0.00 _ Calc Valuation: $8,000.00 Permit: $137.25 Claim Valuation: $6,000.00 SMIP Res: $0.80 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $138.05 SETBACKS ACCESSORY PARKING NOTES: Front 0-0 Front 0-0 Existing: 0 Rear 0-0 Rear 0-0 Required: 0 PLANNING & ZONING Left 0-0 Left 0-0 Proposed: 0 Right 0-0 Right 0-0 EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 v i I- % Adill WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure forworkers' compensation, as provided for by section 3700 of the Labor Code, for the performance o1 the work for which this permit is Issued. ❑ 1 have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issu . My cooIII///kkkooerrr///scoyyym�pe�ns/aIlan dI rance tamer and policy number are: / Cartier. /r/// ` Policy Number: (This section nosio not be completed it the permit Is valued at one hundred dollars ($10.0) or less.) ❑ 1 certity that In the performance of the work for which this permit is Issued, I shall not employ any person in any manner so es oma subject to the workers' compensation laws of Califomle, andragree that if I should become subject to the workers' compensation provisions of Section 370 of the bar Code, I shall f rthwlth comply with Ih 'rov' o7 / , / yP)) Applicant Signature: A /Q�(''r�6/ BVI^ (/ L Date: r WARNING: FAILURE TO SEWRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO Cli PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($110,000), IN ADDITON TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST. AND ATTORNEYS FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under pr ter 9 (commencing with Section 7000) of Division 3 of the Business and �ta 'O s Code, and my license Is In lul force and effect. Lic. a l/ Class It Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more then five hundred dollars ($500).): ❑ 1, as owner of the property, or my employees with wages as their sale compensation, WILL DO THE WORK, and the structure is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or Improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or Improvement Is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivet's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth Into which a person Is required to descend, will be made In connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title S. California Administrative Code). - ❑ As owner-bullder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and conity a Business Plan for emergency response to release or threatened release of a hazardous materiel? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ................................................................................................................................................................................................................................................................................... 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 5DO pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ................................................................................................................................................................................................................................................................................... 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)7 ❑ Yes ❑ No (Section 25534 of the Celifomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. .................................................................................................................................................................................................................................................................................... 4 If en RMPP Is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? Elyse ❑ No .................................................................................................................................................................................................................................................................................... 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district Or agency? Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). .................................................................................................................................................................................................................................................................................... 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). .................................................................................................................................................................................................................................................................................... 7 It a errrit from the South Coast Air Quality Management District or other air pollution control district or agency is re wired for the work which is the subject o1 this epplPcation, nave all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑ No .................................................................................................................................................................................................................................................................................... 8 (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. 1 agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described pror-inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. opert SI \ure Of Legal Owner(s) / Date And/Or Authorized Applicant CCC Date CODE t. leg matt= JIM RiIIIIdlS CODE INSPECTION TYPE 2AM g♦IITIAI,$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-R00f q L -Rr 210 Final Electrical 201 Final Bldck/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 244648 PROJECT ADDRESS: 1125 DANIELLE DR UNIT: OWNER'S NAME: DENNIS BUTLER - ADDRESS: SAME - ARCN/ENGINEEB: REG.NO.: ADDRESS: - - UNIT: PERMITTEE: DENNIS BUTLER. (714)979-5746 ADDRESS: 1125 DANIELLE DR C.M. CA 92626 LICENSED CONTRACTOR DECLARATION: I hereby affirm that) am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and. Professions Code, and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified Copy thereof (Section 3900, Lab. C). POLICY NO.: EXP. DATE: COMPANY: , ❑ Certified copy'is hereby furnished. ❑ Certified copy is filed with the city Building Division. `ate: Applicant: :XEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of the work for hich this permit is issued. I shall not employ any person in manner so as to become subject to the W trials' Compensation Laws Calrfomia. Date: Slpnature�� - – - NOTICE: f, ldi6r roiling this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I. hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: - ADDRESS: OWNER BUILDER DECLARATION: 1 hereby affirm that I am exempt from the Contractors' State License Law for the followinA reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption: Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (55.00).. I, as owner of the property or. my emplevees with wages as their sale compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors State License Law cars not apply to an owner of a property who builds or improves thereon, and who does such work himseff/herself or through his or her own employees, provided Thal such improvements are not intended or offered for sale. It, however the building or Improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). ' I, as owner of the propefry, am exclusive)9 contracting with licensed contractors to construct the project (Section 71344, Business and Prole55ions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. A P. C. /J for this reason: r�'A�s?`��// Date: Owne�� I do hereby cenity t at I'S aware of and understand the requirements o/ California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant willAvill not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby candy that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state lam relating to building construction and hereby authorize representatives of this city to ante u the above mentioned property for mspe tion pu ses. (/ Date: ` Signan r v I Driver's Lic se or S ial Security 164146 Whit.—Building; Groan—Cc Oe Enforcement; Canary—ApplicanC Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA — BUILDING,PERMIT PERM NO: B 045594 PERMIT NO: B 045594 PLAN CHECK NO:.02161-90 S GOVT: N SUPP: N' CONSTRUCTION TYPE: PERMIT TYPE:.STH PURPOSE; ALT JOB'DESCRIPTION REPLACE A WINDOW W/ SLIDING DOOR SQ FT:' 31000 CLAIM VALUE: 3,000.00 CALL -VALUE: `3,000.00 GROUP OCC: R-3 / COMMENTS: ANDERSON DOUBLE PANED 6 TEMPERED DOOR/WI• *+E.��r+r+r*�*����N�iExx**�E�6��E�r*�r*�e��N•����r*�+r�6+r�•�r�E�k*x*�Litx�E***�e�6+EM�r�6�r+�**iP�E+r*�6if ��E*+r�E*x•* 7. O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN.BUILDING-----------------i-- ACCESSORY BUILDING.--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 41207439 ZNE: PDR— iREF NO:' PLANNING N TES> TO REPLACE AN EXISTINGWINDOW WITH SLIDING'FRENCH DOORS AND. > TWO 12 'INCH CASEMENT'WINDOWS,ONLY, iE*ieie9eiE**iEiEieiE**J696iEieaE*iEeei6ieiaieBeit4Eiei6ieilBEle***it itlElElFBtie9eeeiE**kiEae6EiF9tik*ateE*iE*iEiE*iFiE*IEJ6ieitaElEJFkrtiE 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 _ CD • E _ DATE:_��_ BUILDING.APPROVED BY DATE: APPLICATION ISSUED BY: --�� DATE; — 4 Cl 0 ilRe*1E44t*6kieaEieieiti6iEit4tii**iEie36iFiFTF±FT6iFA3F3FiF?F3F7€3F3F'iF3Fi83FiF'iFiFTF # �F3FiFiF76"iF'iF4EBeiEiEitit**iE 3FiF'1'F E ** iE iE 1E ie ie i6 k ie it it BF 4k 3e * iE iE N 9e k iE iE iE iE it * BF iE Be k it SEit 6t iE k * ie ie * ie it * * iF iE Sk Be ie iE 3F ie BE k iF 4E iE 9t * * iE iE * * iE iE iF i6,Ro- i6 RFiE iE 6t if• iE eE i6 i6 iE LEGALIZATION:N F E E S U M M A R Y STRUCTURALiSEGMENT:Y BLDG PMT" PLUMBING ELECTRIC :MECHANIC FIRE SMIP/RES' GRADING PERMIT 54.00 SMIP/N.50 ON—RES PLAN 35.10 ISSUE FEE BUILDING• -DIV—> PERMIT ISSUE PLAN_CHECK. TOTAL PAID DUE TOTALS--_—•> 54.50 0.00 %35.10, 89.60 89.60 .00 REVENUE•. DIVISION TOTALS--> COLLECTED:.'" 89.60 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC/" FIRE SMIP/TOT GRADING PLAN—CHECK 54.00 50 35.1.0 iEkifN*iEiEiE*IE LEae9f3taEiEBFaEatTEiEiF***iiiek7EiE*IFS!*k*****BF**if*EE*lEiE Bt ie*if*J6iEieiEiE**iEiE4E 46 itiEiti6iFataFi6eFie*iEitiE I N D I V I D U A L F E E B R E A K D O W N 'TYPE QTY D E S C R I P T I O N.' UNIT COST TOTAL COST SFR 3000 ALTER BY VALUE RESIDENTIAL NOZONE END ,OF FEES i D 1.00 3,000.00 01 00051086-00051088 _T' a T 89.60 DATE: 01/04/90 TIME: 12:00 CONSTRUCTION AND PLANNING - POOL & S:, -k _ APPROVALS .Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location :2r,Soil Pipe-Undrgrnd, 53. Steel Reinforcement - ' ='3.�Electrical CondU:t-Uiility-Undrgrnd. < 54. Forms L " ,41. Electrical Condiiii Undrgrnd. 55. Electrical Bonding Q 5'. Steel Reinforcerneiat 56. Rough Plumbing & Pressure Test ,-0 c ^-c } , ElectricalLIFEh'Grnd. - 57. APPROVAL TO COVER-GUNITE y.i Footings S 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test - - " 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd: ' 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line-!& House Connection 62. Backwash & Receptor -Final 12. Sewer Cap e, 63. Heater & Vent -Final %<79 'l. 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final ,�. i 15. Rough Electrical -Conduit 66.• Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVEDFOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Roygh Heating 8& Air Conditioning DEPT. REQUIREMENT^ ,FIRE tL >APPRQVALS;HEPermit # r 20 ;Rough Factory Frieplace y ,' `taj * 21rDuets,in•Strdctdi�* "" ''-`"• 5 h J70.lThdergrouh,Hydro Gi _ T. , is 22._,Ducfs, Ventilating}s 'u;; x p 4, o <71. Prod uci-Pjping ❑Gas O -Oil 23. Gas -Pipe -Rough &•*est tri X �: Q 0r W 72• Undergro End24. Fr , Roof Fr _ xx_.- 3-aUndergrnd. _Storagq:T,,-gnk;0Gas ❑Oil _ 25. Roof Sh-dathing ui < _-`.•yx 74-'OGerhead Hydroj 26.4T -Bar Ceiling (Stw'Aural) OMonocoat x; - =: 75:.Z ry Chemical 27 iFrame and Flashing: _ - c s ' . a: 76. Dry Stan i ie "� ••i 28.'Lathin0Sidin�;�. -.�.F„ "' 77:-,FIXEDS-YY$7 FINAL.;: 0.y x e c; y Insulation 78=FIRE PREY. FINg1.. _29. ^30. Drywall_Nailing * '"* i jK * HEALTH -DEPT.., REQUIREMENT - ;. i -FINAL 031. Plaster Brown Coate .* i x r ,79. IN_SP_ECTI©_N - c.32:_.Electrical, Power Meter= Final -80.t:f OOD CERTIFIZ/ TE ISSUED,-, �`-,.::* :E331FinaJ Electric. -+xr% F- ' «: IT Notes: ": '- + " _ `•'�^ _ 341_Fingl Heating`& Xiii"QgMitioning `lin C1"" y 5 - _ 35r Final Gas Pipe-Testi: 1 Gf'36.�Ho6d orCanopyC:z a _St 37..Final Factory Fireplacex -, 0,3 •a - I ;x. x ir. . � M _ �:38.`FAIPlumbin az* {'� as:;;tr i i� Ex' �' -' xc-- "39._,Water Service -Fina ry- •+ S I i =y# x ;- '`,• • + " _ v r, 40. 'Gas Service -Final * t': a, z r: r^ x I x» �Z x I< ';�41.Solar Domestic-Final- omestic-Final`42.-Backflow 42.­ BackfowPreventerRcl- 43. Backflow Irrgationt; y _ 0'44. Landscape Irrigation Systemv,'"q Wit`' n t' C =' '-5 F is R s'j co ,^ .) x {i: o ' �45 :Sound Attepu ationx M - C46.•Handicap Regulations �: '`• - �- r STR6CTUAE & BUILDING V. ix' J ;jam � .47=FIA}AL -V48 FIIVAL PLANNING * Y. 1 ,� i ;�x:x' _ x 249.'-Eleari6fleleiseto clison 7 ; c -n- 5 �50sGavRelease to Southern California Gas Cov "' - X A: is S r1�• l� • 51. CERTIFICATE OFrOCCUPANCY ` -" :-1,7 r No. Date ,VIRIESSOFMI.GING 1125 DANIELLE DR UNIT, (La"T"N"'aBUTLER, DENNIS G FLOOD: AHL38 ADDREn:BUTLER, JUDI A 1125 DANIELLE DR COSTA MESA,CA 92626 /PPL. WAILING ADDREM ARCHITECT ON ENGINEER: ARCH. OR ENWS ADDRESS: UC. NG: UNIT: cONmACTat'sNAMeCOASTAL CRAFT (714)633-2405 cONTRACTORSIIMUNG 8236 E. WOODWIND ADDRESS: OR CA uc w: 522128 92869 UM: LICENSED CONTRACTORS DECLARATION: I hereby ahkm under array of perjury that I am licensed under rovisma of Chapter 9 ( en . g with Section 70001 d Division 3 d the Boaam and Peefmdos, Code, and my liomne b in MI lace md1 effw. cess C. NO.: LIC. CUSS: B LIC. 2 2 1 �2 J. EXP: Date 1 I S C/ Cm or n -Yt OW R BUILDER DECLARATION: 1 hereby eNIrm under analy d perjury that sen exempt Irom the Contrepors Lieenee Law la the Id p reeeen (Sedion 7031.5 Business and Profesalem Code: Any cry «county xAiich requies s permit to mmvucd, altar, impose, andbh, a repel any structure, prior to as eeumca, abo requires the applicant for such pe nil to Rb a vgned etdemerd fled he a she d, Licensed pursuant to the provisions Other Contractors Limme Law (Chapter 9 (commepring wan Smsion 7000) d IDN01m 3 d the Bminem and Prof.... Code) or that he or she is exempr thadrom and the basis for the alleged ademption. Arty ykamion of Sadism 70OI.5 by any sophism for a permit tableaus the applicant to a oval pemhy of the mile than five hundred dopers j55gpj). ❑ I, as sever of the property or my employees wth wages ae their tide mmpemmion, will do the week, said the maqum b rad intended or offered la time (Section 7044. Budmes end Professions Code: The Cmtreaas License law dose nod appy tom bearer of properly, whe Wads or inproves thereon, and also does such work h ansa f or hened or through he or her own employees, provided that such 'mprovemmn we ret intended or offered for sale. ff, however, the Wiloiep or inpovemewl le add within one Year of oompletion, the owner4auiloer will have the burden of proving he or she did not WiW or improve lar the ampo e of sale). ❑ L ia ovmesd Ida property. ro mdnsively <gntatloe nal Iloemed c omaters to property Nap Wildly (Improv 7011. sed are Prdesame Code: The Caaadoa mesa Lew deme tnI appy to th ower d pts Lice who Willa a Improves (hereon and wW contra<n Ise mrin MaIMe with a antagor(s) licensed pureuml Ip the Conlragors Espies law). ❑ 1 ern arri under Section: B. 8 P.C., M this remoe: Dan: Owner: I do hereby candy Nm 1 am awade of and mderemd the tequiromenn of California Ileaffh and Safety Code Sequa 25505, 45533, W ?5534, and that I or my haure Wilding cassettes will / will red lamb oral reed to canply arm said made codes and aha requiemerm Icr apermbloranmrogion or modifmadbn kom the Ai ua-oT�epemend Diatdq. Residentidamtapie appimiananexemptfmmlheae provisions. Dade: AppliceM: WORKER'S COMPENSATION DECLARATION: I hereby affirm under penalty d perjury my of the folbwfr g declarations: ❑ 1 hese and wit maintain ocertaicate d icor sihi to teff -inmost la waled. e' corrnpenmlon, m ptovkad la W Sepim 3700 d the labs Coda, lathe padomerme of the work for which this permit ie issued. ❑ hero erne sea maimalo waken' corrnOmnembn imurmca, m raquued lay Sepia 3700 d Ha Labor Code, fa the pedamma d the work re which Nb peered b bsued. My workers' ampenaalion insurance carrier end policy number are: Caner: Policy Number: '9 sepim need ret Ee canplefed a the PmmAl9 ler Om hundsad dollen /51001 a bre.) I artily that In the pedomma d the work toe which this permit Le psoe I anal not employ my amem in my mmner so ae to wree mbjep to the waekns' arrrlanaadien lewd d Cdilania,lerq tip a Nm E 1 e ub bxwm eubpp to the waken' a pemmion promlone d Segimn 3700 d the labor Code, I dial= (onhsat ompy with lhoa rovisictes. e; Appliant \ Weminp: Fell te as sacue yrorlrtn'rompematlon roveepa la vola 1, andshall aub/ecf an smp/oysr a gdMnal penaltlM arld clvll ffms em b ma hvndad fhovesM Mrs. (51 O0, 000A In eddltlon ho flit coal of compemaflon, damadpa as pry,vidaq ler In Sxtlan 3705 of me Labor Cods, Infaast, and mvdr a fees. CONSTRUCTION LENDING AGENCY: I hereby aMrm under penalty of perjury that there b a Iona section WMinp Wmc, ler tla pedormma d the work far whidn this perms is toned (Sedlon 3097, Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I array If I have and this sophomore end ma. flow Ihe above inloramoe b coned. I epees b eanply with all cry and oourdy mattresses said state bm reletnp to Warta, ammucdon and hereby au0arbe rapreaentadym of this pay to anter upon the eWN mmmbrlmd properly 1«ire urmass. ROBERT DOEZIE Dade: 4 C (5151da.WP) While-SuiNiq 8 Sdery: Gram -Flo; Cewy-Appkent: Prnk-Rewnue: Goldenrod -Ad. CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 080300 PERMIT NO: B 080300 PLAN CHECK NO: 04590-96 L GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION ALTER CEILING IN KITCHEN, ADD SKYLIGHT SQ FT: 20,000 CLAIM VALUE: 20,000.00 CALL—VALUE: 20,000,00 GROUP OCC: R-3 / COMMENTS: REMODEL FAMILY ROOM R & R WINDOWS, INSTALL SKYLIGHT ICBO#2469 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING-------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: 2 PROV: PLANNING NOTES> KITCHEN & > SKYliIGHT,,C D E V E L O'P M'E- i .• ZONING APPROVED BY BUILDING APPROVED BY.: APPLICATION ISSUED'HY: '3`' LEGALIZATION:N T BLDG PMT PLUMBING PERMIT 287,25 2 PARCEL: 41207439 ZNE: PDR— REF NO: ING ROOM REMODEL; WINDOW REPLACEMENT AND—NEW IDE OF FRONT ENTRY, S E R V I C E S R E Q U I R E M E N,.T S C720_ DATE: / DATE: G 3F iF7'F'3F7FiF'iF"iF'iF iF7FiF7F i�$F7F3F iF7F iF7F 3F 3FiF##It DATE: -x* F E E S U M M A R Y STRUCTURAL SEGMENT:Y ELECTRIC MECHANIC FIRE SMIP/RES GRADING 2.00 TYPE QTY D E S C R I P T I O N SFR 20000 ALTER BY VALUE RESIDENTIAL .NOZONE END OF FEES 3'UBIsECT T®1�5 �ZIS m NO L�rpE , ECTORS 7 'VAOITJJV (INV MgUA �N.SjT�AND AppROv,4L 4S1112'1jjd3' 0 �� � 1`AS UNIT COST TOTAL COST 1,00 20,000.00 01 00218554-00213556 TOT 475.95 GATE: 11/05/95 TIME: 10:29 SMIP/NON—RES PLAN 186.71 ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK,,. TOTAL PAID DUE TOTALS ---- > 289,25 0.00 186.71 '� 475,96 475,96 .00 REVENUE DIVISION TOTALS--> COLLECTED: 475.96 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC 'TIRE SMIP/TOT GRADING PLAN—CHECK 287,25 .1 2.00 186,71 I N D I V I D U A L F E E B,R E A K D 0 W N TYPE QTY D E S C R I P T I O N SFR 20000 ALTER BY VALUE RESIDENTIAL .NOZONE END OF FEES 3'UBIsECT T®1�5 �ZIS m NO L�rpE , ECTORS 7 'VAOITJJV (INV MgUA �N.SjT�AND AppROv,4L 4S1112'1jjd3' 0 �� � 1`AS UNIT COST TOTAL COST 1,00 20,000.00 01 00218554-00213556 TOT 475.95 GATE: 11/05/95 TIME: 10:29 'ONSTRUCTION AND PLANNIN_ .PP 'OVALS Permit # ' Date Inspector ...OL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location I 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement r 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ; 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test t 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE ' 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test . 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK t 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13, Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final - 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas 0Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 27. Frame and Flashing !!-�3 �'� 75. Dry Chemical 76. Dry Standpipe 28. Lathing & Siding 29. Insulation 30. Drywall Nailing I pfi ,`{, 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric 34. Final Heating &Air Conditioning 35. Final Gas Pipe-Test Notes: Tr �T-T�9 �iPEC-TOR�' �}y/�-�� REVIEW=�Y i RO V _ 36. Hood or Canopy 1� 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ADDRPss o< MLNNO: 1125 DANIELLE DR BUTLER, DENNIS G ` uDREu:BUTLER JUDI A 1125 DANIELLE DR COSTA MESA,CA 92626 ADPL. WdLDb ADDRESS: ARCHITECT OR ENGINEER: CH AROR ENti•S ADDRESS: CONTRACTORSNANE:COASTAL CRAFT ca AcmniiiADwD 8236 E. WOODWIND ADDREM' OR 92869 LICENSED CONTRACTORS DECLARATION: I hereby elf oder pointy p Irm�em�'ng with Serfion 7000) d Division 3 d the Sueirmer sect Prdeeabn Q UO NO.: LIC. CLASS: B UC. NO.: 5 UNIT: FLOOD: AHL38 De NO_. UNIT: (714)633-2405 CA ue.m.: 522128 UNIT: I inn Icanaed alder moymom a ChWer S my lieaner Ie b tu0 bine end eBect. 128 in Dine: I - Gmtmda: .kt,aw' v i v 3 OW R BUILDER D CURATION: I Mroby elf under pensly d perjvy I em eaempl barn the CaHmctm limine Lew la de O meson (Semon 70315 Busieer and Pmleaaom Code: Airy c3Y a minty wNdt teatdrer a permt to mmatd. etr, ir9rorw, demd'eh, reropy arty mruauro, prior ro as bmertm, abo rpuier IM epp4mnt to each pend to Ne a aprnd etmetnsm tlut M a aM b licena.d pureurM 1, the mvi ums of Um Conumoton Uo me Lew IDMM. S (...ni, wnh Section 7000) of DNbbm 3 of tlr Business end prafa so codel or Lha he or elm u er,mpl 1lnrehm aM tins h for N, alleged wamption. My Yblmbn of Sedion 7031.5 by my eppliunt Ire a Mmut subjects the epptcem to a dN perutly of M mea Ilan lwe hundred dollars (S5oOD. ❑ I.es.,flee progenya myampl%.e yen wepm erIhi ode compemabn, willdo Ihwork, end thesmmuee a me kuerded ,elma oflar,dbveleI li mon. Bulmerend Pro/er,od, Code:TMComroctmlimine loworae intoploytoanownan shad mp beide nn k.. not tendon, end wh fore vuM work . th a wir, r n,myr he u her own in. year of mop tlm etch imprpwrnerN ars not iaerdW a dlered la vein. ff. tawevr.IM bdkuq a knPeawmW a aatl evhit ane Yam d mnpbibn, tle ownsrauider will new Ih Wden d pmrirp h w aha did m1 Wik a impmw is th gumma d eels). ❑ I, m ow er of Illi, pop". am eedwimly ocreraaip wtlh licamed conamw s to ommmd Ne project (Sect on )OM, Burmese and pmteerbw Code: The Cmtroctan L'iomee LAW does m apply m an owner of pr.Pwy who 1u0da or in" .. therron end yon martinis fa audt peppde ware a mmmcta(s) Icamed pursuant to th Cmlredas Liles Lew)./ 7 ❑ I am emmpt under Sectors: B. S P.C., for IN. meson: Det.: Owner. I do hereby candy tea I am aware of and utdemmrd One re uimmerde of Calilamu Heatlh and Safely Cade Sections 25505, 25533, eM 25Sa1, and doe I or any future WiMiN mouma will / wit not (arch me) mod to comply wth said mate coder and! IM mRuimmanb b Dra: Apdcaed: WORKER'S COMPENSATION DECLARATION: I hereby affine order pemhy d perjury ons of One Iabwbg deaerreiom: ❑ I hew aro wit manlein a cendicele a mneenl Io eatl-inwro la wwkete' compenulion, er praykad la by Semon 3700 d the labor Cads, for the mdo mrtce d IM work la w h Nb pemX is meted. ❑ I hew and win this ,e waken' My ym,one' o mnce. ea On i. by Section 3 end o the Labor Code. b the perfarnmrtm d the wok for whoh Inb perms a booed. My waked mmmnemim imumnce meter eM pdiry number ans: carder: gamy Ntmla,n gat5ft= mer M earrtplefed 3 Ns mm3 o b aro hrmdred ddmn (51001 w mu.) in IM pedmmme d tM work b which ihie oemb b mad I e dl int ampby dry prion k erry mrmer ao m to pd ro the wakes' emWrurion bws d CeMamie, ap tlta ! 1 mrornd became nAjeQ to IM woM1en• n proybbew d Srmion 3)00 a IM Labor Cade, I ehe0 fah ' mnpy wth N s p tins. \\ C Apdbem: p .ra�r..�k-�����' ro acus woklani rorrmermatlon coverage h unbnHul, erM sell erb/acl.n smployr ro rslMrW penatler arttl war lenders. *Mound ddmra 11moneye A M MdIWn b M. poaN of mmparuaUors Wnmpea u pyovMM br In 9ectlm 37yA6 a/ tlIs Labor COM, In*emsA arW efromaY'a fere. CONSTRUCTION LENDING AGENCY: I hereby effim urder pemby of perjury thet stare b a mmimd'an mlkmg agrcry b dr p.dmmem of IM eek for WSCh the pemi b bored (Sedan 3087, Ce. C). LENDER'S NAME: LENDER'S ADDRESS: I certify tW I hew mod dus appicamn and male that the aboa iaametb b eonwl.I agora to campy wilh as city add coumy adamnms and We mwe relating to WHIN mmmrudmn end hereby eu lyorbe repeeenlmiwe of thio sty Io enter upon IM,bow-mWiatatl aapany for impmoon pummen. ROBERT DOEZIE Dina: (5151) Mlo) WhGo-Buldiq A Samy.Omen-R :Gerry-hppF ; Hnk4Wmue: Gddenmd-Aamemr CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 080303 PERMIT NO: P 080303 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: ALT JOB DESCRIPTION ALTER CEILING IN KITCHEN, ADD SKYLIGHT SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: REF:B-80300 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 41207439 ZNE: REF NO: PLANNING NOTES> > I iEdElEiEiE*dfi(-iE1E3f1EiE1f**1E 3E 1E if 1E*1E*iefElEiEiF is ieiR3Eif*1E*3E 3E 3E3Efk*1E 1EiEiE9E1E1E**fEiEiE1E*1iiE*if*3(-1Ei01E*1E ♦E ♦E if 3FiEiEiEiE3Ef4iE 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 : i DATE: � r1�": APPLICATION ISSUED BY; DATE: df 1F♦E iFMih iE iF 3f iE iE ik iF dk*if 3k 1E 1E iE 1E kTFiFiFiF�FTF�F'iF'iF3FiF i'FTF 3F 'iF 3F'iF'iF 3F �'iF.�F �7F 3F3f�3fi(•�'N!E lE iE iF if if iE iE jE df LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC .. MECHANIC FIRE SMIP/RES GRADING PERMIT 17.50 25% SMIP/NON—RES PLAN"" ISSUE FEE 22.00 BUILDING—DIV—> PERMIT ISSUE PLAN�CHECK TOTAL PAID DUE TOTALS ---- > 17.50 22.00 1 0,00 39.50 39.50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 39,50 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 39.50 4 I N D I V I D U A L- a -'F E E B R E A K D O W N TYPE QTY D E S C R I P T I OOOyN' UNIT COST TOTAL COST PLU 1 DISHWASHER -'�Z 8.75 8.75 PLU 1 SINK, KITCHEN ' 8,75 8,75 ENDz,bF FEES 01 00218557-00213557 T O T 39.50 DATE: 11/05/95 TIME: 10:29 CONSTRUCTION AND PLANNINL. ' APPROVALS Permit # Date Inspector ' JL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ; 2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ' 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE i- 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe•Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd, 10. Structural Floor System 61. APPROVAL TO DECK ' 11. Property Sewer Line & House Connection 62. Backwash & Recepto, -Tina) ' 12. Sewer Cap - 63. Heater & Vent -Final 13. Roof Drains 64• Plumbing System - Final 14. Rough Plumbing �, 6 _ 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring - 67, Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ' 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT, REQUIREMENT APPROVALS Permit 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24, Roof Framing 73. Undergrnd. Stor age Tank OGas 00il 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT - 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating &Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE&BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51, CERTIFICATE OF OCCUPANCY No. Date Y wOREssagwLGNa`"" DANIELLE DR UNIT. °"Tb "�0AAgp LBUTLER, DENNIS G FLOOD: AHL38 BUTLER, JUDI A 1125 DANIELLE DR WLeiuwaADDRMCOSTA MESA,CA 92626 ARCHITECT OR MNEER: ARCIL OR END.Y ADDRESS: UC. NO.: UNIT. CarimACTORSNAeR:COASTAL CRAFT (714)633-2405 CQURACTORSMMIINo 8236 E, WOODWIND ADORESS OR CA mw, 522128 92869 UNIT; UCENSED CONTRACTORS DECLARATION: I hereby OR m under penalty d perjury Nst I am licened uMa provisions d Chapter S (commemirp with Section ]000) of Div®ion 3 of the Busimss ental Pmlasaio e, artd my loarwe a in full lace end e"w C .NO.: UC. CUSS: UC.N .: S 2128 XP: /,a.,/— � Contradar: , WNER BUILDS DE RATION: I hereby affirm under penalty of perisir, that I Are exempt frau the Contractors License Law for the fdbwiW reason (Serl'en 7031.5 Business and Professions Coda: Any city or county wrl h requires a permit to consaua, eller, imprare, demoleh, or repair any structure, pWr to his esuartce, also requires the applicant for such permit to fib a signed statement that he or she is licensed pursuant to the provisions of the Contredors License Law (Chapter S (commencing whh Section ]000) of Division 3 of the Bualress and Professions Coast or that he or she'n exempt therehan and the bean fa the eloped exemption. A, vHetbn of Section 7031.5 by any applicanl for a pernnd wbpae the applicant to a wit penalty of not more than live hundred "lays j55OOD. ❑ I, as owner of the property or my amplaYees whin wages ns their We compensation, will do De work, and ted thud.. a rax intended or all for sale (Section 7014. Busineae and Professions Code: The Contractors Unman Laweoes not applyb an owners prop" Who Wilds or inproves the., Aral who does such sale Nmaed or herself or through he or has own aroPloysm. provided that wdt impmvemersa are M imended or dkmd for sets, 0, hoverer, IM Wildity or hnprwemeal is sold within ate year of wmplelion. the ownerbuiNer will have the When of proving he or she did our Wild a irh re for the purpose of eats). ❑ I, as owner of the property, am exdusivdy oontradirg whh licensed ompacbre to construct the project (Section 7014. Business and Professions Code: The Conned ate License Law do® sot appy to an own« of property weto Wilts or imamas thereon and vdlo comrade for such projeda wiN a mm mior(a) licensed pursuers to IM Contractors License Law). ❑ I am exempt under Section: B. A P.C., M Nis reason: Ode: Cwnec I do hereby omAy that I err. aware of and urMerslmd IM requimemb of California ifaahh and Seery Code Sections 25505. 25533, and 25531, and now I w any More Wildcat, occupant will / wit nm (dime ore) reed to comply wilt said state mdea and the requimmenb for aMmhfamnstmdionwmndifipatbnhomlhe Ak uut"Cy7.fe omen Dimrid.Residenlidc Omdbnapphmionswe Mplfmmlheea provisions. Date: Applicaa: WORKER'S COMPENSATION DECLARATION: I hereby off. under penalty of perjury one of the folbwirg detlerelions: ❑I have ental wire meintab a cenifcate d cpneenl to sett insure for w«kan' ampensatbn, as prwlded la by Section 3700 d the Labor coda. la the pedormance d Ne welt fa w this penal a neued. ❑ I have ane wilt manses worsen' compensabn insurance, a+rpuimtl by Section 3]00 a Na Labs Code. for the perlormence d the work fa whits this M min is eaued. My wakens' mmpensetim insumn cerrkr end pdicy number ere: Carrier: Pdicy Number: te section need rut be aunpkred X the pmr r is for one hundred ddlars /SIM] or bas.) partly that in the �Mormaa:e d the work for which this pwmh a issued.�l'a I sot employ any penin in any manner m as to became subject to the work rat' compensmon Lawn d CalRomie, end epma old E I d,oaI become sub d xo the worsn' pensd n pati ioru d Sadiron 3]00 d the labor Code, Ishell /onhwn ugly with NateAppl. Yi- inp: Fel un b axun wo trete' comp«uetlon coverage b unkwlul, arts ahs/I subject an employer M rNnsl penarop and c/vll fines up b use hundred tleasend dollen (5100,000). In adlltlun 0 Of cast of ronponsatbn, denepa As pmvidsof four In Ramon 3M of due Labor Coes, Inters 1, and ettomsy's leas. CONSTRUCTION LENDING AGENCY: I hereby aFrm under penalty of perjury that there is e construction krdin, agency for the ,surf.... of IM wok M whits the .it is issued (Sedbn 3097. Chu. C). LENDER'S NAME: LENDER'S ADDRESS: I candy that I Moe read this application end state that the above iaarmabn Is sorsa. I spree to Campy whh al aty end county ordvwrs arts state Laws relating to Wilding oocussua n and hereby atabor¢e rapreaentativea of this any to enter upon the above trierauned property kr ins,ion pun e ROBERT DOEZIE (Name Data signarms of Owner/AgenvAp ontredor (515i.s,wp) NNhe-Buil hg 5 Seery: Gmen-Fb; Canary-Appioaa: Pink- mrrue: Gokenrod-Avseaaa CITY OF COSTA MESA - BUILDING PERMIT IPFRM n. M 0903021 PERMIT NO: M 080302 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: MEC PURPOSE: ALT JOB DESCRIPTION ALTER CEILING IN KITCHEN, ADD SKYLIGHT SQ FT: CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / COMMENTS: REF:B-80300 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- — 46,50 --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 41207439 ZNE: REF NO: PLANNING NOTES -1i—./l TYPE QTY D E S C R I P T I G N eE eE dE dE dE*fEeE*eE eE iE eE*iE 1E**fE dE**9E dE dE eE dE eE dE*dE.)E**iF,dE'eF*iE**iE*9E irk iE*9F dE**gE IE iE gE lE dF gE 9E dE*iE dE dE 9E 3E )E dE ♦E gE irk iE dE*dE 1E*iE dE D E V E L 0 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 W/CNTLS 12,25 12.25 END OF FEES BiJILDING APPROVED:BY APPLICATION ISSUED.BY: LEGALIZATION:N BLDG PMT PLUMBING PERMIT F E E S U M M A R Y ELECTA'',IC MECHANIC 24.50 253 i 22.00 PLAN�CHECK 0.00 PLAN ISSUE FEE BUILDING -DIV-> PERMIT ISSUE TOTALS ---- > 24.50 22.00 DATE: ! DATE:WEGEN b/ *dEX_*TdEdF3EIFdE STRUCTURAL:N FIRE SMIP/RES GRADING SMIP/NON-RES TOTAL PAID DUE 46,50 46.50 .00 REVENUE DIVISION TOTALS.--> COLLECTED: — 46,50 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 4.50 iE dE eE lE df iE dE*iE♦F dE iE dE dE*1E dE iE 9E*iE dE eE 9E gE dE dE*dE♦FiE*dE gE df df 9E idE eE eE 3E 1E IE**eE dE iF SE iE 1E*dE iE eE dE fE iE iE dE*1E 1E eE*dE dE 9E dE fEdE eE *dE lE dE dE*dE I N D I V I D U A li, ',-F E E B R E A K D O W N TYPE QTY D E S C R I P T I G N UNIT COST TOTAL COST MEC 1 REPAIR/ALT COOLING UNIT/SYS W/CNTLS 12,25 12.25 MEC 1 REPAIR/ALT HEATING 'UNIT/SYS W/CNTLS 12,25 12.25 END OF FEES 01 00218553-00218553 T CIT 46,50 DATE: 11/05/95 TIME: 10:28 CONSTRUCTION AND PLANNIN... APPROVALS Permit # Date Inspector ...OL &SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. : 3. Electrical Conduit Utility-Undrgrnd. 53. Steel Reinforcement 54. Forms I 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. Electrical Conduit-Undrgrnd. ' 8. Foundation - 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines. P•Trap, O Undrgrnd. 10. Structural Floor System 61, APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final ' 12. Sewer Cap 63. Healer & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final - 15. Rough Electrical -Conduit. 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69, POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning / FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas OOil 23. Gas Pipe -Rough & Test 72, Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test - Notes:- 5-22t- 36. Hood or Canopy ,{ / 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY N0. Date r /y mDAEsspE BaLma: 1125 DANIELLE DR UNIT: pXFdN EIFUMN:BUTLER, DENNIS G FLOOD: AHL38 .DORESS:BUTLER, JUDI A 1125 DANIELLE DR COSTA MESA,CA 92626 APPL. YARpM AWRE54 ARCHITECT 011 ENILIEER: ANON OR M'S ADDRESS: UC.Nora UNT: croNIRAcivrtimumCOASTAL CRAFT (714)633-2405 cwmxc cum 8236 E. WOODWIND ADORES: OR CA mm.: 522128 92869 UNIT: LICENSED CONTRACTORS DECLARATION: I hereby allow uMer Ueneey d het I sw hoerno d uniana dlml der hossCher S (wmmandng with Soclion 7000) d Dheen 3 d the Business end Pmteeeio e, d my Iwuw is in No fan eM effed. NO.: LIC. CLASS: uc.N.: S 128 EXP• we: Corweda: W SIRLDEDE LARATION: I hereby eHium older pwdy of psirry that I am exemq flan iM on LieN nee law for e rsawn (Section 7MI.5 Bueiwaa aM Professions Code: Any cGy or aunty whidl mquima a permit to aeutrucL a.. imlxo s, deunoksh. or repel rR' ebadme, Prior Is ifs it.. ales m wee the erne f fa such psnma ro fib s signed nweesse Net M a she is licensed Menem to the provisions of the Conlradon Linens Lsw ]Cheger S (cammeair, wah $spun 7000) d DMleiun 3 of the Beinsu rd Prdessi Code] or Ihd M or she is exemqr thaimm end the have for the allped exemplion. My vidd elion Srfion 7031.5 by any applin s for a "(ere subjects the applicant to a dell Pwaty d not more than two huMred ddeaua ]5500]). ❑ 1, u.weer d the propedy or my empb,.. wah wages as Ihe'r sole campenswion, will A the work, end the alN .m is not inleMed or offered fa eels (Session 7046, Bumen and Pmfesdma Code: The C lrrwsore Lksea Lew dou rw1 appyto m ower of property eM hoods or smwoves thereon. tout wfio does each week Nmadf or hersell or through he or her own ampbreet, prosidsd lisp soi impmrsmene we M imended or offered for ON. I. however, the W ildis, or enplaanem a sofd within ore yea of conpfrbn, the owner-0uidr %ill have the Wden of proving M or she d'M mf buikt m improve fa the purpose of eels). ❑ I, u owner d the property. ale esd eivey c nlrectk, with licensed cOnbamaa ro ro ist ss the project (Sedian 7044, Somerset and Profsser. Code: The Contrenow L.. Lew dee rrot spply to an ower of puopeM wM WiMt a imposes maroon eM whe .taw. for wch ploisds Ovid, a wmrsd-sM IiceeM yore—1 to the Conowuse Limree Lew). ❑ I we exemq .Mer Section: B. 8 P.C., la Ota reason: Dab: Cr.: 1 do hereby Gerdy this Ism +were d end un lahol the Munwri ort, d CsNomia IleabA and SsWy Code Srakw 25505, 25533, aM 25534. rd flum I or any More WGde, oo owns will / woe not (dree pry) need ro nmpy with aid gate codec aM the rpubamrda ler e perma lorowbudnn amodifiresbn tram the AiT yy %Wnnapsmon Dwfrid. Reudesidoamnuction Wisseliae—exemqm n Nothe le .. n. Day: Applium: WORKER'S COMPENSATION DECLARATION: I hereby slfi undr, penalty of perjury ane of the blocs ivg dadwmiw: ❑ I have aM W mmmen a certri of ppnaem to assumes ler wcnkers'rrmpenewion. as provided for by Stlian 37M of the Leber Code, for the pwfansnaa d the ewk for wfkdu Nn penriu is rued. ❑ I neve well will moven worlrs' oorehwsseb inureee. u requaed by Section 37W d the Labor Code. W he Prfamasca of [he work fit yNoh Out Peen: is causd. My women' camlynction inmaeee unix wee pdry mvnbr we Cwnw: Policy Number. l uctim need M M aagsedf fM perms u b one hurdretl tlo'lers (5100/ ow otos in he padomynca d the work for witch the pemd a ewe shell n I employ try prspn In wry manor w u to come wbject to 1M workers' axnpentwian kws d CelNgnie, aM re N ! I thauM "scams wbjw Ip the waken' c tpansalion viae a d Section 3700 of IM labor Cods, I ehwl fMhwdh wrlu WN t,�ai ate: Applrenl: / WemMp: Fwlu ro u un wgwi <orrpmtatlon rovampa b u4MwM( why al ell aub/ecf en employr tp ctl lul perraNu end old/ flays W ro art Aundverl f swisf old". ($ IUG000), In edllfbn ro Nt root o/ romprdefbrt d+rfltget u 17wvbad ler In S.'. 3705 of tllt Lebo' CoA, Intents, sent wfomsy't leu. CONSTRUCTION LENDING AGENCY: I hereby afOnn uMer penely d perjury thm then s a metmaion Iwdirp agency for he perfomrw d the eork for wstich this prmi a eeued (Section 3097, Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I certify Ina I hew need this application aM state lhal the ebove infmhation is coned. I agree to comply with all my erld county pdimncaa wd erste bwe meas, ro WiMe, tune ion and hereby wthorae represemwivu d this city to sena upm [he show-mwisytl propady fawpectwn%ieaROBERTI DOEZIE 7 Owe. (5151`5.W P) WNSBuddng d Sdrr. Gree": Crmv-.essL®rpbkJirwmy(bMwm6daeeswr CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 080301. PERMIT NO: E 080301 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: ALT JOB DESCRIPTION ALTER CEILING IN KITCHEN, ADD SKYLIGHT SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: REF:B-80300 fE aF ♦E iE iE 9E 1E NE iE-0E iE 9F iE iE 1E sE aE dE.)E 1E iE iE aE iE iE dE 1E iE 9E iE 9E if df jE 1E iE iE iE NE if iE 1E iE dE 9E iE ♦E iE 9E 9E 9E 1E iE )E iE iE 9E dE 1E iE iE lE IE iE iF dE iE ii NP iE # iE dE 3E iE eE dE iE iE Z 0 N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 41207439 ZNE: REF NO: PLANNING NOTES> 98.50 98.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 98.50 OVER/SHORT: > BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK iE if 9E NE iE NF iE iE 1E iE 9f lE SF SE NE iE NE*iE iE NE 9F iF NE*fF*iE 141E IE*fE iE NE iE 9E iE 9E SE 9E iH IE 9E*9E 9E***9E IE 9E 9E 3E 9E*♦E iE IE 9E IE IE*if iE if iE 1E 9E NE iE iE 1E IE 9(-9E iE NE 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 : 1_: UNIT COST TOTAL COST DATE: BUILDING APPROVED BY DATE: a L__-1 APPLICATION ISSUED BY *�*�if9Eif9Eifif*9E 1E*****�** LEGALIZATION:N I F E E- S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 76.50 508 SMIP/NON—RES PLAN ISSUE FEE 22.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 76.50 22.00 0.00 98.50 98.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 98.50 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 98.50 iE * iE * iE 9f iE iE iE iE * M iE 1E 1E 1E lE iF iE 9E iE IE 1E 1E IE IE 3E ♦E * NE * NE iH iH iE * sE iE NE sE 9(- iE iE iE yF sE iF 9f !E 9E df 9E iE if io fE ♦E 9F 9H NE iE NE iH * iP 9E iE if iF NE iE ♦E 1E iE Nf * NE iE iE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 18 FIXTURES, LIGHTING 1 ST 20 EA. 1.00 18,00 ELE 14 RECEPT/OUTLET 1 S 20 EA, 1.00 14,00 ELE 12 RECEPT/SWITCH 1 ST 20 EA. 1.00 12.00 ELE 1 SUB—PANEL 16.25 16,25 ELE 1 MISC CONDUIT NOT LISTED REQ PERMIT 16.25 16.25 END OF FEES 01 00218552-00213552 T CET 93.50 DATE: 11/03/95 TIME: 10:28 Q( CONSTRUCTION AND DPLANNIN.. Permit # 7Datel nspector .. 01_ & SPA' ermit # APPROVALS Permit' Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrnd. ., 53. Steel Reinforcement ' l 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. j 55. Electrical Bonding I 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd, 60. Backwash Lines, P -Trap, Q Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12, Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System � Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical-Conduitlar System -Final 16. Rough Electric Wiring /1 �.Q6 f e67.ncing & Access Approval ` 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ' 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT, REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas 000 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final FOOD CERTIFICATE ISSUED 33. Final Electric 1i� 91 Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41, Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50, Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date BUILDING •. PERMIT • • ADDRESS: P)A OF VALUATION:F- gbb4 SQUARE FOOTAGE: PERMIT FEES: •� ONLY ONE ADDRESS PE HEET- TIME IS TO C e � s .. RECORDING THE NEAREST 15 MINUTES PLEASE BE AS SPECIFIC AS POSSIBLE IN W, .Z+4 DEcv LAID FLAT <. ' 7rfz AC-T'VY..AL T%CTAIL F" P' ''µ4x. SI'A1J 4VI VeDLQoZ)D F-*-md 4x4 P,D$TS WHERE WEtDED i. 1125 DAvlICLLE jOR -- - C -O S Tr- iKSSA_— L �►ppG�Oo^�n�D __ Ct4y Of C000 MMS Building Dept. I THESE PLANS MUST BE ON JOB AT ALL TINIES MAKI NO CHANGES WITHOUT PRIOR APPROVJ4L OF CIFi. TI'E ISSUANCE OR GRANTING OF A PERMIT OR APPR01 AL OF PL IUS AND SPECIFICATIONS SHALL NOT BE CONSTRU TO BEA PERMIT FOR, OR AN APPROVAL OF, ANY VIOLATION OF qN OF THE PROVISIONS OF THIS CODE. NO PERMIT PRE. SUMIN TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVLS ONS OF THIS CODE SHALL ��I�I '11 n FzCEPT IN_=^ FAR HO iNE WORK 0° USi �•n�`.N FiTJU�Ifli IS LAWFUL THE ISSUAN'I OF ERMIT l ASED OF) V PLANS I JD SPECIFICATIONS SHALL NI' PREVENT THE BUI IING OFFI,IL FROM THEREAFTER RLiQUI t NG THE ; ARECTIC \ OF ERR,' :S IN SAID PLANS AND !SPE: FICATION, OR FR01 PREVENT , C BUILDING OPERATIONS BEI G CARRIE ON THER L JNDER WI N IN VIO—M9l OF TTDS! CC ; ° OR OF NY OTN f OR04NAI 'E OF TH� rT I 2X12 SrF.)NIn, ER5 1 -OR 6'rcr'5 vCjT. CP 'MOSTA MESA,:,\ MAR. ihaClUV 42" PLANNING DEPT. /�S�U,,BJJECTT,,TTO BLDG. DEPT. REG. BY .G VT w L,. l..- DATE -1 DIRECTOR Of PLANNING 4. 6 3cAM5; Max. sRVI I; �z6 To)5TS: MAY. SFQ)J ('G" 24 "O/c. J AiAx, SPACIW4 So " 01G FL-l_13EAr�.s �1'o!s 1's A: rACNCV Wr-rH STA- PIZAMIA14 AIKhaRS Lcm;ccs A"A:IIgD Tu rvp11J0ATI OW !::/3/Zc LACS HAILIWCT h'KAAAI: UN Exs-rNJ� C=tsOEYLE i'ot,:CH 4.G 2aCz ELt ]r G LE` i R I R FACING ordl'k ;n •;.a r.,,-T�li :: JN TOP U CoucRE.TE PtE4 8tc<JCS cy POµRE� F'OOTrfJC7S NONRO7TIfJG WOOD *U{'PDT"1. F OC S-E7�5 1125 DA" la -LE DRI✓F COsrA MCSA . CA . Lor 47 or- 'rF-A%!" 2>=awoob E�nn-r.� Dcc.l� >'LLr KW> , : r<xy s LAIC) r-LAr SCALE; Vs"= I rooT A ����D I TA M A PL NING DEPT. SUBJECTTO BLDG. DEPT.. REG,"� By,,6kJE�l DATE..A � DIRECTOR OF PLANNING i I �KIVE:UAy DANIELL.0 nF1VE s-rce E'T' NG0.-sc a7" I i I Iwuse it C�?I DECD; Stl><j;f[£' 2 rr�t`s 13'x" Ji v`Ctttx _ V. L.i Lcc.k 741 1 i � i I i\ �1]"'ititi; iJ I GIJtDE STRUCTURAL APPR VAL ONLY 14" Als:"�E DECk Sugvnc6 - SEPI.RATE PERMITS +RE REQ -01 POR ELECTRICAL„ PLUMBING, HEATING, VENT�I.ATING AND REFRIGERAT'ON WORK # d' Z S- J' THIS NUMBEP FAUST ACCOMPANY / ALL INSP'CTION REQUESTS FOR BUI'.dINGS WHERE PERSONS ARE TO Dc<.k SUKr.+ur BE EP, LOYED, WE SUGGEST THAT THE STT" E OF CALIFORNIA DIVISION Of SNDUSTRIAL SAFETY BE CONSULTED FOR ADDITIONAL REQUIREMENTS. OWNER Dermis G. Butler DATE 8/30/79 JOB ADDRESS 1125 Danielle Dr. BUILDING PERMIT NO. 48%25 No. 412-071-51 LOT 47 TRACT 9866 INSPECTIONS Signature Date TYPE V GROUP ZONE SOIL_ SUBCONTRACTOR p RMITS ISS GAS Data Nam ber Si nature _ WATER Plum in ROUGH PLUMBING O /-PL1705iX PROP. SWR. LINE I, j HOUSE CON, SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNOERGROUND POWER ROUGH WIRING Heatino and Vent. TRENCHES I—I FORMS L] STEEL REINF. FLOOR SYSTEM BOND BEAM_ STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING _— IN OUT PLASTER. BROWN COAT STRUCTURAL. FINAL Electrqc HEATING, VENT., REFRIG. AND A.C.. FINAL PLUMBING. FINAL AND GAS TEST ELECTRIC. FINAL -- BUILDING. FINAL Uancep `-'COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BU ADIDRESS 1195- ��y.�I/��-�-�rJ� •l""a�� OWNER OR Te7A)AI�� TENANT /, O MAILING ADDRESS '5AA.6 Ac (0011e TEL. p CITYC�%) lriE�A NO. CONSTRUCTION I , I I BRANCH ADDRESS ARCHITECT TEL. ADDRESS CONTRACTOR 0A�. 6 'jl� /�/,�1 ��y�9 ADDRESS .5i4 ,octe 49 'A iBoVt�7 TEL. CITY NO. STATE CITY LIC. NO. LIC. NO. SIZE NO.OF BLDGS. OF LOT 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 acknowledge that I have read this application and state that the above Information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are In full force and effect, or I em exempt from the provisions of the State of California Business and Professions Code, Division 3, Chapter 9�//// Signature Pee ->z or ly �79 Authorized Agent Date JS�, a, y 21.69 8/30/79 30.50 TL TION FOR STRUCTURAL PERMIT sa A.P. NO.BUILDING ADDRESS ZZ GM - UNIT OR SPACE NO. TR.NO.LOT �� BI q86 6 NEW ADD ALTER REPAIR MOVING DEMOL OWNER VALUE USE E ZONE TYPE GROUP APPROVED r] BY DATE V APPROVED SETBACKS (FROM L STfi EET) C(V l/I FRONT FT.� I R. SIDE L. SIDE REAR PLANNING ACTION m i m m SD. FT. N 7 THE UNDER VALUATION IS FOR o1 THE PURPOSE OF ESTABLISHING A PERM rr PURPOSE F ESTABLISHING FEE O�NyLVr: `0 VALUATION PERMIT FEE 5 OD PLAN CHECK $Do �s�s1 $ TAX $ LL ` D TOTAL PAID ; Os S se 449 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING / 117Z_- r\ A I IIGI I L n OWNER u or MAIL ADDRESS 508 29th Street CITY Newport Beach, Ca. No`'675-491 BRANCH ADDRESS —CH^T,,, Frank SDaneler "IL673-09K PAID "GV 10-77FHSA00 531* ****95.37 APPLICATION FOR STRUCTURAL PERMIT RECEIVED By I DATE RECEIVED Wert IM I.R BUILDING I I�J ADDRESS TRACT 9866 I-- roper leses evelop- OWNER men orp. VALUE _ w ADDRESS 4 4T PE GROUP by acknowledge nowlatlpa that t have raa his epplica n and state the above Information Is correct nd spree to comply with allws regulating building construction, and 1 shall not employ erson In vlolatlon of the workman's compensation laws of VED CONTRACTOR DATE ADDRESS tate of California. TEL. NO.OF Z USE OF m .v sp THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: xempt from the provisions of the State of California Business Chapter 9. rofessions cc000ddee,, BUILDING w CITY NO.PLANS PERMIT FEE E /plvision/3, ture of '��i1.r/izsi-tL�) -�// ' �L� ittee E 48,200 STATE CITY R DS APPROVED YARDS APPR VED LIC. NO. LIC. NO.IN BUILDING ACCESSORY BUILDING SIZE NO. OF BLDGS. C/ I trANCE OF LOT NOW ON LOT FT. FT. USE OF EXISTING BLDG. F Separate permits are required for FT FT. electric, plumbing and heating work. - FT. FT. USE OF BUILDING AND WORK TO BE PERFORMEDCE BET. BET. MAIN & LOGS. ACCESS. SLOGS. VAR.* Qf -J� .nI DATE .r. ___ -s-* w by acknowledge nowlatlpa that t have raa his epplica n and state the above Information Is correct nd spree to comply with allws regulating building construction, and 1 shall not employ erson In vlolatlon of the workman's compensation laws of 'n N m o /�O CA F 1 ❑ FAA tate of California. _ by certify that I em properly Iicansetl as a contractor under tate of California Business and Professions Code, Division 3, ter 9, and that such licenses are In full force and effect, or 1 EAuthorized SO. FT. 1 84 m .v sp THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: xempt from the provisions of the State of California Business Chapter 9. rofessions cc000ddee,, y in VALUATION PERMIT FEE E /plvision/3, ture of '��i1.r/izsi-tL�) -�// ' �L� ittee E 48,200 m PLAN CHECK $92.00 TAX E 3.37 er—/ / TOTAL PAID E • 3 orized ABant� m DEC-9-77«MOO 478 v*+ 184.00 COSTA MESA BUILD NG -SA ETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Rmpletely — Use Ink Only RECEIVED By DATE RECEIVED DATE ISSUED BUILDING ADDRESS " PERMIT NO. OWNER A.P. NO. BUILDING MAIL ADDRESS ADDRESS TRACT LOT BLOCK TEL. CITY NO. W ADD A P CONSTRUCTION LENDER BRANCH OWNER ADDRESS V UE • s $ ARCHITECT TEL. OR ENGINEER N 0. FIRE ADDRESS ZONE TVP GROUP AMY. APPROVED CONTRACTOR BY DATE ADDRESS TEL. ZONE NO. OF USE OF NEW CITU NO. PLANS BUILDING STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF SLOGS. (F ROM C/L STIR EET) OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. T. FT Separate permits are required for L. SIDE FT. FT. electric, plumbing and heating work. REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BLDGS. VAR. alb DATE • C.U.P.# APPROVED APPROVED By DATE 1 hereby acknowledge that I have read this application and state v that the above Information is correct and agree to comply with a all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of a the State of California. 1 hereby certify that I am properly licensed as a contractor under SO. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, a Chapter 9, and that such licenses are In full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business and Professions Code, Ivision 3, Chapter 9. VALUATION PERMIT FEE $ v r PLAN CHECK $ Signature of i c c Permittee � L TAX S TAX TOTAL PAID $ Authorized Agent SCC/ ( ✓v/.Z/L